Growing pains chiropractic

Growing pains chiropractic asks why we simply seem to have no clue of the cause of this sometimes quite disabling condition; is it real, or behind it is there a real problem?

When doctors have no idea what is the cause of a problem, in adults they call it a virus, or stress and, in a child, growing pains.

But you as a parent know that your child is not whingeing about nothing; they are in pain.

If you scour the net, the first thing that will strike you is that no one seems to have a clue as to what is really the cause of growing pains. There are any number of theories and opinions, but nothing that is substantiated.

Certainly it has nothing to do with the growth spurts of a child, and the term is almost certainly inappropriate. There is a cause, but your doctor just doesn't know what it is.

So, growing pains; just what are they?

I'm not going to pretend to be a know it all, but having treated many children I know that pains particularly in the lower limbs are a reality. If it's bilateral, in both legs, then one is less concerned.

Of particular consequence is that some serious diseases begin in childhood; written off as growing pains they can lead to lifelong problems.

Does your child have pain in one leg only? Then be more concerned. Does he or she have a limp? Then a careful and thorough examination is certainly called for.

Growing pains medical

Growing pains medicine, though there is no certainty of this, is that they are neuralgic in nature; and that they are associated with the muscles rather than the joints.

Anterior thigh, knee and the calf appear mostly affected; the lower limbs.

There is no sign of swollen or angry joints.

Making a diagnosis of growing pains is a hazardous business, because one has to rule out more serious disease. To be certain your child doesn't have juvenile rheumatoid arthritis or Perthe's disease for example, xrays and blood tests must be taken.

One difference is that children with serious disease, for example, as yet undiagnosed leukaemia do not like being touched as it hurts. But gentle massage and movement appears to relieve growing pains.

Read more at Kid's health growing pains site.

Growing pains chiropractic

Growing pains chiropractic would suggest this probably more to do with joint hypermobility than being neurological in nature.

We know that in adults hypermobility is certainly problematic; show me a person who can pick strawberries without bending their knees and I'll show you someone with lower back issues.

Hyper mobile joints are far more prone to become painful.

All children are hypermobile; the joints are not yet fully formed and the range of motion is excessive. Capsular ligaments are stretched to their limits during sport, and the mechanoreceptors are apt to complain. That can certainly refer via neurological pathways back to the spine, and then to the muscles pertaining to the joint.

But in my book it's not primarily neurological, but orthopaedic in nature.

Normal growing pains

So, normal "growing pains" if we insist on calling them that, are not uncommon or of great concern in the child, particularly if he or she is very active and sporting.

There is no swelling associated with the pain, no limp and it's usually bilateral; one week the pain is in the right knee, and next in the left.

Some gentle massage of the tissues around the joint, ice followed by heat for pain control, and gentle exercises are the order of the day. Laying off sport for a few days or a week may be indicated. Assuming it soon passes, neither medical nor chiropractic treatment is indicated.

Abnormal growing pains

Abnormal "growing pains" are another matter altogether. Is there hiding behind these complaints something real happening that needs attention, and perhaps immediate attention?

One of the key signs is a limp. Please, if your child starts to limp, then take it seriously and get a professional opinion. And be very cautious about accepting a cursory opinion that your child is merely suffering from "growing pains."

Likewise, if there are definite signs of redness, a swelling or bump, or if your child starts running a temperature.

Perthe's disease is a very serious hip condition in the child; miss it and your he or she is doomed to a lifetime of disability and pain. A limp is the key sign, with stabs in the groin and radiating to the muscles in the front of the thigh down to the knee.

Osgood Schlatter's disease gives a painful swollen lump on the shinbone, just below the knee. Active use of the thigh muscles, straightening the knee as in running and jumping hurts.

Aggressive bone cancers love the area just above and below the knee.

Hip dysplasia

Hip dysplasia is characterised by an abnormally formed socket, often if the foetus in uterus did not lie in the usual lotus position that forces the ball into the socket.

Notice in the x-ray below of a seven year old girl how the left socket does not have a rounded appearance; it slopes upwards allowing the hip to subluxate and if it it clunks then it's more serious. It's noticeable that the ball protrudes, but only very slightly; it's only marginally "unroofed".

This girl has been diagnosed as having growing pains, but hiding behind the hypermobility of her hips are distinct signs of a mild hip dysplasia. Nothing was diagnosed at birth by the paediatrician, there's no clunking of the hip, it doesn't subluxate but she has aching legs.

I hope in ten years time to put up another view of this girl's pelvis, and see what transpires. Meantime she has specific exercises to strengthen the muscles around the hip, chiropractic help to check the sacroiliac joint which regularly fixates, and an insert in her shoe to correct the leg length inequality.

Prevention is the name of the game; otherwise there's a significant possibility of early hip arthritis, and several total hip replacements.

Interestingly she also gets a tender area just below the knee where the patella tendon inserts onto the tibia, but with no swollen bump on the bone. It's often after sport, and resisted knee extension is painful. At this stage it would appear to be normal "growing pains" but we watch to be sure that there is no Osgood Schlatter's disease developing.

› Growing pains chiropractic

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Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?

Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

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Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.

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