As many as 10-20 percent of children may complain of vague leg pain on a recurrent basis. The diagnosis commonly provided is "growing pains." The pain is usually unilateral and is located deep in the leg, most commonly in the thigh, knee or calf. This type of leg pain typically occurs at night when the child is in bed and lasts 30 minutes to one hour. Systemic signs and symptoms are absent. X-ray findings and blood tests are normal.
Case Report
Jacqueline was a beautiful six-year-old ballet dancer. Her life was as free of stress as one could imagine at this age, yet she had a problem. Jacqueline had leg pains which occurred in bed several nights of each week. Usually in the early morning hours, about 3 a.m., she would awake crying and complaining of pain in her leg. Always just one leg -- always the same leg. Her parents had become concerned enough to take her to the medical doctor for a checkup. The doctor did not know what was causing the problem but suggested that Jacqueline have blood tests and x-rays to rule out pathology. Several days later the blood test results were returned indicating no apparent abnormalities. The x-rays of her knee and leg, likewise, revealed no problems in the bones of the leg or joins of the knee. The next procedure was to order a bone scan to see if there was an infection in the bones or joints that had not shown up on the regular x-ray. Once again the bone scan results were returned as normal. The doctor concluded that Jacqueline was suffering from that ubiquitous disorder called "growing pains." He explained that the pain was really not from her bones growing, but other than that he did not know what to do for her. The doctor told Jacqueline's parents that she would eventually grow out of the problem with time, maybe in another year or two.
The parents were relieved to know that their daughter did not have anything major wrong with her, but still the problem persisted. Several nights each week they would be awakened by the sound of Jacqueline crying with her "growing pains." The father would dutifully sit at his daughter's bedside rubbing her leg and knee for periods up to an hour, usually at which time his daughter had fallen asleep through exhaustion. Needless to say that poor old Dad was getting a bit exhausted by this time himself.
This all too common scenario continued for some months until one day someone suggested to Jacqueline's mother that she take her daughter to a chiropractor. Not being too sure what a chiropractor could do for her daughter's problem, the mother made an appointment anyway. Several days later, Jacqueline and her parents went to the chiropractor's office. After they had recounted their story of all the tests and evaluation that had been made for Jacqueline's problem, the chiropractor made a careful and thorough evaluation of the young girl's spine. Within a few minutes, the chiropractor announced that Jacqueline had a problem in her sacroiliac joint and that this could possibly be causing referred pain into the young girl's leg and around the area of the knee. After explaining the possible link between the sacroiliac joint and Jacqueline's "growing pains," the chiropractor proceeded to lie her on her side and make a gentle finger-tip adjustment of her sacroiliac joint. The adjustment made an audible "click" and the treatment was over.
The next few weeks were happy ones in Jacqueline's home. She no longer awoke with the pains that had bothered her for months before, and her parents were a lot happier. The bags under her father's eyes disappeared too. The chiropractor evaluated the problem on several further occasions to ensure that the spinal problem was corrected, but the growing pains never returned.
Discussion
The condition referred to as "growing pains" occurs in children from three to four years old up until adolescence. The pains are intermittent and do not occur every night, but seem to be more likely to occur after a day of increased activity. The pain experienced with this condition would appear to be associated with referred pain from a sacroiliac subluxation on the side of the leg pain.
There appears to be no detailed research studies, and just a few case reports, recorded in the chiropractic literature which deal with the effect of spinal adjustments on children with growing pains. The clinical experience of this author would indicate a high incidence of posterior/inferior ilium misalignment on the involved side, with symptoms usually responding rapidly, sometimes instantaneously, with the chiropractic adjustment.
In Jacqueline's case, her ballet training, which she did several times a week after school, may have been the initial cause of the problem. Alternatively, the sacroiliac joint problem may have been due to a trauma or fall earlier in her life that was simply being irritated by the regular ballet training.
My recommendation is that any child who has been either diagnosed with "growing pains," or who complains of intermittent leg pains in bed at night, should have a thorough checkup with a chiropractor to ensure that spinal problems are not the underlying cause.
Peter N. Fysh, D.C., B.APP. Sc.
Sunnyvale, California
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