Background: Growing pains are the most common form of intermittent childhood non-inflammatory musculoskeletal pain but their causes remain unknown; they occur at least twice a year, in children without a history of trauma, infection or other specific illness. The pain usually appears late in the day, often awaking the child, each episode lasts from minutes to hours in the absence of local tenderness, swelling, limitation of joint movement or joint hyperextensibility; the intensity can be mild or very severe. Objective and hypotheses: We wanted to clarified the features of growing pains, in children coming to our Clinic in particular concerning their bone mineral status. Methods: Children completed a questionnaire, in which pain intensity was studied by a Wong-Baker Faces Pain Rating Scale. Serum vitamin D (25- OHD), PTH and ALP levels were measured and the quantitative ultrasound assessments QUS were performed to calculate the AD-SOS and BTT Z- score. For 3 months we administered Vitamin D to the children with 25-OHD deficiency and we then re-evaluated them. Results: We enrolled 34 patients with growing pains: at the beginning of the study they all had 25-OHD levels below 40 ng/ml, while ALP was normal in most patients. The average AD-SOS Z-score and the BTT Z-score were both in the lower normal range for healthy children. After 3 months of vitamin D supplementation we observed the increase in 25-OHD levels, a drop of PTH levels and an important reduction of pain intensity. Conclusions: We subdivided our patients in groups according to their age and their growth velocity for that age; we concluded that since most children had an age, in which growth is low, it could be not appropriate the term “growing pains” used so far. On the other hand, since most children (all with QUS bone density at the lower values of normal range) showed increased bone metabolism markers and pains reduced significantly after the three months of vitamin D supplementation, we reckon that it could be useful to consider vitamin D deficiency in children with musculoskeletal pains.
Bone mineral status in children with growing pains: a pilot study
Morandi, Grazia;MONTI, Elena;Doro, Francesco;MAINES, Evelina;GAUDINO, Rossella;CAVARZERE, Paolo;LAURIOLA, Silvana;ANTONIAZZI, Franco
2011-01-01
Abstract
Background: Growing pains are the most common form of intermittent childhood non-inflammatory musculoskeletal pain but their causes remain unknown; they occur at least twice a year, in children without a history of trauma, infection or other specific illness. The pain usually appears late in the day, often awaking the child, each episode lasts from minutes to hours in the absence of local tenderness, swelling, limitation of joint movement or joint hyperextensibility; the intensity can be mild or very severe. Objective and hypotheses: We wanted to clarified the features of growing pains, in children coming to our Clinic in particular concerning their bone mineral status. Methods: Children completed a questionnaire, in which pain intensity was studied by a Wong-Baker Faces Pain Rating Scale. Serum vitamin D (25- OHD), PTH and ALP levels were measured and the quantitative ultrasound assessments QUS were performed to calculate the AD-SOS and BTT Z- score. For 3 months we administered Vitamin D to the children with 25-OHD deficiency and we then re-evaluated them. Results: We enrolled 34 patients with growing pains: at the beginning of the study they all had 25-OHD levels below 40 ng/ml, while ALP was normal in most patients. The average AD-SOS Z-score and the BTT Z-score were both in the lower normal range for healthy children. After 3 months of vitamin D supplementation we observed the increase in 25-OHD levels, a drop of PTH levels and an important reduction of pain intensity. Conclusions: We subdivided our patients in groups according to their age and their growth velocity for that age; we concluded that since most children had an age, in which growth is low, it could be not appropriate the term “growing pains” used so far. On the other hand, since most children (all with QUS bone density at the lower values of normal range) showed increased bone metabolism markers and pains reduced significantly after the three months of vitamin D supplementation, we reckon that it could be useful to consider vitamin D deficiency in children with musculoskeletal pains.
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