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Leg pains in CHD: a distressing symptom of a wider problem

Published online by Cambridge University Press:  24 July 2018

Suzie Hutchinson
Affiliation:
Little Hearts Matter, Edgbaston, Birmingham, UK
David S. Crossland
Affiliation:
Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle upon Tyne, UK Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
Bill Chaudhry
Affiliation:
Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
Louise Coats*
Affiliation:
Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle upon Tyne, UK Cardiovascular Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
*
Author for correspondence: Dr L. Coats MBBS, PhD, Adult Congenital and Paediatric Heart Unit, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK. Tel: +0 191 233 6161; Fax: +0 191 223 1314; E-mail: [email protected]

Abstract

Purpose

Anecdotal reports suggest that children and young adults with CHD frequently experience pain in their legs. The purpose of this pilot study, performed by Little Hearts Matter patient organisation, was to assess the burden of leg pains in this group and begin to investigate associated factors and consequences for daily living.

Methods

An internet-based survey was distributed by Little Hearts Matter patient organisation. After anonymisation and collation, responses were analysed and compared with their healthy siblings.

Results

Of the 220 patients who responded, 94% reported leg pains compared with 30% of siblings (n=107; p<0.001). In respondents, pain was typically reported to occur in the lower legs or around the knees or ankles, often associated with crying and screaming (49.0%) and most commonly occurring at night-time (82.0%). Individuals taking aspirin and those who were more active were more likely to report leg pains. Older age was associated with leg pain that occurred with stress (p=0.02) and at night (p=0.05). Analgesia (64.1%) or massage (53.9%) was the preferred option for alleviation. There was no gender bias, association with diagnosis, surgical history, and/ or relationship with diagnosed orthopaedic issues.

Conclusion

Leg pains are more frequent in those with CHD compared with their healthy siblings. Aetiology is uncertain, but pains share many common characteristics with benign “growing pains”.

Type
Original Article
Copyright
© Cambridge University Press 2018 

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References

1. Ronksley, PE, Sanmartin, C, Quan, H, et al. Association between chronic conditions and perceived unmet health care needs. Open Med 2012; 6: e48e58.Google Scholar
2. Ronksley, PE, Sanmartin, C, Quan, H, et al. Association between perceived unmet health care needs and risk of adverse health outcomes among patients with chronic medical conditions. Open Med 2013; 7: e21e30.Google Scholar
3. Kirk, S, Milnes, L. An exploration of how young people and parents use online support in the context of living with cystic fibrosis. Health Expect 2016; 19: 309321.Google Scholar
4. George, DR, Rovniak, LS, Kraschnewski, JL. Dangers and opportunities for social media in medicine. Clin Obstet Gynecol 2013; 56: 453462.Google Scholar
5. Hall, S, Chen, S, Kao, A, et al. 162 symptom impact and unmet need in systemic/cutaneous lupus erythematosus: results from a patient-centred study set in a social media community. Lupus Sci Med 2017; 4: A77.Google Scholar
6. Peterson, H. Growing pains. Pediatr Clin North Am 1986; 33: 13651372.Google Scholar
7. Mohanta, MP. Growing pains: practitioners’ dilemma. Indian Pediatr 2014; 51: 379383.Google Scholar
8. Hawksley, JC. Growing pains in relation to rheumatism. Br Med J 1939; 1: 155157.Google Scholar
9. Evans, AM, Scutter, SD. Are foot posture and functional health different in children with growing pains? Pediatr Int 2007; 49: 991996.Google Scholar
10. Evans, AM, Scutter, SD, Lang, LMG, Dansie, BR. “Growing pains” in young children: a study of the profile, experiences and quality of life issues of four to six year old children with recurrent leg pain. Foot 2006; 16: 120124.Google Scholar
11. Friedland, O, Hashkes, PJ, Jaber, L, et al. Decreased bone speed of sound in children with growing pains measured by quantitative ultrasound. J Rheumatol 2005; 32: 13541357.Google Scholar
12. Hashkes, PJ, Friedland, O, Jaber, L, Cohen, HA, Wolach, B, Uziel, Y. Decreased pain threshold in children with growing pains. J Rheumatol 2004; 31: 610613.Google Scholar
13. Naish, JM, Apley, J. “Growing pains”: a clinical study of non-arthritic limb pains in children. Arch Dis Child 1951; 26: 134140.Google Scholar
14. Walters, AS, Gabelia, D, Frauscher, B. Restless legs syndrome (Willis–Ekbom disease) and growing pains: are they the same thing? A side-by-side comparison of the diagnostic criteria for both and recommendations for future research. Sleep Med 2013; 14: 12471252.Google Scholar
15. Morandi, G, Maines, E, Piona, C, et al. Significant association among growing pains, vitamin D supplementation, and bone mineral status: results from a pilot cohort study. J Bone Miner Metab 2015; 33: 201206.Google Scholar
16. Baxter, MP, Dulberg, C. “Growing pains” in childhood – a proposal for treatment. J Pediatr Orthop n.d.; 8: 402406.Google Scholar
17. Avitabile, CM, Leonard, MB, Zemel, BS, et al. Lean mass deficits, vitamin D status and exercise capacity in children and young adults after Fontan palliation. Heart 2014; 100: 17021707.Google Scholar
18. Avitabile, CM, Goldberg, DJ, Zemel, BS, et al. Deficits in bone density and structure in children and young adults following Fontan palliation. Bone 2015; 77: 1216.Google Scholar
19. Uzark, K, Zak, V, Shrader, P, et al. Assessment of quality of life in young patients with single ventricle after the Fontan operation. J Pediatr 2016; 170: 166172.e1.Google Scholar
20. Macran, S, Birks, Y, Parsons, J, et al. The development of a new measure of quality of life for children with congenital cardiac disease. Cardiol Young 2006; 16: 165172.Google Scholar
21. Idorn, L, Jensen, AS, Juul, K, et al. Quality of life and cognitive function in Fontan patients, a population-based study. Int J Cardiol 2013; 168: 32303235.Google Scholar
22. Marino, BS, Shera, D, Wernovsky, G, et al. The development of the pediatric cardiac quality of life inventory: a quality of life measure for children and adolescents with heart disease. Qual Life Res 2008; 17: 613626.Google Scholar
23. Smailhodzic, E, Hooijsma, W, Boonstra, A, Langley, DJ. Social media use in healthcare: a systematic review of effects on patients and on their relationship with healthcare professionals. BMC Health Serv Res 2016; 16: 442.Google Scholar
24. Colineau, N, Paris, C. Talking about your health to strangers: understanding the use of online social networks by patients. New Rev Hypermedia Multimed 2010; 16: 141160.Google Scholar
25. Koschack, J, Weibezahl, L, Friede, T, Himmel, W, Makedonski, P, Grabowski, J. Scientific versus experiential evidence: discourse analysis of the chronic cerebrospinal venous insufficiency debate in a multiple sclerosis forum. J Med Internet Res 2015; 17: e159.Google Scholar
26. Eiser, C, Varni, JW. Health-related quality of life and symptom reporting: similarities and differences between children and their parents. Eur J Pediatr 2013; 172: 12991304.Google Scholar
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