Growing pains

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.

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.

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.

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.

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 acetaminophen 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.

Prognosis

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

References

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.
3. Goodyear-Smith F. & Arroll B. (2006). Growing pains. BMJ: British Medical Journal 333: 456457.
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5. Growing pains. (-b). Better Health Channel. Accessed 23 September 2014 from link here
6. Harel L. (2010). Growing pains: myth or reality. Pediatric endocrinology reviews: PER 8: 7678.
7. Hashkes P.J. & Lowe R.M. (2008). Growing pains: a noninflammatory pain syndrome of early childhood. Nature Clinical Practice Rheumatology 4: 542+.
8. Leung A.K.C. & Robson W.L.M. (1991). Growing Pains. Canadian Family Physician 37: 14631467.
9. Moyer M.W. (2013 August 2). Are Growing Pains Real? Slate. Accessed from link here
10. Pavone V. Lionetti E. Gargano V. et al. (2011). Growing pains: a study of 30 cases and a review of the literature. Journal of Pediatric Orthopedics 31: 606609.
11. Peake S.T. Mason J.C. Mittal T. et al. (2008). Growing painsand a heart attack. The Lancet 372: 600.
12. Uziel Y. & Hashkes P.J. (2008). [Growing pains in children]. Harefuah 147: 809811 836.
13. Wong M.W. Williamson B.D. Qiu W. et al. (2014). Growing pains and periodic limb movements of sleep in children. Journal of Paediatrics and Child Health 50: 455460.

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