Growing Pains

Dear Lisa,

My 10 year old son has had muscle twitches for about 1.5 months. They are only painful when he tries to stretch them out. He will be sitting there and suddenly his arm or leg will start jumping and jerking. Are these just regular growing problems or could it be more?

"Son with Muscle Twitches"

Dear "Son with Muscle Twitches",

Growing pains are pains that children experience in their extremities. The pains typically occur in the calves or the shins of both legs and do not include any joints. Commonly the pains occur at night and may even wake a child from his sleep. By the next morning the pain disappears and the child walks, runs and plays normally as if nothing ever happened.

Growing pains are more common in the 3 to 5 year and in 8 to 12 year age groups. (1) Upon inspection of the legs or extremity there should be no abnormal findings; no bruising, no swelling and no deformity. The exact cause of growing pains is unknown but they are thought to be caused by swelling of the muscle bodies within the tight fascial sheaths during periods of activity or overuse. (1) The treatment for growing pains is heat, massage and Acetaminophen (Tylenol). (1)

From the description you gave about your son’s symptoms it does not seem that he is experiencing growing pains. There is no involuntary jumping, twitching or jerking involved with growing pains. It may be possible though, that your son has a growing pain and then moves his leg back and forth voluntarily in response to the pain. If your son is having movements which are out of his control, then the symptoms are not due to growing pains.

Fibromyositis on the other hand can cause local muscle spasms or twitching. Fibromyositis is characterized by pain, tenderness and stiffness in the joints, muscles or surrounding structures. When the thigh is involved it is called a “Charleyhorse”. A Charleyhorse is caused by bruising and tearing of the muscles fibers resulting in a collection of blood. (2)

The pain usually has a sudden onset, is aggravated by motion and muscle spasms are noted. The symptoms disappear with rest, heat and massage. Occasionally Charliehorses can become chronic or recur at frequent intervals. (2) The symptoms you described may be consistent with a Charleyhorse. You stated that your son has muscle twitches and then has pain when he tries to stretch it out. Charleyhorses tend to cause pain with movement.

Tetany is another health condition that causes muscle twitches, spasms and may also cause convulsions. Tetany is caused by a calcium deficiency. The Parathyroid gland is located in the neck and is attached to the thyroid gland. This gland is responsible for the balance of calcium in the body. Children who have had surgery on the thyroid gland, have Parathyroid disease, infection or injury can develop Hypoparathyroidism which causes calcium deficiency. (2) Tetany is not common in childhood, but should be strongly considered if your child has had an operation or injury to his neck or thyroid gland.

Without physically examining your child and witnessing the events it is not possible to determine the cause of your son’s symptoms. The best way to diagnose your son is to have him evaluated by his Primary Care Physician. I recommend keeping a diary of the events, writing down the time and duration of the twitching and pain, the part of the body that is affected, the pain severity, any associated symptoms and what measures relieved the episode. It would also be beneficial to make a video recording of the episode so that your Doctor can witness the event in case it does not occur in the office.

It is important that you seek medical attention because it is not normal for a child’s extremities to involuntarily jump and jerk.

References:
(1)Graham M, Uphold C. Clinical Guidelines in Child Health. Gainsville, Florida: Barmarrae Books. 1994:566,572.
(2)Tortora G, Anagnostakos N. Principles of Anatomy and Physiology. 4th ed. Sao Paulo, Sidney:Biological Sciences Textbooks, Inc. 1984: 219, 416.


Lisa-ann Kelly R.N., P.N.P.,C.
Certified Pediatric Nurse Practitioner

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