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


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.

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  1. Uziel Y, Hashkes PJ (2007) Growing pains in children. Pediatr Rheumatol Online J 5:5

    Google Scholar 

  2. Evans AM, Scutter SD (2004) Prevalence of “growing pains” in young children. J Pediatr 145:255–258

    Article  PubMed  Google Scholar 

  3. Kaspiris A, Zafiropoulou C (2009) Growing pains in children: epidemiological analysis in a Mediterranean population. Joint Bone Spine 76:486–490

    Google Scholar 

  4. Duchamp M (1823) Maladies de la croissance. In: Memoires de Médecine Practique Paris, Jean-Frederic Lobstein Edited by Levrault FG

  5. Al-Khattat A, Campbell J (2000) Recurrent limb pain in childhood (‘growing pains’). Foot 10:117–123

    Article  Google Scholar 

  6. Ladhani S, Srinivasan L, Buchanan C et al (2004) Presentation of vitamin D deficiency. Arch Dis Child 89:781–784

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Plotnikoff GA, Quigley JM (2003) Prevalence of severe hypovitaminosis D in patients with persistent, nonspecific musculoskeletal pain. Mayo Clin Proc 78:1463–1470

    Article  PubMed  Google Scholar 

  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):CD007771

  9. Gloth FM 3rd, Lindsay JM, Zelesnick LB et al (1991) Can vitamin D deficiency produce an unusual pain syndrome? Arch Intern Med 151:1662–1664

    Article  PubMed  Google Scholar 

  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 186:132–142

    Article  CAS  PubMed  Google Scholar 

  11. Jones AN, Hansen KE (2009) Recognizing the musculoskeletal manifestations of vitamin D deficiency. J Musculoskelet Med 26:389–396

    PubMed Central  PubMed  Google Scholar 

  12. Holick MF, Vitamin D (2003) Deficiency: what a pain it is. Mayo Clin Proc 78:1457–1459

    Article  PubMed  Google Scholar 

  13. Holick MF (2006) Resurrection of vitamin D deficiency and rickets. J Clin Invest 116:2062–2072

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Holick MF, Vitamin D (2007) Deficiency. N Engl J Med 357:266–281

    Article  CAS  PubMed  Google Scholar 

  15. Huh SY, Gordon CM (2008) Vitamin D deficiency in children and adolescents: epidemiology, impact and treatment. Rev Endocr Metab Disord 9:161–170

    Article  CAS  PubMed  Google Scholar 

  16. Gordon CM, Feldman HA, Sinclair L et al (2008) Prevalence of vitamin D deficiency among healthy infants and toddlers. Arch Pediatr Adolesc Med 162:505–512

    Article  PubMed Central  PubMed  Google Scholar 

  17. El-Hajj Fuleihan G, Nabulsi M, Choucair M et al (2001) Hypovitaminosis D in healthy schoolchildren. Pediatrics 107:e53

  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 31:606–609

    Article  PubMed  Google Scholar 

  19. Qamar S, Akbani S, Shamim S et al (2011) Vitamin D levels in children with growing pains. J Coll Physicians Surg Pak 21:284–287

    PubMed  Google Scholar 

  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 32:1354–1357

    PubMed  Google Scholar 

  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 126:1168–1198

    Article  Google Scholar 

  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 122:398–417

    Article  PubMed  Google Scholar 

  23. Perrine CG, Sharma AJ, Jefferds ME et al (2010) Adherence to vitamin D recommendations among US infants. Pediatrics 125:627–632

    Article  PubMed  Google Scholar 

  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 96:1911–1930

    Article  CAS  PubMed  Google Scholar 

  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):9–18

    Google Scholar 

  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 13:219–227

    Article  PubMed  Google Scholar 

  27. Baroncelli GI (2008) Quantitative ultrasound methods to assess bone mineral status in children: technical characteristics, performance and clinical application. Pediatr Res 63:220–228

    Article  PubMed  Google Scholar 

  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 7:402–412

    Article  CAS  PubMed  Google Scholar 

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

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Correspondence to Grazia Morandi.

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Morandi, G., Maines, E., Piona, C. et al. Significant association among growing pains, vitamin D supplementation, and bone mineral status: results from a pilot cohort study. J Bone Miner Metab 33, 201–206 (2015).

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