Q. My 12-year-old daughter has pain in legs, lower back and stomach. What could be the reason?

Hello,

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Information given by you is quite deficient. Still I will try to explain you. Some of the children in this age group has this pain. It has variable etiology. Most common cause is related to anemia (deficiency of hemoglobin in blood) and deficiency of vitamin D. Rest may have pain so-called growing pain which is a non specific pain occur in the growing child without any clear etiology. So I need more information about her growth. weight and whether she had menarche (menstrual cycle) or not and about history of any weight loss and tiredness.

Stomach pain also has varied etiology, most common is due to increased acid secretion or due to worm infestation. I need information about her dietary intake and whether it is associated with vomiting episodes and what is the severity of the pain?

For pain in legs and back, I would suggest you do complete blood count including hemoglobin and to do blood level for Vitamin D and iPTH (intact parathyroid hormone), calcium, phosphate, alkaline phosphatase. If she has low hemoglobin then, we have to start on hematinics. If she is deficient in vitamin D, then we need to supplement her by the same along with adequate sun exposure.

For control of abdominal pain do stool examination for three days to look about worms in the stool. Give her Albendazole 400 mg, and if she had burning in epigastrium then stop her morning milk and give tablet Pantoprazole 20 mg BD (twice daily). Kindly do the prescribed work up, and try to provide additional information.