DEAR DR.PAUL: My son has several nights a week in which
he wakes up repeatedly with sore feet. He says they hurt, especially
his toes. I even get him out of bed and walk, but this does not
stop the pain. I am concerned about this. What should I be looking
into?
PEDIATRICIAN DR.PAUL Answers: This is quite a common
complaint, especially in children between three and six years
of age. Most of the time it's really nothing to worry about,
and for lack of a better explanation, it's called "growing pains"
or "benign limb pain of childhood".
Typically, the pain is located in the calf or shin area, occurs
at night, is aggravated by cold temperature and humidity and
affects both legs or feet (sometimes both at the same time,
other times one limb or the other). Often the pain occurs after
an active day. When a child presents these symptoms we look
for signs of more serious illness such as: persistent limping
into the day, associated fever, swelling or redness of a particular
joint and pain consistently in one specific limb or joint.
During the medical evaluation, the doctor looks for any of the
above signs and symptoms and examines the child. Under normal
circumstances, no x-rays or other tests are needed. Fortunately,
in most children these worrisome signs or symptoms are absent,
and the diagnosis of exclusion of simple growing pains is made
(in other words, a serious illness has been ruled out).
Once the diagnosis is made, parents are usually relieved and
worry less about the problem. In the meantime, putting on socks
during cold humid weather may help, as may wearing pajamas that
keep the lower leg area warm. Additionally, massaging the shin,
calf and foot area may also help alleviate the pain.
Explaining to your child that this is not serious will help
to decrease her anxiety as well. Finally, in cases where the
child is really uncomfortable, simple analgesics such as acetaminophen
may help.
Parents often try to seek an orthopedic reason, for example,
in-toeing or out-toeing of the feet, or seemingly "crooked or
curved legs or feet," and wonder whether special shoes will
alleviate the problem. In most children this is not the case,
and special shoes or boots will not help.
In summary then, night-time childhood leg, shin, calf and sometimes
foot pain is common. Once, after a medical evaluation, one is
sure that there are no other worrisome symptoms or signs present,
(usually after a medical evaluation) the diagnosis of growing
pains is made. This is not serious and usually goes away on
its own.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
