Growing Pains - A Predictor of Fibromyalgia?
The title of a recent article from Reuters Health caught my eye - "Kids outgrow growing pains: study." Since I frequently hear from adults diagnosed with fibromyalgia who say they had growing pains as children, I was anxious to learn more about this study.
As I looked further into the details of the study, published in The Journal of Pediatrics, several things disturbed me.
The article reported that "most youngsters" outgrow growing pains. In fact, of 35 children studied, 18 (51%) no longer had pain five years later. While 51% technically qualifies as "most," it's hardly a resounding majority.
The study stated, "No patient developed fibromyalgia." However, the five-year study ended when the children were about 13. Since FM is often not diagnosed until adolescence, or more commonly, adulthood, a study that ends when children are 13 can hardly be considered the final word as to whether growing pains might be a precursor to FM.
The study concluded, "We confirm that growing pains has a benign prognosis and probably represents a pain amplification syndrome of early childhood." I think that labeling all growing pains as having a benign prognosis based on one very small study - where 49% of the participants continued to have some level of pain - does a disservice to children in pain, who already have a hard time being taken seriously.
- I wonder whether the lead scientist in this study, Dr. Yosef Uziel, may have some degree of bias in his approach to growing pains. In a 2008 article, "Growing Pains in Children," he said, "There is also an associated familial and patient behavioral element. Treatment is conservative with patient and parental education on the benign outcome of these pains the most important element, in order to decrease anxiety." I don't want to put words into his mouth, but to me this sounds like a fancy way of saying that kids and their parents are over-reacting and that if doctors can just convince them that it is nothing serious, they will be fine. In addition, Dr. Uziel told Reuters that in his experience he had not seen any cases of growing pains develop into a more serious pain syndrome. I can't help but wonder if he might be letting his personal experience and opinion color his research conclusions.
At the very least, the subject of growing pains and their possible connection to fibromyalgia needs to be studied in more depth. I haven't been able to find any research that looks into adults with FM who experienced growing pains as children.
I did find an interesting survey that was conducted by AFFTER (Advocates for Fibromyalgia Funding, Treatment, Education and Research) in 2007. Adults with FM were asked to recall symptoms they had experienced in childhood. Following are the results:
- Growing pains - 49%
- Headaches - 47%
- Chronic infections - 39%
- Stomach aches - 38%
- Sleep disturbances - 33%
- Unusual illnesses - 24%
Since fibromyalgia has only been formally recognized for 20 years, and has only been taken seriously by the medical community in very recent years, there just is not any good long-term research available that follows children with pain into adulthood. But it seems obvious that at least a subset of FM patients have had symptoms from a very young age. It's time this was investigated more thoroughly because the sooner a child with FM is diagnosed and begins receiving treatment, the better the prognosis.
If Your Child Has Growing Pains
If your child is complaining of pain on a regular basis, don't let his/her doctor immediately brush it off as growing pains. Miryam Williamson, in her book Fibromyalgia: A Comprehensive Approach, says, "Growing pains are a particularly pernicious myth. It should not hurt to grow, and the child whose pain is brushed off that way is a very unfortunate little person."
Recurring pain in a child should not be dismissed. Although it may turn out to be simple overuse of muscles and joints or normal skeletal growth variations, other possibilities like fibromyalgia, hyper-mobility, and juvenile arthritis should be investigated.
Since there does seem to be a genetic component to fibromyalgia, if you or a family member has FM and your child exhibits other FM symptoms in addition to "growing pains" like headaches, abdominal pain, fatigue, sleep disturbances, and/or difficulty concentrating in school, it would be a good idea to have your child thoroughly examined, including a tender point exam, by a doctor who has experience in treating juvenile fibromyalgia.
One of the best reasons to verify whether or not your child has FM is related by Williamson, "One study found that 30 months after diagnosis, 11 of 15 children with FM (73%) were no longer fibromyalgic." When children are diagnosed and treated early, they have a good chance of beating this painful condition.
Kids outgrow growing pains: study. Reuters Health. 12 March 2010.
Uziel Y., et al. Five-Year Outcome of Children With "Growing Pains": Correlations With Pain Threshold. J Pediatr. 2010 Feb 18.
Ferbert, Shari. Fibromyalgia and Juvenile Fibromyalgia. Advocates for Fibromyalgia Funding, Treatment, Education and Research. 2007.
Williamson, Miryam. Fibromyalgia in Children. Fibromyalgia: A Comprehensive Approach. 1996. Chapter 7.