Assessment of Growing Pain and Its Risk Factors in School Children

Background: Limb pain in children is a major diagnostic challenge. In majority of cases limb pain are due to growing pain (GP), which is the most common form of episodic childhood musculoskeletal pain. Some standard criteria are being used for diagnosis of GP. Objective: This study was undertaken to identify the frequency of growing pain and to determine its presentation and risk factors in school children. Methodology: This cross sectional study was conducted from January 2014 to December 2014 among school children aged 6-12 years in four Kindergarten schools at Bhairab Thana in Kishoregonj District. Standard criteria given by Peterson (1986) were used in this study for diagnosis of GP. Pretested questionnaires in Bangla were distributed among the children of Class One to Class Five by purposive sampling. After completions by parents or caregiver, questionnaires were collected from the schools and children with limb pain were selected for further history and clinical examination. Age and sex matched healthy children were selected as controls for comparison of risk factors. Results: Among 540 distributed questionnaires 404 (74.8%) responded. Among responders 95 (23.5%) had limb pain of which 78 (19.3%) were diagnosed as GP (40 were male and 38 were female). Highest number of cases was found in 8+ year age group. Site of pain was calf muscle (69.2%) in the majority. Timing of pain was at night in 82.05% cases. In 66.6% of cases pain was improved with massage. GP hampered activities like sleep in 26.9%, sports in 21.7% and schooling in 8.9%. GP was associated with headache in 12.8% and abdominal pain in 6.4% cases. Obesity, overweight, over activity and family history of GP were found significantly higher among GP cases than controls. Conclusion: Growing pain was found to be the most common cause of limb pain. Typical presentation of GP and multiple risk factors like obesity, over activity and family history were identified in this study.