General

Childhood growing pains

· Oct 17, 2024 ·

What are growing pains?

Growing pains are a common cause of recurring discomfort in children. They are aches, usually felt in the legs.

The pains usually occur in the evening or night. The pain can sometimes be bad enough to wake up your child in the night.

Usually growing pains occur in the legs, particularly

In the back of the leg below the knee (the calf)
At the front of the leg below the knee (the shin)
Around the ankles
At the front of the leg above the knee (the thigh)

Growing pains are usually felt in both legs but sometimes one more than the other, they are often felt in the areas between the joints, rather than in the joints themselves. They are not serious and settle in time of their own accord.

What causes growing pains?

It is not known what causes growing pains. They are not always caused by growing so ‘growing pains’ can sometimes be a confusing term. Various theories about the cause have been tested in studies but none have been proven.

Growing pains are sometimes more common in active children. It is possible that the pains are due to the effect of lots of activity on muscles and bones but do not cause damage so you do not have to restrict your child’s activity levels.

It is important to remember that growing pains do not develop into anything serious and do not do the child any harm.

Some research studies have suggested that growing pains might have a connection to vitamin D levels – especially living in Scotland multivitamins or vitamin D supplements sometimes seem to help with growing pains.

Who gets growing pains?

Growing pains usually affect children between the ages of 3 and 12 years. Up to half of all children may experience growing pains at some point.

What are the signs of growing pains?

There are no signs. If there is anything unusual to see in the area of the pain the cause is probably not growing pains and you should contact your GP.

Are any tests needed?

Usually, no tests are needed for growing pains. A doctor or physiotherapist can usually diagnose growing pains from your description and a physical examination. There should be nothing unusual to find on examination of a child with growing pains.

Blood tests and x-rays would be normal in a child with growing pains so there is no need to do these tests unless there are symptoms or signs suggesting other causes.

What treatment is there for growing pains?

Reassurance, gentle massage to the area and a hot water bottle or a warm bath can help with the pain and is usually all that is needed. In time growing pains should settle of their own accord, this however can take months and sometimes years.

Sometimes the pain can come and go during this time before completely settling.

Occasionally simple pain relief can help but often isn’t needed. Try the following stretches to see if they help your child’s pain.

Stretches to help with child’s pain

Hamstring stretch

Lie on the floor with both legs bent.
Lift one leg off of the floor and bring the knee toward your chest.
Clasp your hands behind your thigh below your knee.
Straighten your leg and then pull it gently toward your head, until you feel a stretch.

If you have difficulty clasping your hands behind your leg, loop a towel around your thigh.

Hold for 30 seconds and repeat 2-3 times and repeat 2-3 times on each leg.

Stretch Quads prone self

Lie face down.
Reach back and grasp the ankle.
Relax your leg and gently pull your ankle towards your buttocks.

Hold for 30 seconds and repeat 2-3 times and repeat 2-3 times on each leg.

Knee to Chest

Lie on your back on the floor with your legs extended straight out.
Bend one knee and hold below your knee with your hands.
Gently pull your knee toward your chest as far as it will go.

Hold for 30 seconds and repeat 2-3 times and repeat 2-3 times on each leg.

Wall push-ups or stretches for Achilles Tendon

Stand to face a wall with one leg forward with a slight bend at the knee.
Keep the leg behind you straight with the heel flat on the ground.
With both heels flat on the floor, press your hips forward toward the wall.

Hold for 30 seconds and repeat 2-3 times and repeat 2-3 times on each leg.

When should I see a doctor about growing pains?

If your child develops a limp, has warm swollen joints, or has signs of stiffness in the morning and a temperature with their pains.

Burns and scalds

· Oct 17, 2024 ·

What is a burn?

A burn is a type of injury to the skin or other tissues caused by heat, cold, electricity, chemicals, friction or radiation. Burns are one of the most common household injuries, especially among children.

Wound dressing

Your child may have a dressing applied in Accident & Emergency (A&E). It is important that this is kept clean and dry and ensure that your child avoids playing in sand or water. You should attend A&E if:

The dressing becomes wet, dirty or loose
There is an offensive smell from the dressing
There is leakage through to the outer layer of the bandage
There is increased pain from the wound
The bandage appears too tight and the fingers/toes become swollen, cold or blue.

Some of these could mean there is a wound infection, if left untreated this could delay healing.

Toxic Shock Syndrome

If a wound becomes infected, it can affect the whole body, causing a serious illness called Toxic Shock Syndrome. This is not a common illness; however, it is important that you recognise it. The signs and symptoms are as follows:

Fever (37.5˚c and above)
Rash – anywhere on the body
Vomiting
Diarrhoea
Lethargy.

If your child shows any of these symptoms, you should attend the Accident and Emergency department urgently.

Pain management

Your child may complain of pain for at least 48 hours after the injury occurred. Children’s paracetamol and ibuprofen can be given following the dosing instructions on the packaging, if you are unsure, please contact your GP or pharmacist for further advice.

