Journal of Bone and Mineral Metabolism

, Volume 33, Issue 2, pp 201–206 | Cite as

Significant association among growing pains, vitamin D supplementation, and bone mineral status: results from a pilot cohort study

  • Grazia MorandiEmail author
  • E. Maines
  • C. Piona
  • E. Monti
  • M. Sandri
  • R. Gaudino
  • A. Boner
  • F. Antoniazzi
Original Article


The aim of our study was to analyze the possible relationship between growing pains, vitamin D levels, and bone mineral status. We enrolled 33 children affected by growing pains. Their pain intensity was evaluated through a questionnaire using the Wong–Baker Faces Pain Rating Scale for pain assessment. Serum 25-hydroxyvitamin D (25-OH-D), parathyroid hormone (PTH), and alkaline phosphatase levels were measured as well. A quantitative ultrasound assessment (QUS) was also done, measuring both the amplitude-dependent speed of sound (AD-SOS) and the bone transmission time (BTT), correlating, respectively, with bone density and with cortical thickness. After 3 and 24 months of vitamin D supplementation, we re-evaluated pain intensity and laboratory results. After 24 months we re-assessed QUS parameters. At the beginning of the study the children reported a mean growing pain intensity of 7.5 ± 1.6 SD. The mean values of 25-OH-D and PTH levels were 15.7 ± 6.9 ng/ml and 57.3 ± 27.3 pg/ml, respectively. The AD-SOS Z score was −0.53 ± 1.19 SD, and the mean value of the BTT Z score was −0.72 ± 0.96 SD. After the first 3 months of vitamin D supplementation we observed an increase in 25-OH-D levels (34.1 ± 17.8, p < 0.001) and a reduction in both PTH levels (47.3 ± 30.6, p = 0.135) and pain intensity (2.7 ± 2.2, p < 0.001). After 24 months we observed a further significant reduction in the pain intensity (3.9 ± 3.4, p < 0.001) and in PTH levels (43.7 ± 28.5, p = 0.004) and an improvement in the QUS parameters, in particular in BTT Z scores (p = 0.014). Our study suggests an interesting relationship between growing pains, vitamin D levels and bone mineral status.


Growing pains Vitamin D Parathyroid hormone Bone mineral status Quantitative ultrasound assessment 


Conflict of interest

We declare no conflict of interest in relation to this paper, and we report no sources of funding.


