UNASSIGNED: Growing pains are the most common cause of musculoskeletal pain in children, affecting both children\'s and caregivers\' well-being. The lack of definitive diagnostic criteria complicates diagnosis and treatment.
UNASSIGNED: This study aims to outline the clinical features and identify factors associated with the frequency and intensity of growing pains in children in Chongqing, China.
UNASSIGNED: A cross-sectional study was conducted in a children\'s hospital using its Internet hospital follow-up platform. Children initially diagnosed with growing pains between July and September 2022 were enrolled. Sociodemographics, pain locations, duration, frequency, intensity, and potentially related factors were collected.
UNASSIGNED: Eight hundred sixty-three children were enrolled (average age: 8.19 ± 3.24 years; 455 boys [52.72%]). Pain frequency was reported as quarterly (62.11%), monthly (24.80%), biweekly (1.74%), weekly (10.08%), and daily (1.27%). The prevalence of mild, moderate, and severe pain was 26.65%, 55.74%, and 17.61%, respectively. The knee was the most common pain location (63.85%), mostly encountered between 4 pm and 5 pm (20.51%). Multivariate analysis revealed that pain frequency negatively correlated with vitamin supplementation during pregnancy, positively correlated with underweight, bad temper, increased exercise, and cold lower extremities. Pain intensity positively correlated with irritability, increased exercise, and pain sensitivity but negatively correlated with age and vitamin supplementation during lactation.
UNASSIGNED: Growing pains typically occur on a quarterly basis, predominantly affecting the knees during 4 pm to 5 pm. Factors in sociodemographics, maternal aspect, temperament, and exercise levels can influence pain frequency and intensity. Clinicians should consider these aspects when developing comprehensive strategies for pain management.

Children and adolescents may experience pain in the lower limbs, predominantly at the end of the day or during the night, without any relation to organic disease. These pains are often called \"growing pains\" (GP) by pediatricians and orthopedists. They are commonly attributed to rapid growth.
The aim of this study was to review and characterize GP in children and adolescents as a precursor/comorbidity with migraine.
The study was of a cross-sectional, prospective, longitudinal cohort, with group comparison. A sample of 100 children/adolescents born to mothers with migraine seen at a headache clinic was recruited in a random order chosen by lot, maintaining the ratio of 1:1 for the group with GP and the controls. Both groups were followed for a period of 5 years.
After 5 years of follow-up, 78 patients completed the study, of which 42 were from the GP group and 36 were from the control group. Headache fulfilling the International Classification of Headache Disorders, 3rd edition diagnostic criteria for migraine without aura or probable migraine occurred in 32/42 (76%) of patients with GP and in 8/36 (22%) of controls (p < 0.001). In the sample that initially had \"growing pains,\" these pains persisted in 6/42 (14%) and appeared in 14/36 (39%) of those who were previously asymptomatic (p = 0.026).
Pain in the lower limbs of children and adolescents, commonly referred to as GP by pediatricians and orthopedists, may reflect a precursor or comorbidity with migraine.

Growing pains (GP) are the most common cause of recurrent musculoskeletal pain in children. There are no diagnostic criteria for GP. We aimed at analyzing GP-related characteristics and assisting GP diagnosis by using machine learning (ML). Children with GP and diseased controls were enrolled between February and August 2019. ML models were developed by using tenfold cross-validation to classify GP patients. A total of 398 patients with GP (F/M:1.3; median age 102 months) and 254 patients with other diseases causing limb pain were enrolled. The pain was bilateral (86.2%), localized in the lower extremities (89.7%), nocturnal (74%), and led to awakening at night (60.8%) in most GP patients. History of arthritis, trauma, morning stiffness, limping, limitation of activities, and school abstinence were more prevalent among controls than in GP patients (p = 0.016 for trauma; p < 0.001 for others). The experiments with different ML models revealed that the Random Forest algorithm had the best performance with 0.98 accuracy, 0.99 sensitivity, and 0.97 specificity for GP diagnosis. This is the largest cohort study of children with GP and the first study that attempts to diagnose GP by using ML techniques. Our ML model may be used to facilitate diagnosing GP.

