Paediatric leg pains, long described as ‘growing pains’, frequently present to clinicians, are prevalent in early childhood, disrupt sleep, and distress affected children and parents. There are many cited associations, but no defined leg pain sub-types, nor revealed predictive factors. We explored the implicated factors (viz. foot arches, foot strength, joint mobility, vitamin D, iron) in children with leg pain versus a control group. Leg pain sub-groups—growing pains (GP), restless legs (RLS), both (mixed)—are defined for the first time. A case controlled study design, in a primary care setting, Mumbai, India. A total of 77 children with leg pains (n = 64) and controls (n = 13), aged 3–12 years, identified by paediatricians, completed data collection. Blood assays for iron and vitamin D, pain, Beighton score, foot arch, foot strength and anthropometrical data were collected. All outcome measures were validated, with standardised protocols. Leg pain (all groups) was predicted by increased joint mobility and increased ankle dorsiflexion strength (β = 0.56, P < 0.05). GP sub-group was predicted by increased ankle dorsiflexion strength (β = − 0.06, P < 0.05). Mixed (GP/RLS) and RLS sub-groups were predicted by increased ankle dorsiflexion strength (β = 0.66, P < 0.05) and pain questionnaire (β = 0.11, P < 0.05). Hypovitaminosis D was detected in 87% of the sample, and anaemia in 13%. Increased strength of ankle dorsiflexors and joint flexibility were each found predictive for leg pain. Increased body weight, waist girth, and BMI were all associated with leg pain.
Growing pains Restless legs Paediatric Leg pain Hypovitaminosis Foot posture Strength
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AME is a Ritchie Trust Fellow, Royal College of Physicians and Surgeons, Glasgow, UK. Jaslok Hospital Research Society for project/author support (TP, PR, NS, RK).
AME and RK conceived and designed the study; TP, PK, RK, NS, AME collected the data, LK and AME analysed and interpreted the data, AME drafted the article; RK and AME revised it critically; all approved final manuscript.
This study was funded by The Fellowship Fund of the Ritchie Trust, RCPS (Glasg); with further support from The Jaslok Research Society.
Compliance with ethical standards
Provided by Ethics Committee, Jaslok Hospital. Mumbai, India, at the 34th meeting on 25th July, 2015 (Dr Fazal Nabi, Secretary).
Conflict of interest
All authors have completed conflict of interest declarations.
Macarthur C, Wright JG, Srivastava R et al (1996) Variability in physicians’ reported ordering and perceived reassurance value of diagnostic tests in children with ‘growing pains’. Arch Pediatr Adolesc Med 150:1072–1076CrossRefPubMedGoogle Scholar
Walters AS, Rye DB (2010) Evidence continues to mount on the relationship of restless legs syndrome/periodic limb movements in sleep to hypertension, cardiovascular disease, and stroke. Sleep 33:287CrossRefPubMedPubMedCentralGoogle Scholar
Abujam B, Aggarwal A (2014) Hypermobility is related with musculoskeletal pain in Indian school-children. Clin Exp Rheumatol 32:610–613PubMedGoogle Scholar
Evans AM, Scutter SD, Lang L, Dansie BR (2006) “Growing pains” in young children: a study of the profile, experiences and quality of life issues of four to six year old children with recurrent leg pain. Foot 16:120–124CrossRefGoogle Scholar
Engelbert RHH, Juul-Kristensen B, Pacey V et al (2017) The evidence-based rationale for physical therapy treatment of children, adolescents, and adults diagnosed with joint hypermobility syndrome/hypermobile Ehlers Danlos syndrome. Am J Med Genet C Semin Med Genet 175:158–167. https://doi.org/10.1002/ajmg.c.31545CrossRefPubMedGoogle Scholar
Markula-Patjas K, Valta H, Pekkinen M et al (2015) Body composition and adipokines in patients with juvenile idiopathic arthritis and systemic glucocorticoids. Clin Exp Rheumatol 33:924–930PubMedGoogle Scholar
Sperotto F, Balzarin M, Parolin M et al (2014) Joint hypermobility, growing pain and obesity are mutually exclusive as causes of musculoskeletal pain in schoolchildren. Clin Exp Rheumatol 32:131–136PubMedGoogle Scholar