Nutrition

It is important that your child continues to have a balanced diet including protein (e.g. yoghurts, chicken, eggs, milk, and beans) for good wound healing.

Depth of burn

There are 4 levels of burns; your child may have one or a mixture of these. The depths are as follows;

Superficial – heal within 7 days with no scarring.
Superficial Partial Thickness – heal within 10-14 days with little or no scarring.
Deep Partial Thickness/Deep Dermal – will leave a scar and may require a skin graft to heal.
Full thickness – will require a skin graft and will leave a scar.

Follow up appointments

You may be asked to arrange a practice nurse appointment at your GP or to attend an appointment in the Plastic Dressings Clinic in the outpatient department of the hospital (OPD 12, 1st floor by therapies) for further review.

This appointment should be within 48-72 hours following the burn/scald.

If you have been asked to return for an appointment, we request that you give your child some paracetamol or ibuprofen at least 1 hour before the appointment to make them more comfortable when the dressing is removed and the wound reviewed.

Looking after a child in a cast

· Sep 26, 2024 ·

Your child has had a cast applied. This is to protect the injured limb and to relieve pain.

During the first 48 hours, the limb should be elevated as much as possible.

This is to help reduce the swelling which often occurs after an injury. It is important to encourage your child to move the fingers or toes of the affected limb as this helps to prevent them from becoming stiff and sore.

If you have further concerns including:

Increased pain
Numbness or “pins and needles” sensation in the fingers or toes
Swollen fingers or toes, with difficulty moving them
Blue appearance of fingers or toes
Cast becomes wet
Any foul odours from inside the cast
Condition of the cast
Any objects (coins etc) pushed inside the cast.

Please call for advice on 0131 312 0007 or 0131 312 0008 and ask to speak to the Orthopaedic Technician if available.

We may need to ask you to attend the hospital for a review of the injury or cast.

Pain

It is normal for there to be a degree of discomfort after an injury, however this should not be severe. The recommended dose of your child’s usual painkiller e.g. Paracetamol (Calpol) or Ibuprofen may be given. If the medication does not ease the pain, please call for advice.

Removing a soft cast

You should have received advice on how long to leave the cast on for. At the end of this time, you can remove the cast at home by unwrapping the bandage.

Follow-up

Most injuries heal very well and do not need any planned follow-up. We do like to review some injuries at either an Emergency Department clinic or a fracture clinic and you may be given an appointment for this before you leave.

Pain relief in children

· Sep 26, 2024 ·

Paracetamol for children (often called Calpol)

Paracetamol is a common painkiller for children with mild to moderate pain (for example headaches and stomach aches). It can also be used to treat a temperature over 38ºC. Calpol is one brand of paracetamol, but others are available.

Your child should start to feel better about 30 minutes after taking paracetamol. Do not give paracetamol to babies younger than 3 months old unless you have been advised to by a healthcare professional.

How often should I give paracetamol?

You should wait at least 4 to 6 hours between doses of paracetamol. Give no more than 4 doses of paracetamol in 24 hours.
What if my child has too much paracetamol?

If you give your child 1 extra dose of paracetamol by mistake, wait at least 24 hours before giving them any more. If you are in any doubt, you should contact 111 for advice.

What if my child has too much paracetamol?

If you give your child 1 extra dose of paracetamol by mistake, wait at least 24 hours before giving them any more.

If you are in any doubt, you should contact 111 for advice.

Ibuprofen for children (can be called Nurofen, Calprofen, Brufen)

Ibuprofen is a common painkiller for children with mild to moderate pain. It can also be used to treat a temperature over 38ºC. Nurofen, Calprofen and Brufen are brand names for Ibuprofen, but others are available.

It is best to give ibuprofen with food, so it doesn’t upset your child’s tummy. Your child should start to feel better about 30 minutes after taking ibuprofen.

Do not give ibuprofen to your child if they have asthma or chicken pox unless advised to by a healthcare professional.

How often should I give ibuprofen?

You should wait at least six hours between doses of ibuprofen. Give no more than 3 doses of ibuprofen in 24 hours.

What if my child has too much ibuprofen?

If you give your child 1 extra dose of ibuprofen by mistake, wait at least 12 hours before giving them any more.

If in doubt call 111 for advice.

How much paracetamol or ibuprofen should I give?

You should follow the instructions on the bottle carefully to make sure you give the correct amount of medicine.

There are different strengths of paracetamol and ibuprofen syrup available – make sure you are using the correct strength for your child’s age.

It can be useful to write down the time that you give each dose.

Can paracetamol and ibuprofen be given together?

Paracetamol and ibuprofen can be given together when using to treat pain and work better for pain used this way. You can also stagger them so that every few hours if needed, the child can have some medication.

For example, you can give paracetamol at 8 am, ibuprofen at 11 am and paracetamol again at 2 pm (i.e. 6 hours after the first dose of paracetamol). Do not give more than 4 doses of paracetamol in 24 hours. Do not give more than 3 doses of ibuprofen in 24 hours.