UNASSIGNED: Commonly applied diagnostic criteria for growing pains (GP) have evolved without determination by an authoritative representative body. GP and restless legs syndrome (RLS) share anatomical, distributional, temporal, and other clinical features and are associated in individuals over time, in families, and in population samples. In this study, we tested the hypothesis that GP, diagnosed by widely used criteria, is confounded by cases of painful restless legs syndrome (RLS-Painful).
UNASSIGNED: A twin family study of genetic influence and associations of GP using questionnaires was administered by Twins Research Australia. Twins (3-18 years; monozygous 503, dizygous 513), their oldest siblings, mothers, and fathers were randomly selected from the twin registry. Family members completed the questionnaires assessing lifetime prevalence of GP by commonly applied criteria and covariates including the history of iron deficiency and pediatric pain disorders. A GP-Specific phenotype was defined as GP without urge to move the legs. We determined similarities in twin pairs for the GP and GP-Specific phenotypes, family associations, and estimated familial and individual-specific associations for each phenotype.
UNASSIGNED: Lifetime prevalence was one-third lower for GP-Specific than for GP among the twin and family members. Monozygous twin pairs were more similar than dizygous twin pairs for GP and for the derived GP-Specific phenotype by three methods, consistent with genetic influence. There were familial associations, but the essential evidence for genetic influence was the twin-cotwin data. GP was associated, in multivariable analyses, with migraine, headaches, recurrent abdominal pain, and iron deficiency, while GP-Specific associations were limited to migraine and headaches.
UNASSIGNED: GP is hybrid, one-third of cases having symptoms and associations of RLS, necessarily RLS-Painful. GP-Specific (without symptoms and associations of RLS) could have a genetic etiology. We propose new criteria to facilitate etiological and therapeutic research.

BACKGROUND: Restless legs syndrome (RLS) and growing pains (GPs) share many common features and are sometimes overlapping diagnoses. The present study aims to investigate the shared features of patients with RLS, classified based on the 2013 diagnostic criteria of International Restless Legs Syndrome Study group and of patients with GPs, diagnosed based on the combined criteria proposed in 2013.
METHODS: A cross-sectional population study was conducted in 7 Istanbul schools, which were selected randomly. A total of 4565 (56.1% female) children aged 9 to 18 years were included. In the first stage, candidates of RLS and GPs were identified based on 2 separate questionnaires, whose diagnoses were confirmed by a second survey applied to them under parental supervision.
RESULTS: Out of 192 children (65.6% female) diagnosed as definite RLS (yearly prevalence: 4.2%), 30 (15.6%) reported bilateral leg muscle pain localized typical regions for GPs, which started <13 years of age in 17 children. An urge to move the legs to relieve unpleasant sensations or pain was present in 39.3% of 140 children (64.3% female) classified as GPs (yearly prevalence: 3.1%). Occurrence of symptoms at rest or when lying down was present in 36.4% of GPs children and relief by gross movements was in 21.4% children. Only 12 patients (9 with definite RLS and 3 with GPs) (0.03% of total cohort) were eligible for overlapping diagnosis of GPs and RLS.
CONCLUSIONS: Although a considerable number of patients with RLS and GPs share some clinical features, a combined phenotype is very rare.

OBJECTIVE: The present study aimed to assess the diagnostic significance of serum bone metabolic parameters in children with growing pains (GPs).
METHODS: All patients diagnosed with GP and healthy controls matched with age and gender were recruited at the outpatient clinic of Children\'s Hospital at Zhejiang University School of Medicine from August 2016 to August 2021. In all subjects, serum levels of calcium (Ca), phosphorus (P), procollagen type-I N-terminal (PINP), parathormone (PTH), 25-hydroxyvitamin D (25-(OH)D), osteocalcin (OC), N-terminal cross-linked telopeptides of type-I collagen (CTX), and tartrate-resistant acid phosphatase type 5b (TRACP5b) were investigated. The univariate analysis, multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve were used to identify the bone metabolic parameters factors for diagnosing GP.
RESULTS: We enrolled 386 children with GP and 399 healthy controls in present study. The mean age of GP group was 5.319 years, and, primarily, the subjects were preschool-age children. The gender ratio (male-to-female) was 1.27 in GP group. After adjusting for age and gender, we identified that the serum levels of Ca (p < 0.001, OR: 25.039), P (p = 0.018, OR: 2.681), PINP (p < 0.001, OR: 1.002), and PTH (p = 0.036, OR: 0.988) were independent diagnostic factors associated with GP. Area under curve (AUC) of the ROC curves was in the order: PINP (0.612) > Ca (0.599) > P (0.583) > PTH (0.541). A combination of independent diagnostic factors and multivariable logistic regression analysis provided a refined logistic regression model to improve the diagnostic potential, of which the AUC had reached 0.655.
CONCLUSIONS: Serum levels of Ca, P, PINP, and PTH could be independent diagnostic factors associated with GP. The logistic model was significantly superior to bone metabolic parameters for diagnosing GP.

