Growing pains are harmless, self-resolving extremity pains that often wake children from sleep. Despite their name, growing pains are not actually caused by growth and they do not affect a child’s growth. Their actual cause remains unknown. These pains most commonly affect preschool and school-aged children and occur slightly more frequently in girls than in boys. It is important for doctors to distinguish these pains from other pain that may deserve further investigation.

Symptoms

Growing pains usually begin between the ages of two and 12. They occur primarily in the lower extremities (especially the calves and thighs), and are frequently described as being deep and crampy. The pain occurs in episodes – typically in the evening – and may frequently wake the child up from sleep. These pains generally resolve quickly, and in the morning children are fine and able to resume their normal activity. Children with growing pains show no visible signs of illness or injury, and they do not have fevers, rashes, weight loss, joint swelling or limping. Any child exhibiting any of these symptoms should be evaluated promptly by a doctor to determine whether there is another cause of the pain.

Diagnosis

Typically, with a thorough medical history and physical exam, a doctor can make the diagnosis of growing pains without performing imaging studies or laboratory tests. If such tests are performed, however, they will return normal results. In children who have more concerning symptoms such as fever, weight loss, worsening pain during the daytime, limp or the inability to participate in typical activities, further evaluation is necessary to look for other possible conditions. Further testing is also important for those who display other concerning signs during the  physical examination, such as joint swelling or limited range of motion.

Treatment

Acute periods of pain can often be relieved with heat packs, massage and over-the-counter pain medications such as ibuprofen or acetaminophen. Muscle strengthening exercises may be helpful for more chronic pain, although this has not been well studied. Above all, the pain should not be allowed to disrupt a child’s normal daytime activities. Stopping daytime activities will not help prevent further episodes of growing pains and may actually make pain worse.

Learn more in the article, What Are Growing Pains?, featured in the HSS Pediatric Newsletter.