by Lance W. Christiansen D.O.

Created on: December 21, 2009

Children from toddlers to the mid teens experience growing pains. They are just thought to be a nuisance experience, but older medical literature indicates a more serious cause.

Older medical literature from the late 1800's, physicians of New York Society of Medicine, for instance, and, I believe, Sir William Osler, in some of his earlier writings, indicate that growing pains are indicative of very low-level, chronic rheumatic fever.

Rheumatic fever is not understood by today's physicians, because its cause, the bacteria Streptococcus pyogenes, was just understood be be the cause of rheumatic fever in 1930 (Coburn), but as high-grade rheumatic fever became less common in the '50's and '60's doctors, more or less, to a great deal gave up thinking about it and most physicians, even pediatricians, would not recognize a case of severe rheumatic fever if it was presented to them.

Surprisingly, rheumatic fever started coming back into American society in the mid-1980's (L. George Veasey M.D.'s report of 1987) and there have been many reports since then. Other "syndromes" caused by Streptococcus pyogenes are now common in America, such as Streptococcus Toxic Shock Syndrome and Streptococcal Necrotizing Fasciitis.

Since about the late 1940's the Jones Criteria are used to diagnose rheumatic fever. That criteria only appropriate to diagnose the most high-grade cases, for Sir William Osler, in his text, Osler's Principles and Practices of Medicine, 1935, for instance, speaks of high-grade rheumatic fever, subacute rheumatic fever, and rheumatic fever less than subacute and that if a child has aches, pains or acts sick in some general way (paraphrased) consider less than subacute, chronic rheumatic fever. Growing pains are one manifestation of that problem.

In the Encyclopedia Britannica,  first edition printed in 1771, it is stated that chronic rheumatism, the sequela of a rheumatic fever ( of the high grade type) , or lesser but neglected colds. The truth is that Streptococcus pyogenes is very common in the USA and in the text, Rheumatic Fever and Streptococcal Infections (Massell, B. Harvard Press, 1997) it mentions that in various communities 5 to 70 % of people are non-symptomatic carriers! That means, that in general, infections, usually those with no symptoms, but also low grade disease just with symptoms of a low-grade respiratory disease could be just as likely caused by Strep A as by some virus. The mistaken idea that all "colds"

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