Behavioural difficulties are common in children with sleep disorders. However, up to now no study has investigated the association between sleep-related movement disorders (SRMD) and behavior in children with craniofacial cleft. The aim of this study was to assess the frequency and impact of SRMD and growing pains in daytime/bedtime behavior in young children with cleft palate.
Cross-sectional survey study of sleep and behavior in 2.0-6.9 year old children with cleft palate. Parents completed the Pediatric Sleep Questionnaire, which queries reports of periodic limb movements (PLMS), restless leg syndrome (RLS), growing pains, daytime sleepiness, sleep latency/duration, and the Conners\' Early Childhood Questionnaire which asks about behavioral difficulties.
Among 71 children with cleft palate (52.1% boys) 14.1 % screened positive for PLMS, 8.5% reported RLS and 9.9% growing pains. Children who screened positive for PLMS and RLS were more likely to report sleepiness (PLMS 40% vs. 4.9%, p = 0.001; RLS 33.3% vs. 7.7%, p = 0.04) and long sleep latency (PLMS 80% vs. 32.8%, p = 0.005; RLS 100% vs. 33.8%, p = 0.002) compared to those who did not endorse the respective sleep problems. Children who reported PLMS had a higher T-score for emotional (58.2 ± 7.6 vs. 50.7 ± 8.4, p = 0.01) and somatic symptoms (66.2 ± 15.2 vs. 49.9 ± 9.5, p = 0.0001). Sleepiness was associated to an increased frequency of externalizing, psychiatric and somatic problems. While children with long sleep latency reported more emotional and somatic symptoms, and those with reduced sleep duration more internalizing difficulties.
Parents of young children with cleft palate reported frequently PLMS, RLS and growing pains. Daytime/bedtime behavior varies depending on the presence of SRMD. Sleepiness and sleep variables might play a role on behavioural problems in children with cleft and SRMD symptoms.

BACKGROUND: Growing pains is the most common cause of musculoskeletal pain in early childhood and was first described in 1823 by French physician Marcel Duchamp. Although it has been researched extensively, the etiology is still unknown. Several theories have been proposed throughout the years.
OBJECTIVE: Analyze the available scientific literature to provide an update on the latest evidence on the etiology.
METHODS: According to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the scientific literature on the etiology of growing pains was systematically reviewed using the following inclusion criteria: studies of any level of evidence reporting clinical or preclinical results and dealing with the etiology of growing pains. The medical electronic databases PubMed and Web of Science were searched by two independent authors on October 20, 2018. The search string used was \"(growing pains OR benign nocturnal limb pains OR musculoskeletal pains) AND (etiology OR pathogenesis) AND (pediatrics)\".
RESULTS: A total of 32 articles were included. The etiology of growing pains still remains poorly understood. Many theories have been proposed, but none of them are decisive. A lower pain threshold has been found among patients suffering from growing pains in comparison to healthy controls. Furthermore, evidence suggests an association between growing pains and reduced bone strength in young patients, although this finding still remains controversial. Changes in the vascular perfusion pattern have also been studied. However, the etiology of growing pains does not seem related to a vascular component. The anatomical/mechanical theory has not been supported, but the role of vitamin D deficiency has been investigated many times. Strong recent evidence indicates a genetic susceptibility in the pathogenesis of growing pains. Furthermore, psychological factors also seem to play a strong role in the onset.
CONCLUSIONS: The scientific literature about the etiology of growing pains presents heterogeneity and lack of consensus; more studies are needed to understand the genesis of benign musculoskeletal pain syndrome of childhood.

Altuğ-Gücenmez Ö, Makay B, Kaçar A, Ünsal E. Evaluation of restless legs syndrome and growing pains in children with familial Mediterranean fever. Turk J Pediatr 2018; 60: 159-164. Growing pains (GP) and restless leg syndrome (RLS) are one of the frequently seen pain syndromes of childhood. These two pain syndromes -GP and RLS- may be confused with exertional leg pain (ELP) of familial Mediterranean fever (FMF). The aim of this study was to evaluate the frequency of fulfilling the criterion for GP and RLS among children with FMF. Sixty FMF patients and 70 healthy controls were enrolled. Clinical and demographic data of patients were recorded. A questionnaire including the symptoms of GP and RLS were applied to all participants and their parents. Twenty-seven patients (45%) had ELP. Ten FMF patients and 10 healthy children fulfilled GP criteria. There was not a significant difference between patients and controls regarding GP. Three FMF patients and 7 healthy controls fulfilled RLS criteria. There was not a significant difference between two groups regarding RLS. Two out of 27 FMF patients with ELP had RLS while one out of 33 FMF patients without ELP had RLS. Eight out of 27 FMF patients with ELP fulfilled GP criteria while two out of 33 FMF patients without ELP fulfilled GP criteria (p=0.01). There was a significant inverse correlation with FMF severity score and GP (p=0.003 and r=-0.376). There was not a significant association with FMF severity score and RLS. This study suggested that GP and RLS are not more common in pediatric FMF patients than their healthy peers.

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.