(256) Q & A: Growing Pain

[HB KIM]

Q:  I have a 13 year old patient who has severe growing pains.  She went from 5'5" to 5'10 in about 6 months.  The pain is mostly in her knees, and was so severe that she missed 2 months of school because she could hardly walk. 
Does anyone have any thoughts on diagnosis, and how to treat this?  I am also wondering what, if any, affects this may have on her immune system, as the primary reason she came to me was for yin deficient cough.


A:  From the information you've provided, I think Mai Wei Di Huang Wan would be a good formula.

Liu Wei Di Huang Wan is a very popular formula for growing pains, and it seems especially appropriate since you have identified a yin deficiency pattern and knee pain.  Also growing pains occur in the evening, which corresponds to to the pattern of yin deficiency.  For the condition of yin deficiency cough you can add Mai Men Dong + Wu Wei Zi.  Shu Di Huang, the king herb of this formula, nourishes Kidney essence and bone marrow.   In the condition of fast growth rate, the bones are expanding so quickly that they're not well nourished, so Shu Di Huang is good for this condition.

The following herbs strengthen bones and sinews and also stop pain: Wu Jia Pi, Du Zhong, Xu Duan, and Sang Ji Sheng.  So if it is appropriate for your case, you could modify Mai Wei Di Huang Wan with some of these herbs.  Personally, I would try Mai Wei Di Huang Wan first and only modify later if it is not effective enough on its own.

According to Four-Needle Technique, you could strengthen the Kidneys by tonifying LU8 + KD7, and sedating SP3 + KD3.

School absence for two months sounds very severe.  Some experts say that growing pains doesn't occur in the day time, but usually in the evening after physical exertion.  Also, for growing pains that persist more that a week or so, the patient should visit the physician to make sure there is no underlying problem.  Juvenile Rheumatoid Arthritis and neoplastic bone diseases must be ruled out.