  1. 1.
    Uziel Y, Hashkes PJ (2007) Growing pains in children. Pediatr Rheumatol Online J 5:5Google Scholar
  2. 2.
    Evans AM, Scutter SD (2004) Prevalence of “growing pains” in young children. J Pediatr 145:255–258CrossRefPubMedGoogle Scholar
  3. 3.
    Kaspiris A, Zafiropoulou C (2009) Growing pains in children: epidemiological analysis in a Mediterranean population. Joint Bone Spine 76:486–490Google Scholar
  4. 4.
    Duchamp M (1823) Maladies de la croissance. In: Memoires de Médecine Practique Paris, Jean-Frederic Lobstein Edited by Levrault FGGoogle Scholar
  5. 5.
    Al-Khattat A, Campbell J (2000) Recurrent limb pain in childhood (‘growing pains’). Foot 10:117–123CrossRefGoogle Scholar
  6. 6.
    Ladhani S, Srinivasan L, Buchanan C et al (2004) Presentation of vitamin D deficiency. Arch Dis Child 89:781–784CrossRefPubMedCentralPubMedGoogle Scholar
  7. 7.
    Plotnikoff GA, Quigley JM (2003) Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc 78:1463–1470CrossRefPubMedGoogle Scholar
  8. 8.
    Straube S, Derry S, Moore RA et al (2010) Vitamin D for the treatment of chronic painful conditions in adults. Cochrane Database Syst Rev (1):CD007771Google Scholar
  9. 9.
    Gloth FM 3rd, Lindsay JM, Zelesnick LB et al (1991) Can vitamin D deficiency produce an unusual pain syndrome? Arch Intern Med 151:1662–1664CrossRefPubMedGoogle Scholar
  10. 10.
    Baeke F, Korf H, Overbergh L et al (2011) The vitamin D analog, TX527, promotes a human CD4 + CD25highCD127low regulatory T cell profile and induces a migratory signature specific for homing to sites of inflammation. J Immunol 186:132–142CrossRefPubMedGoogle Scholar
  11. 11.
    Jones AN, Hansen KE (2009) Recognizing the musculoskeletal manifestations of vitamin D deficiency. J Musculoskelet Med 26:389–396PubMedCentralPubMedGoogle Scholar
  12. 12.
    Holick MF, Vitamin D (2003) Deficiency: what a pain it is. Mayo Clin Proc 78:1457–1459CrossRefPubMedGoogle Scholar
  13. 13.
    Holick MF (2006) Resurrection of vitamin D deficiency and rickets. J Clin Invest 116:2062–2072CrossRefPubMedCentralPubMedGoogle Scholar
  14. 14.
    Holick MF, Vitamin D (2007) Deficiency. N Engl J Med 357:266–281CrossRefPubMedGoogle Scholar
  15. 15.
    Huh SY, Gordon CM (2008) Vitamin D deficiency in children and adolescents: epidemiology, impact and treatment. Rev Endocr Metab Disord 9:161–170CrossRefPubMedGoogle Scholar
  16. 16.
    Gordon CM, Feldman HA, Sinclair L et al (2008) Prevalence of vitamin D deficiency among healthy infants and toddlers. Arch Pediatr Adolesc Med 162:505–512CrossRefPubMedCentralPubMedGoogle Scholar
  17. 17.
    El-Hajj Fuleihan G, Nabulsi M, Choucair M et al (2001) Hypovitaminosis D in healthy schoolchildren. Pediatrics 107:e53Google Scholar
  18. 18.
    Pavone V, Lionetti E, Gargano V et al (2011) Growing pains: a study of 30 cases and a review of the literature. J Pediatr Orthop 31:606–609CrossRefPubMedGoogle Scholar
  19. 19.
    Qamar S, Akbani S, Shamim S et al (2011) Vitamin D levels in children with growing pains. J Coll Physicians Surg Pak 21:284–287PubMedGoogle Scholar
  20. 20.
    Friedland O, Hashkes PJ, Jaber L et al (2005) Decreased bone strength in children with growing pains as measured by quantitative ultrasound. J Rheumatol 32:1354–1357PubMedGoogle Scholar
  21. 21.
    Tomlinson D, von Baeyer CL, Stinson JN et al (2010) A systematic review of faces scales for the self-report of pain intensity in children. Pediatrics 126:1168–1198CrossRefGoogle Scholar
  22. 22.
    Misra M, Pacaud D, Petryk A et al (2008) Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 122:398–417CrossRefPubMedGoogle Scholar
  23. 23.
    Perrine CG, Sharma AJ, Jefferds ME et al (2010) Adherence to vitamin D recommendations among US infants. Pediatrics 125:627–632CrossRefPubMedGoogle Scholar
  24. 24.
    Holick MF, Binkley NC, Bischoff-Ferrari HA et al (2011) Evaluation, treatment and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930CrossRefPubMedGoogle Scholar
  25. 25.
    Cadossi R, de Terlizzi F, Canè V et al (2000) Assessment of bone architecture with ultrasonometry: experimental and clinical experience. Horm Res 54(Suppl 1):9–18Google Scholar
  26. 26.
    Guglielmi G, de Terlizzi F, Scalzo G et al (2010) Cortical thickness and medullary canal dimensions of the bone phalanx are predicted by quantitative ultrasound parameters. J Clin Densitom 13:219–227CrossRefPubMedGoogle Scholar
  27. 27.
    Baroncelli GI (2008) Quantitative ultrasound methods to assess bone mineral status in children: technical characteristics, performance and clinical application. Pediatr Res 63:220–228CrossRefPubMedGoogle Scholar
  28. 28.
    Mauloni M, Rovati LC, Cadossi R et al (2000) Monitoring bone effect of transdermal hormone replacement therapy by ultrasound investigation at the phalanx: a four-year follow-up study. Menopause 7:402–412CrossRefPubMedGoogle Scholar

Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2014

Authors and Affiliations

  • Grazia Morandi
    • 1
    • 3
    Email author
  • E. Maines
    • 1
  • C. Piona
    • 1
  • E. Monti
    • 2
  • M. Sandri
    • 1
  • R. Gaudino
    • 1
  • A. Boner
    • 1
  • F. Antoniazzi
    • 1
  1. 1.Department of Life and Reproduction Sciences, Pediatric Clinic, Giambattista Rossi HospitalUniversity of VeronaVeronaItaly
  2. 2.Complex Operative Unit of PediatricsLegnagoItaly
  3. 3.Clinica Pediatrica, Policlinico G.B. RossiVeronaItaly

Personalised recommendations