DEAR READER: Osgood-Schlatter (OS) causes a painful lump below the kneecap (where the tendon attaches to the shinbone) in some children. It results from growth spurts during puberty and typically occurs in children who participate in sports that involve jumping, running and swift changes in direction.

OS was more common in boys in the past, but as more girls become active in sports, this gap is narrowing. It affects about one in five adolescent athletes. Because puberty occurs at different ages between genders, OS commonly affects girls around age 11 or 12 and boys around age 13 or 14.

Symptoms of OS include tightness of the muscles around the knee, especially the thigh muscles; pain, swelling and/or tenderness of the uppermost portion of the shinbone, just below the kneecap; and knee pain that worsens with activity and improves with rest.

The cause of OS is repeated stress. Children have growth plates at the ends of bones, which are made of cartilage. These growth plates are not as strong as bone, and recurrent stress can cause injury. When the tendon that holds the kneecap in place is pulled constantly, it can begin to separate from the bone. In some cases, the body may try to bridge the gap by building more bone, causing a tender lump.

Osgood-Schlatter typically improves without treatment and disappears once the bones stop growing. In the meantime, if the swelling and pain become truly bothersome, over-the-counter anti-inflammatory medications or pain relievers may be used. Rest is also important to prevent further injury. In some cases, this may include wrapping the knee or discontinuing or reducing the offending activity. In some instances, physical therapy or strengthening exercises may be beneficial.

Home treatments include stretching, ice, rest and even switching to different activities that don’t involve running or jumping until symptoms resolve.

As a parent, it can be frustrating because you don’t know how to help. This was our solution, and it worked for our kids. Hopefully, it will help some of your readers as well.

DEAR DR. GOTT: I read your column about growing pains. I also suffered from these as a young boy. My mother took me to many doctors and was always told that it was growing pains. During my teen years, I had many joints that clicked and made noise. I have been suffering from arthritis for many years now.

The boy in the letter needs to be tested for juvenile arthritis, as I now believe that is what I had.

DEAR DR. GOTT: I am writing in response to your column on childhood growing pains. I was told for years that my daughter had growing pains when in fact she had a genetic condition known as Ehlers-Danlos syndrome. Her pediatrician recognized her combination of symptoms and sent her to a geneticist. It is a condition that should be considered.

DEAR READERS: I have chosen to print all your letters together as they offer insight into the many causes and “treatments” of growing pains and childhood joint pain.

Most childhood growing pains are benign and are no cause for concern. However, if the pain is severe, persistent or lasts or returns over several weeks, further investigation is necessary.

Juvenile arthritis is a definite cause of joint pain in children. According to the Arthritis Foundation (www.arthritis.org), it is one of the most common childhood disorders, affecting nearly 300,000 children under the age of 18. There are also several types, the most common of which are the juvenile-rheumatoid-arthritis groups. Symptoms may include joint pain, fever, joint swelling and/or redness, rash and others depending on the specific variety.

Ehlers-Danlos syndrome is an uncommon group of disorders that affects the connective tissues (joints, skin and blood-vessel walls). It is inherited, meaning it is passed from parent to child. Those affected have a 50/50 chance of passing the condition on to their offspring.

I urge all parents first to try home remedies such as heating pads, ice and over-the-counter children’s pain medications, such as acetaminophen or ibuprofen. I have even had parents write in to tell me that the soap-under-the-sheets has worked to alleviate leg and calf pain in children, some without their knowing the soap is even in their beds. If these conservative steps do not help, make an appointment with a pediatrician for examination, testing and treatment if necessary. If symptoms continue to be troublesome, perhaps a referral to an orthopedist or other specialist might be in order.

Anyone who would like further information about arthritis and pain in general can order one or both of my Health Reports “Managing Chronic Pain” and “Understanding Osteoarthritis.” Requests must include a self-addressed stamped No. 10 envelope and a $2 check or money order for each report and should be mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s). Readers may also wish to print an order form off my website at www.AskDrGottMD.com.

DEAR READER: Yes, it is, sort of. Up to 40 percent of children experience “growing pains” during two periods — from the ages of 3 to 5 and 8 to 12. There is no evidence to substantiate that bone growth causes pain. What is experienced is likely caused by activities such as running, jumping, climbing on a jungle gym, and being extremely active during the day. Most of the pain is concentrated in muscles behind the knees, in the calves and on the front portion of the thighs. It is often severe enough to awaken a child in the middle of the night, leaving a parent unsure of what to do.

When any unusual symptom such as fever, fatigue, rash, loss of appetite or weakness occurs, a pediatrician should be involved. There may be something going on that truly needs to be addressed. In the case of a serious medical condition, a child will prefer not to be touched, because movement commonly increases pain; however, if the child has growing pains, massage, stretching, the use of a heating pad and general comforting techniques will be welcomed.

Keep in mind that your grandson can awaken refreshed and free of pain. This does not imply he is seeking attention or faking an illness. It’s simply the way the condition presents.