will pass. Science, however, has a more critical view. Some pediatric advisors state
their opinion that, while“‘growing pains’are the commonest musculoskeletal
problem of children and the phrase is an accepted medical term, the pains are not
due to growing”(Manners 1999 ). A more evidence-based approach is taken by
others who note that the etiology of the“growing pain”experience is unknown and
have proffered views relating causality to low pain thresholds,fibromyalgia, restless
leg syndrome, reduced bone strength, and overuse pain, as well as emotional factors
involving the child’s family and social stress—all with the clinical assurance that
the syndrome self-resolves with time (Friedland et al. 2005 ; Lowe and Hashkes
2008 ; Walters 2002 ; Oberklaid et al. 1997 ). As in many situations where limitations
in current medical knowledge lead to diagnostic dilemmas, clinical reframing of a
lived experience tofit known causal pathways and/or a denial by medical authority
of the reality of an individual’s experience is not uncommon. The lack of definitive
support for growing pains at the present time is not surprising given the rare data
documenting saltatory growth events and the difficulty with objectively measuring
the hallmark symptom, pain. It is difficult to envision what a convincing body of
evidence might look like. Nonetheless, given the commonality of the narratives,
seeking a way forward so that the experience is both acknowledged and managed
appropriately is recognized as clinically important (Evans 2008 ).
All parents want to support their children’s growth, health, and well-being. How do
they actualize this? Ethnographic work conducted among American mothers by
Reifsnider et al. ( 2000 ) aimed to document parental concepts of normal growth and
captured a range of maternal concerns over the healthy growth of their children.
Mothers’explanatory models (Kleinman 1980 ) for appropriate child size and growth
patterns reflected attention to medicalized approaches focused on nutritional recom-
mendations and eating behaviors, as well as the ubiquitous application of clinical
growth monitoring. Mothers attended to pediatric reports of their child’s normality in
terms of size and worried about the potential for growth problems arising from illness
and heredity. On an everyday level, they described wanting to help their child grow by
providing foods that are“right”or healthy, and expressed attention to clothing size and
relativefit as indicators of their children’s growth in real time (Reifsnider et al. 2000 ).
Parents rely on medical authority to help them interface with their children’s
biological needs. There is presently a scientific gap in the medical model of normal
growth. There is little pediatric acknowledgment of growth spurts, and this void
inhibits parents from acquiring information that would be helpful in interpreting
their children’s experience. The reality of saltatory growth events corresponds to
the everyday language overheard among parents at the playground, who relate to
one another with statements such as,“he shot up overnight”and“her pants were
long enough yesterday.”The lack of correspondence between the smooth lines on
growth charts, the traditional biomarkers summarizing growth, and parents’actual
experience watching the quick bursts of length accrual, all likely contribute to
confusion about what healthy growth truly means. This is exacerbated by the lived
experience of both physical“growing pains”and by outbursts that erupt suddenly in
daily behaviors—irritability and tantrums that are coincident with“pants no longer
fitting.”
4 The Lived Experience of Growing 55