Integrative Medicine Approach to Growing Pain in Pediatrics: Testing, Supplements, and Complementary Therapies

Growing pains are the most common musculoskeletal pain condition in children. One assessment determined the prevalence to be 37% in ages 4 to 6 years. Although this can be expressed as a common childhood experience, it's uncomfortable and can be disruptive to a child's life. An integrative medicine approach may help support children with pains and discomfort while potentially decreasing the severity and frequency of growing pain episodes.

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What are Growing Pains?

During childhood, cramping, aches, and muscle pains in both legs, can be caused by growing pains. This common phenomenon typically occurs in toddlers between ages 3 and 4 and then again around ages 8 to 12. While one would think that the name implies that the pain is prevalent during growth spurts, that is not necessarily the case. This discomfort is episodic musculoskeletal pain with a hallmark sign of waking children up from their sleep with benign limb pain.

What Do Growing Pains Feel Like?

Pain typically occurs in the lower extremities, with the most common sites being the thighs, calves, knees, and ankles. Some kids also have pain in their arms. While the discomfort varies from child to child, the pain has been reported as a deep cramp or sharp sensation that ranges in intensity and is present bilaterally. This occurs most frequently in the middle of the night, which wakes your child up. The next morning, the pain is usually gone, and no residual discomfort exists. Some children do experience intermittent pain, meaning it will come and go over a few months or possibly years.

What Causes Growing Pains In Children?

The most recognized cause of growing pains in children is increased physical activity. This is more of a clinical evaluation rather than an objective finding. Objective measures have been found in a couple of areas regarding growing pains. One study on joint hypermobility and growing pains found that they were highly associated, especially when it comes to growing pains in the knee. Insufficient vitamin D levels have also been associated with growing pains. Bone strength depends on calcium absorption, in which vitamin D is the critical driver of calcium and phosphorus bone mineralization. If the bone doesn't have the necessary vitamins for development, the lack of these micronutrients can cause musculoskeletal complaints like growing pains. Evidence on this is provided by research. Multiple studies have revealed a correlation between low vitamin D status and growing pains in school-aged children.

Additional areas of study concerning growing pains are increased physical activity and low pain thresholds in children. Growing pains are not all such a bad sign. It is a good indicator that your child is running around and being physically active! With that being said, most complaints of growing pains come after a long day of physical activity or sports. The intense movement can wear their muscles out and later cause the pains they're experiencing.

A study investigated growing pains in relation to the pain threshold. Children in this study participated in this five-year span data, where they were assessed at the beginning and again at five years. The results showed that the children who continued to have persistent growing pains in those five years had significantly lower pain thresholds than those in the control group and those whose pain had resolved over the years. This study suggests that growing pains may be more of a pain amplification syndrome, in which the child is more symptomatic due to the body's inability to modulate pain optimally. While this hypothesis sounds logical, more research is needed to confirm why some children's pain thresholds are diminished.

Functional Medicine Labs That Can Help in the Management of Growing Pains in Children

Growing pains are a clinical diagnosis primarily based on the symptom picture. Testing for micronutrient deficiencies associated with this condition can provide some therapeutic insight.

Vitamin and Mineral Testing

Looking at vitamins and minerals that can, directly and indirectly, contribute to growing pains can help determine the root cause. Since calcium and phosphorus contribute to bone density, assessing these statuses along with Vitamin D.

Magnesium is an essential mineral for muscle contraction, blood vessel integrity, and the lack thereof can contribute to muscle aches and pains. While it is not a known cause of growing pains, testing for Magnesium deficiency could provide insight into a hidden deficiency and management option. Magnesium supplementation is often considered for reducing pain while inducing muscle relaxation, which may bring welcoming relief.

Bone Scan

No specific test exists for a growing pain evaluation. A child's primary care physician will diagnose primarily on exclusion or based on clinical symptoms. One way to exclude more serious conditions is to do a bone scan. Approximately 19% of children will undergo a bone scan as part of their evaluation when presenting with growing pain symptoms.

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Conventional Management for Growing Pains

At-home massages, comforting reassurance to the child, and pain medications are the leading course of management. Acetaminophen (Tylenol) and ibuprofen (Children's Motrin) are the most common conventional medicine recommendation for children for pain management. In addition to these interventions, daytime stretching, applying a heating pad before bed, and soaking in a bath can bring relief.

Functional Medicine Approach to Management of Growing Pains in Children

Addressing the micronutrient deficiencies, associated pain, and discomfort while emotionally assisting the child through this phase of adolescence is a supportive course of action.

