Pediatrics at HSS

What are “growing pains” and when should a parent be concerned?

What are “growing pains” and when should a parent be concerned?

We’ve all heard the term “growing pains,” but what exactly are they? Although fairly common in children, it’s difficult to pinpoint a specific cause, according to Dr. Karen Onel, Chief of Pediatric Rheumatology at HSS.

Often used to describe childhood aches and pains, the term itself is a misnomer, as "growing pains" have nothing to do with growth. “Classic ‘growing pains’ occur in small children,” says Dr. Onel, who describes a typical scenario: “A child goes to bed and wakes up an hour or so later crying because of pain in their legs. They may ask to have the area rubbed to make it feel better; eventually the child goes back to sleep. The next morning, the youngster is fine, goes to school and engages in all of their usual activities. The next night, the child goes to bed and again wakes up crying in pain.”

It can be frightening for parents and upsetting for children, especially if it goes on for a couple of weeks. Despite the disruption, growing pains are usually a normal part of childhood and generally not cause for alarm, according to Dr. Onel.

A second type of pain is also often called “growing pains.” These pains occur in older kids and are thought to come from the demands placed on an active child’s muscles throughout the day from playing a sport, running, climbing and jumping, according to Dr. Onel. This type of pain is often felt after activities or later in the day, but rarely wakes children up from sleep.

“It’s important to remember that kids are very active and some aches and pains are normal, especially if they play a lot of sports,” Dr. Onel says. “If a child is playing soccer 12 hours a week or taking ballet lessons and dancing 15 hours a week, some soreness may be expected.” If a child or teenager seems to be participating in excessive athletic activity, Dr. Onel advises parents to persuade them to listen to their bodies and take a break, especially if they start feeling aches and pains.

When is a child’s pain a sign of something more serious? Dr. Onel says parents should be on the lookout for the following symptoms:

  • Swelling
  • Stiffness, especially upon waking up
  • Redness
  • Walking with a limp
  • Persistent pain in the same location that starts to interfere with daily activities

Pain accompanied by fever, a rash or loss of appetite should prompt an immediate visit to the child’s doctor, Dr. Onel says.

A more serious problem can be misdiagnosed as growing pains, and if a child is experiencing persistent pain, it may be a good idea to see an expert. “We’ve seen children with swollen joints and morning stiffness being told they have growing pains, while they were getting progressively worse over weeks or even months,” says Dr. Onel. “The nice thing about HSS is that we have all the appropriate specialists to make the right diagnosis, whether it’s a pediatric orthopedic surgeon, a rheumatologist or a sports medicine physician.”

When the cause of discomfort is indeed “growing pains,” the good news is that they eventually go away and do not interfere with growth. In the meantime, parents can help their child feel better with gentle massage and a dose of children’s Tylenol or Motrin.