BENIGN NOCTURNAL PAINS OF CHILDHOOD

BENIGN NOCTURNAL PAINS OF CHILDHOOD

Introduction:

§  Usually call "Developing PAINS'

§  Most common cause of episodic musculoskeletal pain in children

§  Peak onset at ages 3 to 12 years

§  Does not really match with development spurt; along these lines the term 'developing pains' is a misnomer.

Clinical presentation:

§  Episodic, bilateral leg pain occurring primarily at night

-        Localized to the calf, shin, behind the knees, or sometimes thights.

-        Responds to massage or over-the-counter analgesics

-        Always disappears by morning 

§  Children are normally active and pain-free during the day in between episodes

-        Pain episodes may occur after days with increased physical activity

-        Motor development is normal 

§  Symptoms usually resolve by late childhood

Diagnosis and evaluation

§  Physical examination is normal

§  Children with flat feet (pes planus) or hypermobility may be predisposed.

§  Radiographs, if obtained, are also normal.

Treatment:

§  Supportive care.

§  Warms baths before bedtime, massage, or over-the-counter analgesics as needed.

§  Education and reassurance that the pains are benign and self-limited.