Growing Pains: How to Detect and Relieve Them?

How to be sure it’s indeed growing pains? (Symptoms)

Firstly, know that growing pains are well-known and studied. They were first described and studied by the medical community in the 1800s.

Sometimes the pains can be very intense (like cramps, or even stronger) and your son or daughter may cry or scream a lot. It can be very distressing, and in those moments, despite knowing it exists and isn’t serious, we can be very afraid of missing something serious.

Like a tumor or cancer (I’m a parent, I know the anxiety related to our children’s problems!).

Here are the characteristics and symptoms of growing pains that will help you identify them:

• This type of pain first appeared in your child between 3 and 6 years old.
• Your child is between 3 and 12 years old (the peak age for growing pains is around 8 years old, but even teenagers or adults can be affected).
• The pain is mainly in the legs (but it can also rarely affect the arms). The pain is often located in the calf or along the shin. But it can also be localized in the ankle, knee, or foot.
• The pain is in one leg (about 20% of cases) or in both legs (much more common).
• The pain occurs only in the late afternoon, evening, or night, whereas your child had absolutely no pain during the day. For example, they could run or jump on a trampoline without any problem a few hours before.
• The pain disappears in the morning.
• The leg is not visually deformed, and the skin is not particularly hard or tense.
• The pain does not happen every night.
• Your child doesn’t have any other unexplained problems. For example, they don’t have a fever, difficulty walking during the day, unexplained pains elsewhere, weight loss, loss of appetite, fainting, skin problems, etc.
• The pain may occur every night or night (5% of children), but more often weekly (45%), or monthly (35% of children).
• Your child does not have pain following a fall or accident they had on the same day or a few days before.

Remember: even if the pain seems severe, it’s not a sign of seriousness. Growing pains can cause very significant pain without there being something more serious behind it.

Source: Lehman 2017

Other conditions that can cause nighttime leg pain in your child

Trying to determine whether your child’s leg pain is due to growing pains or something else is called differential diagnosis.

By observing your child and identifying the symptoms I described earlier, you will likely be able to say to yourself, “It’s okay, this really matches growing pains.”

But if this doesn’t reassure you and you consult a doctor, your doctor will conduct this differential diagnosis to make sure it’s not something other than growing pains.

Here are the diseases or issues that are much rarer than growing pains but can also cause leg pain.

Type of Disease / Problem	Examples of Diseases
Autoimmune / Inflammatory	Juvenile idiopathic arthritis, Post-infectious arthritis, Juvenile dermatomyositis, Transient synovitis/enthesitis (potentially related to inflammatory bowel disease)
Infectious	Osteomyelitis, Septic arthritis, Viral or bacterial myositis, Abscess
Vascular / Hematologic	Legg-Calvé-Perthes disease, Sickle cell crisis, Hemophilia, Deep vein thrombosis
Neoplastic (tumor, cancer)	Osteoid osteoma, Symptomatic osteochondroma, Osteosarcoma, Leukemia, Metastatic lesions (e.g., neuroblastoma), Ewing sarcoma
Traumatic / Structural	Fracture (broken bone), Stress fracture, Non-accidental trauma, Apophysitis, Nerve injury, Slipped capital femoral epiphysis, Joint hypermobility syndrome
Metabolic	Rhabdomyolysis, Hereditary myopathies, Vitamin D deficiency
Miscellaneous	Complex regional pain syndrome (CRPS), Fibromyalgia, Restless legs syndrome

Source : Lehman 2017

What happens in the body during growing pains? (Definition)

Are growing pains really pains “from growing”?

Doctors and research teams struggle to agree on a precise definition of growing pains that allows for a definitive diagnosis. Hence the long list of criteria I provided you with.

Here are the most common criteria used to define growing pains:

• Pain in the lower limbs
• Occurs in the evening or at night
• Occurs occasionally or regularly
• No other observed symptoms
• Pain in both legs

More than 80% of studies do not mention the age of symptom onset, and 93% do not mention growth!

Source: O’Keeffe 2022

You’ve probably told your child the following during a crisis:

“It’s because you’re growing!”

A parent trying to reassure their child 🙂

There is indeed a correlation between having growing pains and the process of growing: we experience more growing pains at an age when our bodies are growing.

But there is no causal link: we don’t suddenly grow “more” or “faster” during periods of growing pains.

Children do not grow because of these pains, but they may feel them at times when their bodies are undergoing significant growth.

Since there is no evidence linking growing pains to a particularly high growth phase, doctors have coined new terms to describe this condition (though these are not widely used) (Lehman 2017):

• Benign nocturnal limb pains of childhood
• Recurrent limb pains of childhood

It is not well understood what exactly happens in the body to trigger these pains.

