Growing pains, which can be observed from time to time until the end of adolescence, usually appear as benign pains associated with the physiological development process. It is very important to distinguish which pain should be considered as a growing pain and which pain should not be missed in order to avoid unexpected surprises. It includes a process that is continuous as in the development of systems and continues until the end of adolescence. The growth and development process, which is very rapid in the first two years after birth, continues in a constant and not very rapid manner until puberty begins. With the adolescence period, which starts at the age of 8-10 years in girls and at the age of 10-12 in boys, height growth and musculoskeletal system development accelerate, growth ends between the ages of 15-17 in girls and between the ages of 16-18 in boys. In some adolescents, growth and development can continue until the age of 20-21.
A number of painful conditions, which can be seen from the age of three until the age of 12-13, are encountered in 25-40% of children, occur more frequently especially in boys and are associated with increased physical activities, are called "growing pain". Misbeliefs and some urban legends about this situation worry families unnecessarily, and the number of visits to the doctor is increasing with the concern that an important disease underlies growing pains, which is a physiological process.
In Which Situations Does Pain Occur?
First of all, it should be noted that the natural growth and development process is a painless one. Physiological height growth of any child and adolescent does not cause pain. However, there may be some pain that can be seen as a result of increased physical activities during the growth period.
Growing pain usually occurs in the lower extremities in children. It is rarely seen in the hips, lower back and upper extremities. These pains are pains that occur in the evening and at night, often in the anterior thigh, back of the knee and calves, awakening from sleep, and lasting from a few minutes to several hours. Pain is in the muscle, not in the joint or bone. In general, increased physical activity after is seen. Sometimes there is no pain for days, sometimes it can show a repetitive feature. The pains are felt in the form of cramps, deep, uncomfortable. It is often bilateral and symmetrical. In some children, it can last all night. These patients do not have limping, deformities in the joints, or loss of physical activity. The pain usually goes away completely in the morning.
Physiological growing pains are completely benign and temporary pains, and the exact cause is unknown. It is thought that during the longitudinal and transverse growth of the bones, the stretching of the bone membrane called the "periost", which surrounds the bones and where the nerve endings are located, causes pain. First of all, the child and family should be relieved by the physician, and it should be explained that such pains are innocent pains.
Usually, the pain is caused by taking the child to rest, terminating or minimizing physical activities, relieving the child by massaging the painful area, applying some pomades to the related area with painkillers (analgesic) and edema-solving (anti-inflammatory) drugs from time to time. can be eliminated. Muscle stretching exercises can help relieve pain in cramp-like pain.
Some pains can be seen in the musculoskeletal system during adolescence, when height growth is accelerated. A more specific type of growing pains called “osteochondrosis” may occur during adolescence. These pains occur as a result of the strain of large muscle and tendon groups adhering to the protruding parts of the bones called the "apophysis", except for the growth nuclei (epiphysis nucleus) of the bones in the areas close to the joint. Such pain should be observed closely and, if necessary, followed by radiographic imaging methods.
It should be known that this situation, which can occur in adolescents who frequently engage in jump-related sports (basketball, volleyball, etc.), may continue until the end of adolescence. The most common areas of pain are the knee and under the knee (lower end of the kneecap bone), the back of the heel and the inner parts of the foot area.
There was no need to worry about growing pains that were perfectly normal. r. However, if there are signs of different diseases such as fever and weakness along with pain, if there are local findings such as redness, temperature increase, color change, swelling, bruising, and pallor in the painful area, and if the child shows extreme sensitivity when the painful area is touched, a specialist physician should definitely be evaluated.
In such cases, some inflammatory, rheumatic and metabolic diseases and, rarely, some tumoral pathologies may be underlying. Detailed physical examination and some imaging methods and laboratory evaluation tests should be performed to clarify the underlying problem.
In Which Situation Should You Go To The Doctor?
Situations that should not be considered as growing pains and that require the child to be evaluated by a physician are:
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