"Doctor, my 5-year-old daughter cries with leg pains daily – what do I do?"
A common complain that we get to hear from parents. It often prevents the child from falling asleep. Parents are concerned that the child is in distress due to pain and are unsure what the cause may be. They do not want to medicate frequently, but as the child is fine by morning, they are uncertain if any tests are required. In most cases, this is due to what is commonly referred to as Growing pains.
'Growing pains' – a term used for the recurrent pain in lower limbs seen in pre-school and school-aged children, are a misnomer as it has does not coincide with the peak growth period. The pain generally is in both legs in evenings and nights and gets better with a massage. The pain may be in calf muscles or the back of knees or thighs.
It may occur daily or may recur every few days or weeks. It may be more on some days when the playtime or exercise was excessive. Typically, the child is always well in the morning when she wakes up and remains active throughout the day. A more appropriate term would be 'Benign nocturnal pains of childhood,' benign indicating no serious underlying cause for the pain.
Nearly 10%-20% of school-aged children can have growing pains. The frequency of the pain decreases with increasing age but may continue until the child is 10-12 years old. A visit to the local top children's hospital in Whitefield may help rule out any other cause and allay anxiety if frequent or severe.
Growing pains is a clinical diagnosis made based on history and thorough physical examination. Sometimes children may have excessively lax ligaments (loose-jointed), called Joint hypermobility, and such children are known to have more incidence of Growing pains. A simple joint examination is sufficient to ascertain if the child has Joint hypermobility or not.
No tests are needed. Many parents want to know if this could be due to Vitamin D deficiency and whether it needs to be checked. While Vitamin D deficiency may be associated (it is common in our country despite there being much sunshine), this is not the cause for growing pains, and parents should not expect that giving Calcium or Vitamin D supplements will relieve pain. Treatment is only massage, reassurance and if the pain is severe, Paracetamol will suffice.
However, it is essential to check with your doctor if any of these symptoms are present (what we call Red Flag signs) - fever, weight loss, night sweats, ‘night cries’ (the pain wakes up the child from deep sleep), any joint or limb swelling, pain in only one particular joint always or is limping when she wakes up in the morning. It is NOT a case of simple growing pains in any of these cases, and such a child will need a thorough physical examination and further investigations to rule out more serious causes like cancer, arthritis, bone problems, etc.
Dear parents, I hope the above information was helpful!
"Daktari, binti yangu mwenye umri wa miaka mitano hulia kwa maumivu ya miguu kila siku <unk> nifanye nini?" Ni malalamiko ya kawaida ambayo tunasikia kutoka kwa wazazi. Mara nyingi huzuia mtoto kulala usingizi. Wazazi wana wasiwasi kwamba mtoto wao ana maumivu makali na hawajui ni nini kinachosababisha maumivu hayo. Hawataki kumpa dawa mara nyingi, lakini kwa kuwa mtoto yuko vizuri asubuhi, hawajui kama kuna haja ya kufanya uchunguzi wowote. Katika visa vingi, hilo husababishwa na kile kinachoitwa kwa kawaida maumivu ya kukua. 'Maumivu ya kukua' <unk> neno linalotumiwa kwa maumivu ya mara kwa mara katika viungo vya chini yanayoonekana katika watoto wa kabla ya shule na umri wa shule, ni jina lisilofaa kwani hailingani na kipindi cha juu cha ukuaji. Kwa kawaida maumivu huwa katika miguu yote miwili jioni na usiku na hupungua kwa kutikiswa. Maumivu yanaweza kuwa katika misuli ya viuno au nyuma ya magoti au viuno. Huenda ikawa hutokea kila siku au huenda ikawa hutokea tena kila baada ya siku chache au majuma machache. Huenda ikawa zaidi siku fulani wakati wakati wa kucheza au kufanya mazoezi ulikuwa mwingi kupita kiasi. Kwa kawaida, mtoto huwa na afya nzuri asubuhi anapoinuka na kubaki akifanya kazi siku nzima. Neno linalofaa zaidi lingekuwa 'Maumivu ya usiku yasiyo na madhara ya utotoni,' yasiyo na madhara yakionyesha kwamba hakuna kisababishi kikuu cha maumivu hayo. Karibu asilimia 10 hadi 20 ya watoto wa umri wa kwenda shule wana matatizo ya kukua. Ugonjwa huo hupungua kadiri mtoto anavyozidi kukua lakini unaweza kuendelea hadi mtoto awe na umri wa miaka 10 hadi 12. Kutembelea hospitali ya watoto ya Whitefield inaweza kusaidia kuondoa sababu nyingine yoyote na kupunguza wasiwasi ikiwa ni mara kwa mara au kali. Maumivu ya kukua ni utambuzi wa kliniki uliofanywa kwa kutegemea historia na uchunguzi wa kimwili wa kina. Watoto wanaweza kuwa na viungo vya mwili vilivyo na viungo vingi vya pamoja (loose joints) na hivyo kuwa na maumivu ya kukua. Uchunguzi rahisi wa viungo vya mwili unatosha kujua kama mtoto ana ugonjwa wa viungo vya mwili usivyoweza kusonga. Hakuna upimaji unaohitajika. Wazazi wengi wanataka kujua ikiwa hii inaweza kuwa kwa sababu ya upungufu wa Vitamini D na ikiwa inahitaji kuchunguzwa. Ingawa upungufu wa vitamini D unaweza kuhusishwa (ni kawaida katika nchi yetu licha ya kuwa na jua nyingi), hii si sababu ya maumivu ya kukua, na wazazi hawapaswi kutarajia kwamba kutoa Calcium au vitamini D virutubisho itapunguza maumivu. Matibabu ni kutikisa tu, kutuliza na ikiwa maumivu ni makali, Paracetamol itatosha. Hata hivyo, ni muhimu kuangalia na daktari wako kama yoyote ya dalili hizi zipo (kile tunachoita ishara za Red Flag) - homa, kupoteza uzito, jasho la usiku, 'kilio cha usiku' (maumivu huamsha mtoto kutoka usingizi wa kina), maumivu yoyote ya pamoja au viungo, maumivu katika pamoja moja tu au ni limping wakati yeye anaamka asubuhi. Kwa sababu ya hali hii, mtoto anaweza kuwa na matatizo ya kukua, na atahitaji uchunguzi wa kina na uchunguzi zaidi ili kuondoa sababu mbaya zaidi kama vile kansa, ugonjwa wa viungo, matatizo ya mifupa, na kadhalika. Wazazi wapendwa, natumaini habari iliyo hapo juu ilikusaidia!