Why does a child have growing pains? (Causes)

There are many hypotheses that have been made and tested to identify the precise cause of these growing pains. For example, why some children experience them often and others never do.

It is estimated that one in five to one in two children between the ages of 4 and 10 will experience growing pains at least once in their life (Lehman 2017).

However, no hypothesis or theory has been validated more than another.

Here are the most likely causes that explain these pains, although none have been truly confirmed through studies.

Increased sensitivity to pain. We are not all equal when it comes to pain. Some people react very differently to the same type of painful stimulus. This also applies to children.

It’s possible that bone structure is also different in children who experience more growing pains, and that they have lower bone density. This could simply be a genetic predisposition: some people (and families) are more affected than others, without further explanation.

The human species may have retained this characteristic in some individuals because pain could have an evolutionary advantage: it encourages children to seek attention and care from their parents, thus strengthening family bonds and offspring survival.

Psychological factors such as anxiety are also likely more common in affected children. Additionally, parents often describe that the pains are triggered when the child has been particularly active during the day.

The most common causes of growing pains are probably increased pain sensitivity, genetic predispositions, psychological factors, or different bone structure.

Source: Pavone 2019

How to relieve growing pains?

Firstly, keep in mind that an episode of growing pains does not last too long and resolves on its own, regardless of what you do.

At best, within a few minutes. At worst, within a few hours.

Here’s what a U.S. research team recently synthesized about growing pains.

There is a small randomized controlled study (36 patients total) that may show benefits from stretching the quadriceps, hamstrings, and calves.

However, for most children, simply having parents massage the painful areas, sometimes using heat, is sufficient to relieve pain.

Some patients have found over-the-counter analgesics such as ibuprofen or acetaminophen helpful. Long-acting anti-inflammatory medications such as naproxen may reduce nighttime pain when given on days of increased activity; however, there is no data to support this recommendation.

Foot orthoses are sometimes used to treat growing pains in children with rearfoot valgus, although research on this is lacking.

Lehman 2017

💡 Here’s what we personally set up for my 7-year-old son, who frequently experiences growing pains in the evening or at night for several years:

• He is allowed to sleep on a mattress at the foot of our bed when a crisis begins, and he stays there for the night.
• We put a pillow under his legs to keep them bent (he’s more comfortable this way).
• We gently massage/rub his legs as instructed.
• We talk to him calmly to reassure him, saying soothing things.
• If the crisis seems significant, we give him acetaminophen.

And what we tried but abandoned because it didn’t work:

• Taking a hot shower
• Massaging other parts of the body to relieve pain
• Trying to read him a story to distract him
• Making him walk (made it worse), making him get up.

We haven’t found anything to reduce the frequency or duration of the episodes.

It seems to occur more often when he takes a nap during the day or when he is very tired, but it’s hard to be certain.

Is there a definitive treatment for growing pains?

Well, I can assure you that I’ve thoroughly researched the topic.

Unfortunately, there is no definitive treatment to prevent growing pains.

Neither to make them less frequent nor to shorten their duration.

The only definitive treatment is the passage of time!

When should you see a doctor about growing pains?

If your child frequently complains of growing pains, you can certainly discuss the issue with their general practitioner or pediatrician at your next scheduled visit. Your doctor will likely be able to reassure you.

Is it necessary to seek urgent medical attention for issues suggestive of growing pains in the legs?

If it is indeed growing pains, the medical team you consult will not be able to do anything more for you and your child (aside from providing reassurance).

If it is another problem, you would typically have identified other symptoms. It is only in the presence of other symptoms that a medical consultation seems appropriate.

But keep in mind that growing pains are extremely common. Therefore, it is highly likely that your child has this issue rather than something more serious.

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Here’s what I wanted to tell you about this! I wish you a very good recovery! Do you have any comments or questions? Your comments are welcome 🙂 !

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 📚 SOURCES

Lehman PJ, Carl RL. Growing Pains. Sports Health. 2017 Mar-Apr;9(2):132-138. doi: 10.1177/1941738117692533. Epub 2017 Feb 8. PMID: 28177851; PMCID: PMC5349398.

Pavone V, Vescio A, Valenti F, Sapienza M, Sessa G, Testa G. Growing pains: What do we know about etiology? A systematic review. World J Orthop. 2019 Apr 18;10(4):192-205. doi: 10.5312/wjo.v10.i4.192. PMID: 31041161; PMCID: PMC6475815.

O’Keeffe M, Kamper SJ, Montgomery L, Williams A, Martiniuk A, Lucas B, Dario AB, Rathleff MS, Hestbaek L, Williams CM. Defining Growing Pains: A Scoping Review. Pediatrics. 2022 Aug 1;150(2):e2021052578. doi: 10.1542/peds.2021-052578. PMID: 35864176.