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The Pain of Defining Growing Pains

July 26, 2022

Have you ever diagnosed a child with “growing pains”? How did you make the diagnosis? How did you define it?

If you’re not sure, you’re not alone! When I was a medical student, I was taught by one attending that it was a diagnosis of exclusion, to be used when a child had recurrent pains in the non-joint regions of the lower extremities and normal examination. However, I have subsequently had different teachers and colleagues give me different definitions.

Mary O’Keeffe from the University of Sydney and colleagues in Australia and Denmark may have had a similar experience, and they reviewed the medical literature to better understand how growing pains are characterized and defined. This week, Pediatrics is early releasing their review and an accompanying video abstract, entitled “Defining Growing Pains: A Scoping Review” (10.1542/peds.2021-052578).

The authors reviewed 147 articles for defining characteristics, such as:

  • Location of pain
  • Typical age of onset
  • Pattern and trajectory of pain
  • Type and severity of pain
  • Risk factors
  • Relationship to activity
  • Functional impact
  • Physical examination and ancillary test findings

What did they conclude? You should read the details laid out in this review, but basically, there was no consensus on the definition and diagnostic criteria of growing pains.

After reading this review, I agree with the authors that we should “be wary of relying on the diagnosis” of growing pains, at least until a better operational definition is established for this condition. In the meantime, we need to remain vigilant and open to other diagnoses that may require treatment.

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