When Growing Pains Aren’t Just Growing Pains: What Every Caregiver Needs to Know

Written By: Robyn Fredericksen, Clinical Trainee at ACS, Outlet Program

WHETHER YOU AREa caregiver or not, witnessing a child in pain is a heart wrenching experience. There is a profound and inherent sense of helplessness when a child complains about illness, pain, and discomfort. My parents recall my complaints of pain beginning around age 4, or as soon as I could verbalize the discomfort in my muscles and joints. Like most caregivers, they assumed it was just typical growing pains. However, as the years passed, my pain, fatigue, and complaints intensified, as did my realization that I was different than my siblings and peers. By age 7, I saw my first chiropractor, a practice I still carry on to this day, but more on that later. Being an athlete, I relied heavily on Tylenol, ice, heating pads, and muscle rubs to ease my daily discomfort. Early on, I knew my experience with pain was not typical of most, but I tried to fit in and pretend I was like everyone else. It took several more decades before I was diagnosed with Ehlers-Danlos syndrome (EDS), a rare genetic condition that explained my chronic pain and its effects on my connective tissues.

Many of us have heard the term “growing pains,” often used to describe the aches and pains children complain about in the legs—thighs, calves, shins, and behind the knees. The term is so widely accepted that these complaints, which typically occur between the ages of 3 and 12, are often brushed off as a normal part of growing up. But what if I told you our long-held beliefs were more myth than reality?

The Growing Pains Myth: What You Should Know

Pain is a complex topic that both medical professionals and society are still trying to understand and navigate. So, it makes sense there is a long-standing belief about how children experience pain while growing up. Unfortunately, because of this belief, sometimes a child’s expression of pain is seen as attention-seeking behaviors that are minimized or dismissed. This dismissal can have lasting psychological effects, leaving a child feeling unheard or misunderstood and therefore learning to hide their pain.

Interestingly enough, research shows that children don’t often complain of pain during a growth spurt, nor do they feel pain around the growth plates as they lengthen. There are many theories as to why children experience pain during their early childhood that are likely from a combination of factors. According to the American College of Rheumatology, this may include muscle soreness from overuse or increased physical activity, joint pain from excessive joint movement during sports or play, increased stress, and low levels of Vitamin D. Another culprit for nighttime discomfort in the legs is restless leg syndrome, which could be due to low levels of iron. So, how does this shift in understanding affect our views on children’s pain, and what signs should we look for that might indicate a more serious issue?

Signs It Might Be More Than Just Pain

Sometimes it is difficult to know the difference between pain caused by playing too hard and the kind of pain that may signal more serious causes or illness. Some things to consider are:

• Persistent Pain: Is the pain lasting longer than expected or returning frequently?
• Intensity: Is the pain so severe that it is not relieved by over-the-counter medications?
• Activity Interference: Does pain disrupt daily activities, play, or sports participation?
• Fatigue: Is there excessive tiredness or the need for frequent naps when peers do not?
• Swelling or Redness: Is there noticeable swelling, redness, or warmth in the painful area?
• Changes in Mobility: Is there difficulty walking, limping, or reluctance to use a limb?
• Associated Symptoms: Do they have a fever, unexplained weight loss, or changes in appetite?
• Emotional Changes: Is there increased irritability, anxiety, or withdrawal from usual activities?

If any of these signs are present or persistent, acknowledge your child’s pain and validate their feelings. Ask specific questions about where it hurts, when it occurs, and how intense the pain is. If complaints of pain (or fatigue) are reoccurring, keeping a journal of their symptoms can be incredibly useful information when it comes time to see a healthcare professional.

