Growing pains?? (chronic intermittent leg pain)

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Specializes in School Nursing, Ambulatory Care, etc..

I need ya'lls help. I apologize up front for this being so long.

I have a student (grade 5, female) who has been diagnosed with "growing pains" - I put that in quotations because, at this point, I'm not convinced that is what is going on.

Last year this student had a PE activity restriction ALL year with no end date. Apparently, anytime the nurse or HA asked for an end date, the doctor's office just sent a renewal of the restriction. Of course, the child was seen running around at recess with no issue.

This year, she came in to the health room once, first or second week of school, for this leg pain. Walks without limp, flat affect. I think mom came and picked her up. I encouraged mom to get us a doctor's order for IBU at school (it's what mom gives at home) for exacerbation - as of yet, no meds and no order.

Thursday before last she slipped and fell down the stairs. I watched the video - her foot slipped on the edge of a step and she fell onto her bottom and slid down a couple of stairs. She came limping into the health room and after sitting down said she could no longer weight bear d/t pain. Mom came to pick her up and she has not been back to school since. I talked to mom yesterday and she said the child has been in so much pain, she couldn't get out of bed until this past Friday. Mom says she took her to the doctor and the x-rays were negative. Mom also says she had her seen by rheumatology and they said her blood work was good (she was worked up by rheum last year d/t this pain).

Have any of you dealt with this with a student (or yourself or your own child)? Do you have any resources for information ? (doctor google isn't much help) Any ideas? Am I crazy - is this how growing pains work? I thought they were more prevelent in the evenings, but, per mom, this child's pain is worse in the mornings. (chronically tardy and > 20 absences last year).

Thoughts??

Thanks!

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Specializes in Peds.

If I was this mom I would push for second opinions. We had a student in our area that was diagnosed with growing pains and a year later they realized they were wrong and he had bone cancer. Be the squeaky wheel.

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Specializes in Cardiology, School Nursing, General.
If I was this mom I would push for second opinions. We had a student in our area that was diagnosed with growing pains and a year later they realized they were wrong and he had bone cancer. Be the squeaky wheel.

I agree. I would get other opinions. Especially if these are happening a lot.

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Specializes in kids.

Squeaky wheel for sure!!! The second opinion definitely is encouraged!! Can you ask mom for a release to talk to MD to see what the school can do to provide for her child, to be the most successful? Using that terminology vs I want to know what is or is not wrong with your child, may ellicit some more buy in from the parent.

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Specializes in pediatrics, school nursing.

A personal anecdote, not related to my nursing experience - A friend of mine growing up was diagnosed with a severe case of Osgood-Schlatter disease (his bones grew almost twice as fast as his muscle tissue which caused extreme pain and even some contractures) and it started out similarly. It took over 2 years for the diagnosis and he ended up out of school for a few months due to intensive PT and I think either a surgery and/or some kind of injections. I agree on pushing the second opinion...It may not be as serious as that, but was she receiving any treatment during the "activity restriction"? I would hope that any condition requiring a child to be out of PE classes for a year was being treated in some way...

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If I was this mom I would push for second opinions. We had a student in our area that was diagnosed with growing pains and a year later they realized they were wrong and he had bone cancer. Be the squeaky wheel.

This is exactly what I was thinking. This actually happened to a kid in my children's school 4 years ago. He was diagnosed with leukemia. He is thankfully now in remission after years of treatment.

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Specializes in School nursing.
A personal anecdote, not related to my nursing experience - A friend of mine growing up was diagnosed with a severe case of Osgood-Schlatter disease (his bones grew almost twice as fast as his muscle tissue which caused extreme pain and even some contractures) and it started out similarly. It took over 2 years for the diagnosis and he ended up out of school for a few months due to intensive PT and I think either a surgery and/or some kind of injections. I agree on pushing the second opinion...It may not be as serious as that, but was she receiving any treatment during the "activity restriction"? I would hope that any condition requiring a child to be out of PE classes for a year was being treated in some way...

I just had a student diagnosed with this. Complained of knee pain every day and was told by doctor it was growing pains. But kid's knee would swell up a LOT. I called home and told parent to take him back to the PCP. Sure enough, Osgood-Schlatter disease. The kid had grown 4 inches in one summer. Right know, treating with regular icing and ibuprofen. No PE modification as of yet.

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Specializes in ICU/community health/school nursing.

That's a lot. You definitely want the support of a up-to-date provider's note to prevent this from becoming a truancy case (use those words- truancy doesn't care why the absences occur). Does the student have a 504? Clear xray is good and would show the kinds of cancer that form in soft tissue but would not show anomalies in the bone, I think....

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This thread is scary. Great advice that I cannot add to.

As an aside, I clearly remember being little and having "growing pains" at night. They hurt.

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Specializes in Pediatrics Retired.
This thread is scary. Great advice that I cannot add to.

As an aside, I clearly remember being little and having "growing pains" at night. They hurt.

True this. I worked with a pediatric rheumatologist along my nursing path. Growing pains occur at night and involve both extremities.

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Specializes in Pediatrics Retired.

As an aside, how long has this girl been there? In other words, was she there before this pain episode?

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Specializes in school nursing, ortho, trauma.

Ouch! I'm sure the kiddo was plenty sore after sliding down the stairs in addition to the mystery bone pain. I agree, a second opinion sound appropriate. Osgood schlatters sounds like it could be on the map and hopefully not anything more menacing. Hoping she gets back to school and mom brings the ibuprofen in to help. Ha there been any thought to her doing a reduced day and coming in late?

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