Introduction

Many teens present with bone pain especially pain at limbs. Sometimes the pains are short-lived and sometimes it may last for several months.

Some of the pain might originate from the bone or it might come from the muscle or joints or other tissues in the joints.

Causes

Most of the causes are not sinister. However it is important to see a doctor to rule out serious conditions. Once serious causes are ruled out, reassurance is important as teenagers and their parents may worry a lot. Hearing from their doctors that these pains are common and absolutely harmless can alleviate worries and anxiety.

• Growing pain

  This is the most common cause of pain in teenagers. Usually occurs in teenagers between 12 to 17-years-old, who develops mild to moderate (and occasionally intense) pain in the calves, shins, knees or thighs.

  The pain is often not confined to one spot or one area; it tends to affect the entire leg. Pain may be most severe at night and may intensify for 10 to 15 minutes later, but it is rarely debilitating. It does not typically prevent walking, running or inclusion in sports.

  There is no fever, redness of the skin, or swelling; in fact the legs and other areas of pain appear completely normal. These pains may last a few weeks or months but rarely become chronic. Then, as mysteriously as the pain appeared, it resolves.

  Previously thought to be due to rapid growth in adolescent and some nutrient defiency in these rapidly growing teens. The pain was also noted to be more in the taller teens. However studies have found no correlation between pain and growth.

  Some experts believe “growing pains” are actually due to muscular injury, strain or even small tears that occur over the course of a teen’s activities. If this is the reason for growing pains, the actual injury is frequently not recalled.

• Trauma (Injuries)

  Some of the most common are minor strains, sprains or other injuries. Teenagers are usually very active and prone to get injuries.

• Osteochondrosis

  This is a group of disorders that affect patients with an immature skeleton. Osteochondrosis results from abnormal development, injury, or overuse of the growth plate and surrounding ossification centers.

  Overall, boys are more affected and symptoms generally appear between 10 and 14 years of age.

• Osteosarcoma

  This is the most common type of bone cancer. In teens, it can sometimes appear during their growth spurt and tends to show-up in people who are taller than average.

  The most common symptoms of osteosarcoma are pain and swelling in an arm or leg that is sometimes accompanied by a lump. Some teens have more pain at night or when they exercise.

• Other causes

  Juvenile rheumatoid arthritis, fractures, bone and joint infection, leukemia are some other causes that need to be ruled out. These are usually accompanied by other symptoms such as pain that persists throughout the day, limping, fever, swelling, loss of appetite, fatigue, rash, or unusual behavior. These symptoms would not be expected to accompany “growing pains” and should prompt medical evaluation. For the vast majority of children, a review of symptoms and past medical problems, a thorough examination, and simple testing can identify these other causes.

What to do?

It is important to see a doctor to rule out sinister causes of bone pain.

Location of pain, type and pattern of pain and whether there are any other symptoms will help to determine the causes of the pain.

What to expect at the doctors?

The doctor will ask about the teen’s medical history and perform a physical examination. Diagnostic tests sometimes may be performed including some blood test, X-rays, CT scan or MRIs.

Treatment

• The treatment depends on the underlying cause of the pain.
• If there is some joint or bone infection, the doctor may prescribe some antibiotics. Usually these antibiotics need to be taken over a longer period of time.
• For fractures, the joint may be immobilised and some painkillers given.
• Ocasionally the doctor may prescribe some painkillers or other oral or local medications when they can’t find any underlying cause.
• It is important not to take over-the-counter medications without seeing a doctor.
• If no cause is found, massage, ice or heat can be helpful.