Growing Pains

Growing pains are aching or throbbing in a child's legs, especially at night. Despite the name, growing pains are not caused by the process of growing; rather, they may be due to muscle fatigue.

Jimmy's Story

Seven-year-old Jimmy had gone to bed and fallen asleep as usual; however, a half-hour later, his dad heard him crying. When he went into the bedroom, Jimmy told him tearfully that both of his legs hurt, and he couldn't get back to sleep. Jimmy's dad gently massaged his legs until Jimmy fell asleep and slept through the night.

The next morning, Jimmy's dad called the pediatrician and told her what had happened. She asked him what Jimmy had done during the day and was told that he had played soccer for two hours and then had run all the way home from the playing field. The doctor said that it sounded like growing pains, which are very common in children and are likely due to tired muscles. She said that he should continue to massage Jimmy's legs when they throbbed or apply a heating pad. She also suggested that next time Jimmy walk home from soccer practice rather than running.

What Are Growing Pains?

Growing pains are discomfort in the front of the thighs and/or shins and sometimes behind the knees of children, especially at night. The term was first used by a French doctor in 1823, although it was later recognized that these symptoms are not necessarily associated with periods of rapid growth. Growing pains tend to peak at about age six, which is not a period of rapid growth. Furthermore, they tend to disappear during puberty * , when a quarter of total body growth occurs. Finally, there is no evidence that bone growth is painful. Nevertheless, the term “growing pains” has stuck, since attempts to impose a more accurate term, such as “noninflammatory pain syndrome of early childhood,” have failed. Although growing pains are not indications of disease, sometimes serious health problems are mistaken for simple growing pains.

The source of growing pains remains unexplained but is unlikely to have anything directly to do with growth. Some experts believe that the pains are caused by muscle fatigue from excessive physical activity. Growing pains are especially common in very active children, so muscle pain at night may be due to overuse during the day—running, jumping, and climbing that can be hard on a child's musculoskeletal system. Parents often report that their children's growing pains are worse on nights following sports practices. However, overused muscles tend to ache consistently, whereas growing pains tend to start suddenly at night.

* . Thus, it has been suggested that children with growing pains may have lower pain thresholds. However, the same researchers found that children with growing pains had lower-than-average bone density and bone quality as determined by ultrasound * . Lower bone density and quality in children are associated with physical overuse. Other researchers have suggested that growing pains may be associated with underlying anatomical differences. For example, children who are double-jointed * —which puts them at higher risk for fibromyalgia and musculoskeletal problems—are more likely to have growing pains. Children with flat (pronated) feet, which can cause muscle imbalances and fatigue, may be more prone to growing pains. It also has been suggested that growing pains are associated with restless legs syndrome * . In some cases, they appear to be associated with psychological issues, since children with emotional problems are more likely to suffer growing pains.

How Common Are Growing Pains?

Growing pains are very common in children. It is estimated that 25 to 40 percent of all children have growing pains at some point. They appear to be slightly more common in girls than in boys. Growing pains most often occur in early childhood between the ages of three and six and again between the ages of eight and twelve. They most often disappear before adolescence, although they can continue on through the teenage years. While many children never experience growing pains, and others have them occasionally, a few children suffer from them every night.

Are Growing Pains Contagious?

Growing pains are not contagious.

How Do People Know They Have Growing Pains?

Growing pains are an aching or throbbing in the front of the thighs, the calves, or back of the knees, usually in both legs. Although some children have them in the afternoon, they most often occur at night and are gone by morning. Growing pains sometimes awaken children from sleep. The pain is in the muscles, not in or around the bones or joints. The intensity of growing pains varies with the child. Growing pains are sometimes accompanied by a headache or abdominal pain.

How Do Doctors Diagnose and Treat Growing Pains?

Diagnosis

Although growing pains can hurt a lot, they are not a disease and do not require a doctor's visit, lab tests, or imaging. They can usually be diagnosed at home by their typical signs and symptoms:

Growing pains are referred to as a “diagnosis of exclusion,” meaning that sometimes other causes for the pain must be ruled out by a physical exam and medical history. One helpful diagnostic sign is that children with growing pains improve when they are held, cuddled, or massaged; in contrast, children with pain from a serious underlying condition do not like being held or manipulated because the movement increases the pain. Rarely, blood tests or x-rays are performed to rule out other conditions that could be causing leg pain, including:

Other indications that leg pain is caused by something other than growing pains include:

Treatment

Children with growing pains should be supported and assured that the pain will disappear as they grow. Treatments include:

Complications

Growing pains do not cause other problems or affect growth, and they often disappear or become less painful within months or one to two years.

Can Growing Pains Be Prevented?

There is no known prevention for growing pains. For children whose growing pains follow a predictable pattern—such as every night after gymnastics practice—prophylactic * ibuprofen or acetaminophen at bedtime may prevent the pain. A small trial found that when parents stretched their child's quadriceps * , hamstrings * , and calf muscles for 10 minutes every morning and evening, the growing pains were completely eliminated. In contrast, children whose growing pains were treated with leg rubbing and pain relievers continued to experience an average of two episodes per month. However, it is difficult to know whether this was a placebo * effect or the result of the children receiving additional parental attention in the mornings and evenings when they had no pain. Another small study found that shoe inserts reduced the frequency and severity of growing pains within three weeks; in most cases, the growing pains returned when the inserts were removed. Shoe inserts may be especially helpful for children with flat feet.

▸ See also Fibromyalgia • Pain • Reye's Syndrome

Resources

Books and Articles

Bellenir, Karen. Pain Sourcebook. 4th ed. Detroit: Omnigraphics, 2013.

Brown, Kerrie Lee. “Growing Pains.” Today's Parent 30, no. 8 (August 2013): 60.

Moyer, Melinda Wenner. “Facts and Figures of Growing Pains.” Chicago Tribune (August 21, 2013): 5.

Websites

Mayo Clinic Staff. “Growing Pains.” Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/growing-pains/basics/definition/con-20029782 (accessed April 15, 2016).

Organizations

American Academy of Pediatrics. 141 NW Point Blvd., Elk Grove Village, IL 60007-1098. Telephone: 847-434-4000. Toll-free: 800-433-9016. Fax: 847-434-8000. Website: https://www.aap.org (accessed March 25, 2016).

* puberty (PU-ber-tee) is the period during which sexual maturity is attained.

* fibromyalgia (fi-bro-my-AL-ja) is a group of disorders characterized by achy, tender, and stiff muscles.

* ultrasound is a diagnostic test in which sound waves passing through the body create images on a computer screen.

* double-jointed is having joints with exceptional range-of-motion.

* restless legs syndrome is a neurological disorder characterized by aching, burning, or creeping sensations in the legs and an urge to move the legs during sleep.

* arthritis (ar-THRY-tis) is any of several disorders characterized by joint inflammation.

* Reye's syndrome (RYES SINdrum) is a rare condition that involves inflammation of the liver and brain and is associated with aspirin use in some children.

* orthotics are supports or braces for weak or ineffective joints or muscles.

* prophylactic (pro-fih-LAK-tik) is something that is used to prevent a symptom, illness, or condition.

* quadriceps (KWAH-dri-seps) are the four-part large extensor muscles of the front of the thigh that join in a single tendon at the knee.

* hamstrings are the three muscles at the back of the thigh that flex and rotate the leg and extend the thigh.

* placebo (plah-SEE-bow) is an inactive medicine or procedure that provides relief despite having no physiological effect.

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)