Nutrition or Dietary Considerations for Managing Growing Pains in Children

Supporting children through food for any micronutrient deficiencies would be essential. If vitamin D is low, eating foods high in this vitamin can not only help increase their status but also help with the absorption and retention of calcium and phosphorus. Foods high in vitamin D include fish (cod liver oil, salmon, sardines), beef liver, and egg yolk. Calcium-rich foods would also help fill the gap in deficiencies. Examples of foods rich in calcium include yogurt, orange juice, sardines, and milk. Phosphorus can also be supported independently by incorporating foods like yogurt, scallops, chicken, lentils, and beef. Lastly, magnesium can be supplemented in kids by consuming foods like spinach, pumpkin seeds, avocado, and black beans.

While there is no specific diet for correcting growing pains, eliminating inflammatory foods can assist in overall well-being while the child is experiencing this distress. A Mediterranean Diet will ensure that your child gets optimal nutrition intake while not consuming foods that will create more dysfunction in the body. A Mediterranean diet focuses on minimally processed whole foods, eating foods in season, healthy fats, lean proteins, complex carbohydrates, and antioxidant-rich fruits and vegetables.

Supplements and Herbs That May Help With Growing Pains in Children

Reducing the pain through supportive plant medicines and micronutrient support can be a gentle yet effective way to help your child through growing pains.

Vitamin D for Growing Pains

Based on your child's lab results, supplementing vitamin D may be justifiable. Vitamin D can assist in getting calcium (from the diet) into the bone, which can support bone strength and potentially improve episodes of growing pains. For children over 5 years old, at least 10 mcg of Vitamin D is the suggested dose.

Magnesium for Growing Pains

Supplemental magnesium comes in many forms. Your child can take a capsule, use a transdermal spray, incorporate them with an electrolyte replacement solution, or my favorite and the most functional option for this condition- use Epsom salts. Epsom salts are a combination of magnesium and sulfate. When added to warm bath water, it dissolves, and your child can soak in it while their body absorbs the supportive benefits of magnesium.

Ginger for Growing Pains

This botanical is well known for its use as a natural analgesic. While it hasn't been looked at, particularly for growing pains, it would be a great option because it is safe for children (age 3 and up) and is regularly used as an antioxidant and anti-inflammatory for pain relief. The average dosing for Ginger is .25-1.0 grams, based on the child's weight. Therapeutic use of Ginger is best done when working with a practitioner that utilizes botanical medicine. Ginger should not be used with children under 2 years old.

Turmeric for Growing Pains

For centuries turmeric has been used as a traditional Indian plant medicine. Research has provided evidence for the supportive benefits for the plant as a whole and for an active component, Curcumin. Evidence shows that the anti-inflammatory properties of this plant can help modulate pain. Utilizing turmeric would be one supportive intervention to incorporate, independently or in conjunction with the above-mentioned natural interventions. Turmeric has a wide range of dosing and a variety of means of administration (liquid, capsules, teas, etc.), which should be done with the assistance of a healthcare practitioner.

Complementary and Integrative Medicine Therapies for Growing Pains in Children

As therapies and referrals expand for patients, working with complementary and integrative doctors can provide additional resources for supportive interventions. When addressing growing pains in children, this includes acupuncture and stretch therapy.

Acupuncture

This Traditional Chinese Medicine involves tiny punctures to the skin to help with energy flow throughout the body, associated with meridians. An anesthesiologist named Dr. Lin looked at the effects of acupuncture and pain. While this study was not particular to growing pains, he found that after a year of following the study, participants who had received acupuncture, those children had significantly reduced pain in multiple categories (headache, stomach, back pain) compared to pre-acupuncture treatment.

Stretch Therapy

Intentional stretching has been shown to decrease symptoms of growing pains. On small study found that in all of the experimental participants, there was a quicker resolution in symptoms during the 18 months of the study compared to those in the control groups. A beneficial bedtime routine includes gradual stretches that the child "holds" for 30-second intervals. The targeted muscles are the quadriceps (front and side thigh muscle), hamstrings (back thigh muscle), and gastroc-soleus muscles (back of the legs). This could easily be done at home or potentially in a clinical setting.

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Summary

Growing pains may very well be a common childhood pain condition, but it doesn't have to be "normal." Functional medicine testing and a clinical evaluation of the child's symptoms and lifestyle may help pinpoint an underlying root cause. Supporting your child through the process with massage, stretching, chiropractic care, acupuncture, optimal nutrition, nutrient support, and botanical medicine are all great integrative options to consider for your child. Working with a naturopathic doctor or other holistic healthcare provider would be an excellent avenue for addressing your child's discomfort and well-being.