What are growing pains?
‘Growing pains’ is the general term used to describe pain that children between the ages of 3 and 12 feel in their legs, primarily in the evening or at night. Most children describe the pain as aching or throbbing in their thighs or calves. Growing pains are a poorly understood condition. A robust study carried out in South Australia, published in 2004 estimated that approximately 37% of children experience these pains between the ages of 4 and 6 years old. This indicates that these pains are the most common cause of musculoskeletal pain in children.
Symptoms of growing pains in children
The symptoms include:
- Muscular aches and pains typically felt in both legs in the thighs, calves and behind the knees.
- Pain that does not improve or worsen by moving the legs.
- Pain that is mostly present in the evening or at night, often when the child is in bed.
- The pain can wake the child up from sleeping but is usually gone by morning.
- The pain is intermittent and may occur each night for a week before subsiding, a few times a week or even just occasionally.
- The pain occurs ‘randomly’ and there is no obvious trigger.
What causes ‘growing pains’ in children?
Growing pains in children have been described in medical literature since 1823, however despite this, there are not many studies that determine the cause of this pain, and previous theories have been disproven.
It was previously thought that the process of the bones growing more quickly than the muscles and tendons may have been a cause of the pain, as well as increased activity level of the child being a contributing factor. It is now known that these factors don’t seem to influence the presence of these pains.
There is not an obvious cause, and the pain begins without any trauma to the legs. It is not a sign of any damage happening to the legs.
Recent theories suggest that excess flexibility, and decreased bone strength may play a role. There may also be a genetic factor in the prevalence of growing pains.
What treatment is best for my child?
There is only one randomised controlled trial which offers evidence for the treatment of children with growing pains. This study offers the best evidence for the management with muscle stretching.
There are no robust studies to indicate the best treatment of these pains with other methods, however paracetamol and massage, as well as hot and cold packs are often used for pain management.
Consultation with a physiotherapist can be very helpful as a physiotherapist will conduct a full assessment of your child’s musculoskeletal system and biomechanics. The physio will be able to provide tailored advice on a progressive stretching programme based on their assessment of your child.
It is important to reassure your child that their pains are nothing to be concerned about and will completely resolve. Do not tell your child that their pain is related to activity as this can make them fearful of movement.
When should I seek further medical assistance for my child?
Growing pains are not a reason to be concerned about serious injury to your child. They are common and do not signify the prevalence of any damage. However, if your child’s pain is persistent and doesn’t resolve with treatment, or if your child has very intense pain, you should have your child assessed by a healthcare professional to rule out other differential diagnoses that may be more serious. Additionally, if your child presents with any swelling or fever you should seek medical attention.
Citations
Evans AM, Scutter SD: Prevalence of “growing pains” in young children. J Pediatr. 2004, 145 (2): 255-8. 10.1016/j.jpeds.2004.04.045.
Evans, A.M. Growing pains: contemporary knowledge and recommended practice. J Foot Ankle Res 1, 4 (2008). https: //doi .org/10.1186/1757-1146-1-4
Better Health Channel. (n.d.). Growing pains. State Government of Victoria. Retrieved February 3, 2025, https: //www .betterhealth.vic.gov.au/health/healthyliving/growing-pains
University of Sydney. (2016, March 30). Are growing pains real? https: //www .sydney.edu.au/news-opinion/news/2016/03/30/are-g rowing-p ains-real-.html