Growing pains

Growing pains are real but essentially harmless muscular pain that can affect children between the ages of three and five years, and from eight to 11 years. Boys and girls are equally affected.

Some young people may continue to experience growing pains into their early adolescence or teenage years. Pain may be experienced in the legs – often the calf, front of thigh or behind the knees – and is often worse in the afternoon or evening. Sometimes, the pain can wake a child from their sleep. The cause is not known.

Even though the child can be in a lot of pain, no damage is happening to the child's bones or muscles, and growing pains can respond to simple treatments.

Symptoms of growing pains

The symptoms of growing pains include:

• Muscular aches and pains are felt in both legs – typically in the calf, behind the knee and in the front of the thigh.
• Moving the legs does not make the pain better or worse, which shows that the joints are not affected.
• The pain comes and goes, occurring perhaps every night for a week or so, or a few times a week, or only occasionally.
• The onset of pain is around the late afternoon or evening.
• The pain is worse during the night, particularly when the child is supposed to be going to sleep.
• The pain may be severe enough to wake the child from sleep.
• The pain is gone by morning.
• The pain doesn't cause a limp or make it hard to run and play normally.
• Occasionally, the muscles of the arms may be affected as well.
• The child may also complain of headaches.

Causes of growing pains

The cause of growing pains is unclear. It is often mistakenly thought that the pain is caused by the growth of bones. Yet bones grow slowly, even during growth spurts, and this slow growth does not cause pain.

Some children have growing pains on and off for many years, but usually they go by mid-adolescence. For some children, there is more pain after they have been doing a lot of running and playing, but not all children have this pattern of play then pain.

The pain may be due to:

• Muscular tiredness – more physical activity than usual can be linked to more aching muscles for some children, although all children have some days when they do a lot more things than other days and most do not get pain.
• Poor posture – standing, sitting or walking awkwardly puts greater than usual strain on the supporting muscles of the body. Sometimes, children whose feet roll in (with very flat feet) may have more trouble with pains than other children.
• Emotional upset – stress or unhappiness may trigger aches and pains, but this is not often the case for many children who have pain.

Growing pains do not affect how a child walks and runs and they do not make a child unwell. If your child is limping, is complaining of pain during the day, is unwell or if the leg is sore to touch, you need to get your child checked by a doctor. They may have an infection or an injury.

Diagnosis of growing pains

Growing pains are diagnosed by ruling out all other causes of leg pain. Other health problems that can cause pain in the legs include:

• arthritis – which damages joints
• infections (such as osteomyelitis) and some virus infections (such as Ross River virus)
• problems that affect how the muscles work together – such as knock knees and very flat feet.

Always see your doctor if your child:

• has severe pain or pain that only affects one leg (or arm), or if the pain is still there during the day
• is unwell or has a fever, loss of appetite or rashes
• has swelling, reddening or tenderness of the leg or arm
• is limping.

Treatment for growing pains

Always see your doctor to make sure that there is no other cause of pain. Things that may help your child manage the pain include:

• plenty of cuddles and reassurance that the pain will go away and that their legs will feel normal by morning
• massaging the painful area using special massage oils (this is not necessary to easing the pain, but may help your child feel special)
• heat treatment, such as warm baths and heat packs
• medicines that reduce pain, such as paracetamol (check the bottle to make sure that you give the right dose)
• if your child has feet that roll in or if they trip a lot, ask a podiatrist to check their legs and posture
• don't tell the child that the pain is associated with playing or growing, or else the child may feel afraid of both.

Where to get help

• Your doctor
• Pharmacist
• Maternal and child health nurse
• Paediatrician

Things to remember

• Many children have pains in their legs without any obvious cause and these are often called growing pains.
• Even though the child can be in a lot of pain, no damage is happening to the child's bones or muscles, and growing pains can respond to simple treatments.
• Most children who do lots of exercise don't get pain, and many children with pain have not been doing more exercise than usual.
• Always see your doctor to make sure that there is no other cause of pain.