Believe DD About Pain? Or Look for Other Cause?

[VisionaryMom]

About 6 weeks ago, DD began complaining randomly that her knee hurt. Ten days ago, DH finally took her to the doctor because she was saying it more & more. We had a knee x-ray done, and it's fine. Today we went for the follow-up, and our PA started moving DD's legs around in various ways. She said that pressing on her hip hurt and that when the PA moved her leg side-to-side, it hurt. So we had a blood count done (because of lots of bruising - though I think those are just from playing) and a pelvic x-ray.

The thing is that I'm not entirely sure it really hurts. DD is 3. There is no pattern that we can discern - i.e. it's not just after lots of walking. She seems to complain randomly. At the same time, she flinched at a couple of the pain spots, which is about the most you'll ever get out of her if she's in pain.

How do you differentiate real and "pretend" pain? It does not mesh with DD's personality to make up something like this, but at the same time, it seems very odd.

[mumkimum]

I've had moments like that too with our dd - unsure how seriously to be taking what she says about whatever hurts. Overall - I do tend to trust her and take her discomfort seriously.

For us here's how I think of it for dd1 - she can tend to be crazy active and will end up with strange (and obvious on her fair skin) bruises, stuff like that. Sometimes, I tend to think she might've done something strange and pulled a muscle and just encourage her to try a warm bath with some epsom salt and get extra rest, might offer a massage or we'll warm up a grain bag for the spot that hurts. Often that seems to help. She might have not really 'been hurt' but a little extra attention that also encourages her to do something quietly isn't that bad to work in here (where it's normally all wild and crazy).

Once she had (obviously) been hurt badly enough she was limping around a few days (from ice skating lessons). There wasn't anything I could see, but we did the above stuff and it improved over a week. She was compensating a lot for wherever she'd gotten injured - trying to pay attention to that might be a good clue to whether she is hurt for real (has her walk changed, has she been jumping differently, whatever).

I think that her age (now 4 here) is also around the time she's starting to get more serious growth spurts, so sometimes that might be her issue - I do think this sort of thing tends to concentrate in joints (like knees). I haven't really looked into what helps out with that, but tend to encourage the above (resting, baths, warmness) and make sure she's eating well.
I'll add that, personally, after having dd2 my knees were killing me and I found out later that often, after having a baby who was posterior, your hips may get stretched and your body needs to learn to walk differently to compensate for the extra wideness. Growth spurts for kids are probably very much the same - bones get longer and they suddenly have to compensate for that and it really does feel uncomfortable (again, not sure what *to do* about that sort of thing - but that another pretty likely thing that could be going on for your dd).

[grumpybear]

DS would occasionally complain of aching and I just always assume that it's a growth spurt.

[GuildJenn]

I can't say for knees but my son was complaining about a tummy ache on and off for about a month and it seemed really random. We had him into the doctor twice and were starting to investigate allergies.

Then he ended up with an emergency appendectomy.

He also has had a lot of growing pains this year. We upped his potassium (bananas) and calcium and started a gentle stretching routine all of which seems to have helped. It was pretty clear there was cramping and it was at night, which is pretty classic.

So...we pretty much err on the side of caution, which it sounds like you're doing. I'd ask the doctor about soft tissue issues and then if nothing shows up, keep a log and go in again in a few weeks. You could try better shoes if she's been wearing ones without a lot of support.

From what you've described it sounds real to me - it's not coming up just when she has chores, she's clear where the pain is, she said it hurt in the situation it probably would, and she's been clear when it's been worse.

[meemee]

it took me a long time to realise dd had two reasons for stomach ache. milk allergy and anxiety. it was confusing because she could feel better with a snap of the finger. so i thought it was pretend. but as i started watching the patterns i started realising the moment the cause of anxiety was gone, her pain was gone too.

dd got growing pains too. mostly during the night though.

the way i look at it, is if the pain is consistent. if she keeps on complaining on and off persistently i would tend to believe her. i honestly think looking back that dd never ever pretended over pain. walking like an old person or anything else, but not pain at 3.

[VisionaryMom]

Okay, I feel better that we're doing the right thing. Jenn, as for soft tissue issues, that was our PA's first thought - that she'd stretched her hamstring too much and being 3, never stopped to rest. I think it still could be that, but we'll see.

