Pavone Vito, Vescio Andrea, Valenti Fabiana, Sapienza Marco, Sessa Giuseppe, Testa Gianluca
Department of General Surgery and Medical Surgical Specialties, Section of Orthopaedics and Traumatology, University Hospital Policlinico-Vittorio Emanuele, University of Catania, Catania 95123, Italy.
World J Orthop. 2019 Apr 18;10(4):192-205. doi: 10.5312/wjo.v10.i4.192.
Growing pains is the most common cause of musculoskeletal pain in early childhood and was first described in 1823 by French physician Marcel Duchamp. Although it has been researched extensively, the etiology is still unknown. Several theories have been proposed throughout the years.
Analyze the available scientific literature to provide an update on the latest evidence on the etiology.
According to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the scientific literature on the etiology of growing pains was systematically reviewed using the following inclusion criteria: studies of any level of evidence reporting clinical or preclinical results and dealing with the etiology of growing pains. The medical electronic databases PubMed and Web of Science were searched by two independent authors on October 20, 2018. The search string used was "(growing pains OR benign nocturnal limb pains OR musculoskeletal pains) AND (etiology OR pathogenesis) AND (pediatrics)".
A total of 32 articles were included. The etiology of growing pains still remains poorly understood. Many theories have been proposed, but none of them are decisive. A lower pain threshold has been found among patients suffering from growing pains in comparison to healthy controls. Furthermore, evidence suggests an association between growing pains and reduced bone strength in young patients, although this finding still remains controversial. Changes in the vascular perfusion pattern have also been studied. However, the etiology of growing pains does not seem related to a vascular component. The anatomical/mechanical theory has not been supported, but the role of vitamin D deficiency has been investigated many times. Strong recent evidence indicates a genetic susceptibility in the pathogenesis of growing pains. Furthermore, psychological factors also seem to play a strong role in the onset.
The scientific literature about the etiology of growing pains presents heterogeneity and lack of consensus; more studies are needed to understand the genesis of benign musculoskeletal pain syndrome of childhood.
生长痛是幼儿期肌肉骨骼疼痛最常见的原因，1823年由法国医生马塞尔·杜尚首次描述。尽管对此进行了广泛研究，但其病因仍然不明。多年来已经提出了几种理论。
分析现有科学文献，以提供有关病因的最新证据。
根据系统评价和荟萃分析的首选报告项目指南，使用以下纳入标准对有关生长痛病因的科学文献进行系统评价：报告临床或临床前结果并涉及生长痛病因的任何证据水平的研究。2018年10月20日，两位独立作者检索了医学电子数据库PubMed和Web of Science。使用的检索词为“（生长痛或良性夜间肢体疼痛或肌肉骨骼疼痛） AND （病因或发病机制） AND （儿科学）”。
共纳入32篇文章。生长痛的病因仍了解甚少。已经提出了许多理论，但没有一个是决定性的。与健康对照相比，生长痛患者的疼痛阈值较低。此外，有证据表明生长痛与年轻患者的骨强度降低有关，尽管这一发现仍存在争议。血管灌注模式的变化也已得到研究。然而，生长痛的病因似乎与血管因素无关。解剖学/力学理论未得到支持，但维生素D缺乏的作用已被多次研究。最近有力的证据表明生长痛发病机制中存在遗传易感性。此外，心理因素在发病中似乎也起重要作用。
关于生长痛病因的科学文献存在异质性且缺乏共识；需要更多研究来了解儿童期良性肌肉骨骼疼痛综合征的发病机制。
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