What are growing pains?

Growing pains are a form of recurring limb pain experienced by children. Despite the name, growing pains are not caused by growth. In fact, the cause of growing pains is still not known. Most often, the pain is felt in the legs, particularly in the thighs, calves and the backs of the knees.

Growing pains occur in children 3-14 years of age. [1]  In a few children, growing pains occur in later teen years as well. Estimates of the percentage of children who experience growing pains range from 2.6-49.4% [ 2] , which serves to illustrate how loose the definition of this condition can be.

1. Hashkes P.J. and Lowe R.M. (2008) Growing pains: a noninflammatory pain syndrome of early childhood. Nature Clinical Practice Rheumatology 4:542-549.

2. Goodyear-Smith F. and Arroll B. (2006) Growing pains. British Medical Journal 333:456–457.

Causes

It is not known what causes growing pains. They are not caused by growth (as was originally suggested); other periods of rapid growth, such as infancy or adolescence, are not accompanied by growing pains.

Factors that may be influencing growing pains include:

  • Overuse of limbs, which may be caused by a particularly active day of running, jumping and climbing;
  • A low pain threshold;
  • Poor posture;
  • Low bone strength, and;
  • Emotional stress.

1. Hashkes P.J. and Lowe R.M. (2008) Growing pains: a noninflammatory pain syndrome of early childhood. Nature Clinical Practice Rheumatology 4:542-549.

2. Goodyear-Smith F. and Arroll B. (2006) Growing pains. British Medical Journal 333:456–457.

Risk factors

Risk factors for growing pains include:

  • Age - children aged 4-12 years of age;
  • Flat feet, and;
  • Unusually flexible joints, also known as joint hypermobility or being 'double-jointed'.

Growing pains are more common among children who suffer from migraines.

1. Hashkes P.J. and Lowe R.M. (2008) Growing pains: a noninflammatory pain syndrome of early childhood. Nature Clinical Practice Rheumatology 4:542-549.

2. Goodyear-Smith F. and Arroll B. (2006) Growing pains. British Medical Journal 333:456–457.

Signs and symptoms

Growing pains:

  • Appear in children aged 3-14 years of age, or, less commonly, in the later teen years;
  • Usually affect the legs, particularly the thighs, calves and the backs of the knees, although they can appear in the arms, shoulders and back as well;
  • Affect both legs - the pain does not appear only in one leg at a time;
  • Are most common in the evening and at night, and are usually gone by morning;
  • Are more common after a particularly active day;
  • Do not cause limping or walking difficulties, and;
  • Are not caused or accompanied by inflammation, swelling, stiffness, fever or other symptoms.

For most children, growing pains will only come once every few days, weeks or even months. A small minority of children experience growing pains nightly.

Although growing pains can sometimes be severe, and at times alarming for children and parents, they do not cause any permanent damage, and usually do not interfere with a child's normal activities. 

Inflammation

A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.

1. Hashkes P.J. and Lowe R.M. (2008) Growing pains: a noninflammatory pain syndrome of early childhood. Nature Clinical Practice Rheumatology 4:542-549.

2. Goodyear-Smith F. and Arroll B. (2006) Growing pains. British Medical Journal 333:456–457.

Methods for diagnosis

Your doctor will diagnose growing pains by excluding other possible causes of limb pain, such as arthritis, hip dysplasia, sprains and fractures.

1. Hashkes P.J. and Lowe R.M. (2008) Growing pains: a noninflammatory pain syndrome of early childhood. Nature Clinical Practice Rheumatology 4:542-549.

2. Goodyear-Smith F. and Arroll B. (2006) Growing pains. British Medical Journal 333:456–457.

Types of treatment

There is no cure for growing pains - they eventually go away by themselves. Leg massages and applying warmth can provide some relief from the aching. Comfort and reassure your child if they are feeling anxious or frightened.

Pain-relief medications such as paracetamol or ibuprofen can be used. In severe cases, your doctor may suggest using stronger pain-relief medications. Calcium or vitamin D supplements have not been shown to relieve growing pains.

There is some evidence that physical therapy can help with growing pains, if followed regularly. Another option is to try the use of shoe inserts.

Growing pains.Growing pains are more common in the evening and usually disappear by morning. 

1. Hashkes P.J. and Lowe R.M. (2008) Growing pains: a noninflammatory pain syndrome of early childhood. Nature Clinical Practice Rheumatology 4:542-549.

2. Goodyear-Smith F. and Arroll B. (2006) Growing pains. British Medical Journal 333:456–457.

Prognosis

Growing pains usually go away on their own after a period of a few months to 1-2 years. 

1. Hashkes P.J. and Lowe R.M. (2008) Growing pains: a noninflammatory pain syndrome of early childhood. Nature Clinical Practice Rheumatology 4:542-549.

2. Goodyear-Smith F. and Arroll B. (2006) Growing pains. British Medical Journal 333:456–457.