Psychological Impacts of Pain

As mentioned previously, pain has a lot of complexity to it, and so do the effects on a child’s overall well-being. Some common impacts are:

• Anxiety and Depression: The unpredictability or uncertainty of their condition can lead to feelings of anxiety about the future, which can foster fear and stress, as well as depression from feelings of frustration and hopelessness about constant pain.
• Social Withdrawal: Realizing they are different from their peers due to their pain can feel isolating, leading to withdrawal from social activities and friendships, which can exacerbate the feelings of isolation.
• Low Self-Esteem: Not being able to participate in activities they enjoy or excel at because of pain has an impact on feelings of inadequacy and low self-worth.
• Behavioral Changes: There may be an increase in irritability, mood swings, or changes in appetite and sleep patterns due to their ongoing discomfort.
• Difficulty with Coping Skills: It is challenging for children to manage stress and emotions when chronic pain hinders the development of healthy coping strategies.
• Impact on Family Dynamics: Pain and chronic illness can lead to stress and emotional instability within the family unit when the family roles and responsibilities must shift to accommodate the child’s needs.
• Educational Challenges: Pain and fatigue can lead to frequent absences from school, contributing to academic struggles and feelings of frustration and isolation.

It is important to address the psychological impacts pain has on children, and doing so increases the overall well-being of those living with chronic illnesses. Support from caregivers, healthcare providers, and mental health professionals can make a significant difference in a child’s life.

Seeking Professional Guidance

Whether your child is experiencing pain from an injury or something more chronic, making an appointment with their pediatrician is a good place to start. A pediatrician will be able to evaluate their symptoms, order tests, refer to specialists (if needed), and provide the reassurance you need. Remember, understanding your child’s pain is not just about addressing it; it’s about ensuring their overall well-being. Trust your instincts and what your child is telling you, even when there are no straight-forward answers from test results.

Pain Management

Caregivers can play a crucial role in helping to manage their child’s pain by using various strategies. Below are some ways to help ease your child’s discomfort, whether it is temporary pain from an injury or something more chronic.

• Medications: For mild to moderate pain, over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil) can help. For more severe pain, a healthcare provider should be contacted.
• Heating Pads: A heating pad or a warm compress can help soothe muscle pain, strains, or cramping. To avoid burns, always make sure it’s at a safe temperature.
• Cold Therapy: Ice packs can help reduce inflammation and numb sharp pain. This is particularly effective for injuries like sprains in the first 24 hrs.
  • Alternating between heat and cold can provide relief for certain types of pain, such as headaches or back pain.
• Physical Therapy: Helps to strengthen muscles, improve flexibility, and develop a personalized exercise plan to manage pain effectively.
• Relaxation Techniques: Guided imagery, deep breathing exercises, or mindfulness practices can help reduce pain perception and promote relaxation.
• Distraction Techniques: Activities like playing games, watching shows, or doing arts and crafts can help divert attention from pain.
• Massage: For localized pain, gentle massage can relieve muscle tension and promote relaxation.
• Chiropractor: A holistic approach that helps alleviate pain by ensuring proper alignment of the spine and nervous system, which can reduce discomfort, improve mobility, and promote overall health and well-being.
• Acupuncture: A holistic approach, performed by a trained professional, can be effective for certain types of pain, especially nerve pain.
• Comfort Items: Soft blankets, favorite toys, or pillows can provide emotional comfort, making it easier for the child to cope with pain.
• Education and Support: Teaching the child about their condition can empower them and reduce anxiety, which may help lessen the perception of pain.

By combining these techniques, caregivers can create a supportive environment that addresses their child’s pain effectively. Remember, always consult a healthcare provider to determine the best approach for your child’s specific situation.

Final Thoughts

An essential part of nurturing a happy, healthy child is understanding their pain—growing or otherwise. Since pain at any age is challenging to manage, we must advocate for our children and ensure their concerns are taken seriously. By embracing this knowledge, we create a safe environment where kids can express their discomfort, knowing that we will be there to listen, validate, and support them every step of the way.

Ultimately, by acknowledging their pain and addressing potential health issues, we strengthen the trust and bond we share with our children. Prioritizing open communication and active engagement will have lasting positive effects on our children’s well-being and their future. In the end, we all want what is best for our children to live their best lives, as free from as much pain as possible.

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References

Growing pains. (2024, September 13). https://rheumatology.org/growing-pains

Growing pains – Symptoms & causes – Mayo Clinic. (2021, September 25). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/growing-pains/symptoms-causes/syc-20354349

Restless legs Syndrome. (2024, September 25). Stanford Health Care. https://stanfordhealthcare.org/medical-conditions/sleep/pediatric-sleep-disorders/types/restless-legs-syndrome.html