I'm also going to try some warming bags, especially at night, to see if that eases up the pain a bit.

[sapphire_chan]

Get a massage therapist who knows about trigger points. There are a bunch of muscles that can get points of tension and cause pain in the knee. Many of them are no where near the knee. They can swell up to cause pain from the stupidest little thing like stepping wrong when walking.

[pianojazzgirl]

I'd suggest a masso-kineo-therapist (good luck finding one!) or a chiropractor or osteopath. No harm in getting her checked out by someone who specializes in the workings of the human body. Even if she isn't really feeling pain, getting her alignment checked out can't hurt, yk?

[Learning_Mum]

I think you're definitely doing the right thing. DS1 isn't really one to make up pain and the few times he's complained about something odd it's usually something. Does that make sense? Sorry, sleep deprived!

[ollyoxenfree]

If she is consistently reporting pain and your PA can't sort it out, I'd seek out a specialist in musculoskeletal systems - a physical therapist, orthopedist, or osteopath - for an opinion.

Most family physicians and general pediatricians have only an overview in orthopedics. They won't be able to figure out the puzzling problems, particularly in a child who may have limited verbal skills or who hasn't really been paying attention to when her pain is aggravated/relieved, and thus can't provide an accurate picture of what she's experiencing.

[Norasmomma]

My DD(and my sisters, my dad and myself) all suffered from serious growing pains in our knees. DD will complain randomly and has since right about age 3 or so, it's so bad she wakes up crying, I did too as a child. I use ibuprofen and Tiger balm or something similar to help with the pain.

My DD has a high pain threshold, so I believe her when it happens, she doesn't just randomly say things hurt.

[happysmileylady]

To kinda come at it from the other side...

My nephew just turned 4 and a little bit ago, he woke up early one morning, crying and saying his leg hurt. He refused to unbend it (at the knee) and actually crawled into the living room. My sister figured he had slept funny on it and that it had fallen asleep, so she babied him a little, brought him breakfast etc, and figured he would be fine in a little bit.

Well, he basically spent all day on the couch, crawled everywhere, refused to unbend his leg, wouldn't even let my sister look at it. All day, and then the next day too. She managed to get him in to the doc on the third day, doc couldn't find anything, my nephew still refused to unbend his knee. An X-ray was considered, but by this point, my sister was pretty sure that there wasn't actually anything wrong and they have a high deductable policy which would have meant X-ray was out of pocket and they didn't have the money.

So she sat him down, talked to him, essentially forced him to unbend his leg and looked, there was nothing there. After a good hour of discussion, she finally got the story out of him.

My BIL's family is full of cops. So there's lots of discussion of shooting and guns and stuff. Nothing graphic or apparently inappropriate, but of course nephew is exposed to the real life idea of shooting and guns. And, the reason he had woken up that morning early and crying was because he had a dream that some bad guys were chasing him and that they had shot him in the knee. He woke up 100% convinced that he had been shot in the knee and that if he unbent his knee, he would start bleeding. Once he saw there was nothing wrong with his knee and had talked about it some with his mom, he realized he was fine, and went on his way. I am pretty sure he's forgotten about the whole thing already.

Now, not saying your child had a bad dream about getting hurt...just that she could 100% believe she is hurt, and still not really be hurt.

[VisionaryMom]

HSL, DS did something similar once. We actually got all the way to the ER when he jumped out of the car because he wanted to see the trauma helicopter up close before I realized he was faking.

As I said, DD doesn't really have the personality type to make up pain, but I'm not sure if it's maybe something else.

We are going to watch & journal for 4 weeks. Then our PA will send us to an orthopedist if it still seems to be a problem.

I'm also going to look for someone who will do a therapeutic massage on a 3YO.

[GuildJenn]

Originally Posted by VisionaryMom

HSL, DS did something similar once. We actually got all the way to the ER when he jumped out of the car because he wanted to see the trauma helicopter up close before I realized he was faking.

As I said, DD doesn't really have the personality type to make up pain, but I'm not sure if it's maybe something else.

We are going to watch & journal for 4 weeks. Then our PA will send us to an orthopedist if it still seems to be a problem.

I'm also going to look for someone who will do a therapeutic massage on a 3YO.

