Leg pain in children is a common complaint. Many kids describe their leg pain as either “behind the knee” or in their calves and thighs. And when a routine examination finds nothing wrong their legs, it’s often just chalked up to normal childhood growth spurts.
But like headaches, there are numerous causes for leg pains in youngsters. The quality and characteristics of the pain are important in trying to determine the cause. One common reason for leg pains is Restless Leg Syndrome (RLS). In fact, 50 percent of children with “growing pains” actually have RLS.
That Creepy, Crawly Feeling
RLS is a neurologic disorder that often runs in families.
Some of the symptoms of childhood RLS are:
- An inability to fall or stay asleep.
- Restless slumber with excessive kicking during sleep.
- Not being refreshed in the morning after sufficient sleep.
Typically, the sensations a child associates with RLS are more of an urge to move their legs with a creepy, crawly, funny feeling inside the leg. These sensations are worse at night and at rest when a child is lying down trying to fall asleep – or else the pain will wake the child in the middle of the night.
These awakenings can result in a loss of sleep and daytime symptoms of drowsiness and not being refreshed in the morning. RLS in childhood has also been associated with daytime attention and behavioral difficulties.
Up to 80 – 90 percent of individuals with RLS will have associated limb movements in sleep that further fragment a child’s sleep. Up to 40 percent of parents are unaware of their child’s kicking in sleep and typically the child is seen by their doctor because of problems falling or staying asleep or not being rested in the morning.
Many children will not have RLS symptoms but will have the leg-kicking problem during sleep. This is called Periodic Limb Movement Disorder (PLMD). Symptoms of PLMD include difficulty falling and staying asleep, as well as restless sleep. Often, the child kicks and moves so much during the night that no one wants to sleep with him or her.
Some children report the urge to move or the creepy, crawly sensations when forced to sit in a confined space for any length of time, such as in a car, on an airplane, or at their desk at school.
The diagnosis of PLMD requires an overnight sleep study. With both RLS and PLMD, treatment helps with the sensations and sleep.
Treating Childhood RLS and PLMD
Children with RLS or PLMD can be treated by learning new behavioral skills and taking vitamin supplements and other medication.
For starters, sleep therapists can help families establish better, regular sleep routines so the child gets enough rest.
Also, your child’s doctor may recommend additional iron intake through diet or medication if the child’s ferritin level is below 50 mcg/L. Ordinarily, multivitamins provide enough iron, but not a sufficient amount to replace the low iron stores in children with RLS or PLMD. In that case, medications such as clonidine (Catapres), clonazepam (Klonopin), gabapentin (Neurontin) or zolpidem (Ambien) may be prescribed.
Interestingly, there is evidence suggesting that treating RLS or PLMD can also reduce or eliminate symptoms of attention deficit hyperactivity disorder (ADHD) in some children and adolescents. Stimulants used to treat ADHD do not worsen RLS or PLMD.
Dr. Jeannine L. Gingras is an expert in treating children and adults with RLS and PLMD. To schedule an appointment with Dr. Gingras in Charlotte or Concord, North Carolina, please call (704) 944-0562 or request an appointment online.