Just like adults, children suffer from aches and pains in the legs too. Growing pains in children are quite common, and treatment options are available. This article describes growing pains, how this condition is diagnosed, and what can be done about it.
Growing pains refers to non-specific muscle pain (i.e. not related to a known injury or other cause) of both legs, which occurs at night time. Pain in the joints of the legs and feet are not growing pains, and need to be assessed to see if there is another problem.
Over the years, there has been some discussion as to what “growing pains” actually is and what causes it. Even if we are not exactly sure what does cause it, growing pains occur commonly enough in children to be regularly seen by Podiatrists and other health professionals. About one third of children will experience growing pains at some point.
What causes growing pains?
The exact cause of growing pains is still uncertain. There are 3 main theories at present:
- The anatomical theory, where orthopaedic or biomehanical factors such as flat feet or knock knees create increased muscle use in the legs.
- The fatigue theory, which proposes that the pain is from overuse of leg muscles in active children.
- The psychological theory, which views growing pains as part of a larger syndrome of pain and susceptability to pain, including abdominal pain and headaches, particularly migraine headaches.
Whatever the cause, there is also a family pattern to growing pains, so that children whose parents or siblings have had growing pains are much more likely to develop them. There is also concern that children whose pain is not adequately addressed are less likely to be able to cope with pain as adults, which makes it important to properly treat growing pains.
Because growing pains are non-specific, a diagnosis is usually made by excluding all the other things it might be, and if nothing else if left, then that’s what it must be. The following table summarises things that could be growing pains and things that are definitely not growing pains.
|May be Growing Pains||Not Growing Pains|
|Nature of Pain||Intermittent. Some pain free nights||Persistent or increasing|
|Which legs?||Both legs||One leg only|
|Location of Pain||Front of thigh, Calf, around knee||Joint pain|
|Timing of Pain||Late afternoon, evening||Pain still present in morning|
|Physical Examination||Normal||Swelling, redness, tenderness, stiff joints, limping|
Sometimes, further investigations or referral to a specialist may be required if it is possible that there are other reasons for the pain.
Typical features of the child with growing pains
Usually the child will complain of aching, sore legs at bed time or they may wake up during the night with the same problem. The amount of distress the child experiences may result in complaining, crying or even screaming in some cases.
The typical pattern of growing pains is that they may occur for a few nights, and then none for one to three months. Sometimes it is more common to get growing pains after a day of intense physical activity.
Many treatment options have been suggested for growing pains, but most do not have any scientific evidence to support them.
- A good first step is to get the parents to start keeping a pain diary, which charts how often child gets growing pains and how severe the pain is.
- Mild cases may be alleviated with reassurance, rubbing the legs, or perhaps a hot water bottle.
- More severe cases may be helped with medication, such as paracetamol.
- The best scientific evidence supports muscle stretching (thigh and calf stretches). Your podiatrist can provide a suitable stretching programme
- If there is an underlying biomechanical problem (for example, flat feet) that might be contributing to the problem, then this can be assessed and treated (for example with orthotics) as well.
Growing pains will eventually disappear as the child gets older.
For further reading:
The material contained in this article was adapted from The Pocket Podiatry Guide: Paediatrics by Angela Evans (Churchill Livingstone, 2010).