I think that sounds really reasonable and I hope it clears up - the stretched hamstring sounds very plausible.

[rightkindofme]

I'm not particularly going to give you advice on treatment, because I agree with what the other ladies are saying. I will gently tell you that my mother never believed me when I was in pain and to this day I have a very hard time going to the doctor or asking for help. My mom was really extreme (I had a broken arm and she screamed at me that I was a liar and I had to beg to go to the hospital) but I also have severe stomach issues because I have overactive stomach acid and it's caused irreversible damage because it went untreated throughout my childhood.

Because as a random person on the internet I see the slightest inkling that your kid might have 1/1000 of my experience I caution you about doubting your kid's pain.

[VisionaryMom]

Originally Posted by rightkindofme

I'm not particularly going to give you advice on treatment, because I agree with what the other ladies are saying. I will gently tell you that my mother never believed me when I was in pain and to this day I have a very hard time going to the doctor or asking for help. My mom was really extreme (I had a broken arm and she screamed at me that I was a liar and I had to beg to go to the hospital) but I also have severe stomach issues because I have overactive stomach acid and it's caused irreversible damage because it went untreated throughout my childhood.

Because as a random person on the internet I see the slightest inkling that your kid might have 1/1000 of my experience I caution you about doubting your kid's pain.

I'm sorry that you've had that experience. My MIL is actually much this way. My husband & one of his siblings both had major health problems that went untreated in childhood because it wasn't "a big deal," according to MIL. DH is, I believe because of this, actually less inclined to believe DD. He was taught, and still largely believes, that pain is mostly psychological. In an interesting twist, *my* mother has Munchausen by proxy, and my sister & I were RUSHED to the ER all.the.time for nothing. So basically we suck at determining the extent and reality of illness, and having a son who will fake pain makes it more complicated.

[tallulahma]

i would take her to the chiro.

i would always believe the child- an xray wouldnt tell you if something was misaligned somewhere else.

[ChristyMarie]

Just another thought...could it be her shoes? I have knee issues and while I've had to do a PT a few different times, one thing that helped was wearing the proper shoes.

If she ends up going the PT route it might be something to disucss.

Good luck, I really hope you can figure out what is causing the discomfort. Knee pain is no fun and mine will come and go - even during a flare up I will have some times that are more comfortable than others.


***interesting side note on faking it...my son once faked a foot injury. First thing in the morning, couldn't get out of bed, couldn't walk, etc etc etc. I assumed he has slept on it weird and it would work itself out and I let him stay in bed for a bit that morning. Finally figured it out (after the 3rd day) - he wanted to stay in bed and watch tv instead of having to go downstairs to watch tv.

[rightkindofme]

Originally Posted by VisionaryMom

I'm sorry that you've had that experience. My MIL is actually much this way. My husband & one of his siblings both had major health problems that went untreated in childhood because it wasn't "a big deal," according to MIL. DH is, I believe because of this, actually less inclined to believe DD. He was taught, and still largely believes, that pain is mostly psychological. In an interesting twist, *my* mother has Munchausen by proxy, and my sister & I were RUSHED to the ER all.the.time for nothing. So basically we suck at determining the extent and reality of illness, and having a son who will fake pain makes it more complicated.

Oof. That is really complicated. I hope that you and your husband find a way to balance one another find a happy medium.

[Phoenix~Mama]

Another perspective from someone who's parents never really beleived me when I would complain of pain. I've ALWAYS had pain in my legs... and they always wrote it off as growing pains.

Until late middle school/early high school I was having so much pain and trouble bending my knees, they finally took me to get some tests done. They came back inconclusive (and thus started my frustrating years on the road to diagnosis of fibromylagia), and the doc just put me on some pain meds anyway. We love our band aids in this society.

Anyway... like I said, years later I finally did get a diagnosis of having fibromyalgia, and I'm pretty sure I have had this most, if not all, of my life. It's pretty hard to diagnose in children.

I'm not saying your DD has fibro... but I guess my point is... never just write off when a child is telling you they are in pain. And if tests come back negative or not showing anything... that doesn't mean they are lying either and they could legitmately be in a lot of pain.

I can tell you it would have meant the world to me if my parents would have beleived me and kept pushing the docs to figure it out.

I saw some PP's mention chiropractor or accupressure or something... I agree that both of these could help.