What Are Growing Pains?
Growing pains are cramping, aching muscle pains that commonly affect children between ages 3 and 12. Despite the name, these pains have nothing to do with growth spurts or growing bones. The exact cause isn't fully understood, but they're believed to result from muscle fatigue and overuse from a child's daily activities like running, jumping, and climbing.
Growing pains typically affect the legs—particularly the thighs, calves, and behind the knees—and usually occur in the late afternoon or evening, often waking children from sleep. The good news is that growing pains are harmless, don't cause any lasting damage, and children eventually outgrow them.
📌 Quick Facts: Growing pains affect about 25-40% of children. They're most common between ages 3-5 and 8-12. Girls and boys are equally affected, and they tend to run in families.
Typical Characteristics of Growing Pains
⏰ Timing
- • Occur in late afternoon or evening
- • Often wake children from sleep
- • Never present in the morning
- • Pain is gone by morning
- • Don't interfere with daytime activities
📍 Location
- • Both legs affected (bilateral)
- • Front of thighs
- • Calves
- • Behind the knees
- • Never in joints
💫 Pattern
- • Come and go (intermittent)
- • May occur nightly for periods
- • Can disappear for weeks/months
- • Often follow active days
- • Unpredictable episodes
😣 Pain Quality
- • Aching, throbbing, or cramping
- • Moderate to severe intensity
- • Deep muscle pain
- • Lasts 10-30 minutes typically
- • Can last up to 2 hours
Why Do Growing Pains Occur?
The exact cause of growing pains remains unclear, but several theories explain why they occur:
💪 Muscle Fatigue Theory (Most Accepted)
Children's muscles work hard during the day as they run, jump, climb, and play. Unlike adults who pace themselves, children go full speed until exhausted. This constant activity can lead to muscle fatigue and micro-tears in muscle fibers, causing pain that becomes noticeable when the child is at rest.
🔄 Biomechanical Stress
Some research suggests that growing pains may be related to biomechanical factors, such as flat feet or leg alignment issues, which cause muscles and tendons to stretch and become strained during activity.
🌙 Lower Pain Threshold at Night
During the day, children are distracted by activities and may not notice mild discomfort. At night, when everything is quiet and they're lying still, they become more aware of any aches or pains. Additionally, pain tolerance naturally decreases at night.
😰 Emotional Factors
Some studies suggest that growing pains may be more common in children experiencing emotional stress or anxiety, or in those with lower pain thresholds.
❌ Common Myth: Growing pains are NOT caused by bones growing. Bone growth doesn't cause pain, and these pains don't coincide with growth spurts. The term "growing pains" is actually a misnomer!
How Are Growing Pains Diagnosed?
Growing pains are diagnosed based on symptoms and by ruling out other conditions. There's no specific test for growing pains:
📋 Medical History
The doctor will ask about:
- • When the pain occurs
- • Where the pain is located
- • How long it lasts
- • What makes it better or worse
- • Child's activity level
- • Any other symptoms
👨⚕️ Physical Examination
The doctor will:
- • Examine your child's legs and joints
- • Check for swelling, redness, or warmth
- • Test range of motion
- • Observe your child walking
- • Check for tenderness
With growing pains, the physical exam is completely normal—no swelling, redness, limping, or joint problems.
🔬 Tests (Usually Not Needed)
Tests are typically not necessary for growing pains but may be ordered if symptoms are atypical:
- • X-rays: To rule out bone problems
- • Blood tests: To check for inflammation or infection
- • These are only done if the doctor suspects something other than growing pains
Treatment & Comfort Measures
Growing pains can't be prevented or cured, but you can help ease your child's discomfort:
💆 Massage
Gently massage your child's legs where they hurt:
- • Use gentle, soothing strokes
- • Apply lotion or oil for smoother massage
- • Focus on areas of pain
- • Continue for 10-15 minutes
- • Very effective for most children
🔥 Heat Application
Apply warmth to soothe aching muscles:
- • Warm heating pad (low setting)
- • Warm (not hot) bath before bed
- • Warm towel or compress
- • Apply for 15-20 minutes
- • Never use heat while sleeping
🧘 Stretching
Gentle stretching may help prevent or ease pain:
- • Stretch leg muscles before bed
- • Hamstring stretches
- • Calf stretches
- • Quadriceps stretches
- • Hold each stretch 20-30 seconds
💊 Pain Medication
For moderate to severe pain:
- • Acetaminophen (Tylenol)
- • Ibuprofen (Advil, Motrin)
- • Use appropriate dose for age/weight
- • Give before bedtime if predictable
- • Not needed every night
🤗 Comfort & Reassurance
Emotional support is important:
- • Stay with your child
- • Reassure them it will pass
- • Distraction (stories, songs)
- • Physical comfort (cuddles)
- • Validate their feelings
🛏️ Sleep Environment
Create a comfortable sleep space:
- • Comfortable mattress
- • Warm blankets
- • Pillow under knees if helpful
- • Calming bedtime routine
- • Adequate sleep duration
⚠️ When to Call the Doctor
Contact your healthcare provider if your child experiences:
• Pain that persists through the day
• Pain in the morning or when waking
• Swelling, redness, or warmth in any area
• Limping or difficulty walking
• Pain in joints (knees, ankles, hips)
• Pain in only one leg (not both)
• Fever accompanying the pain
• Rash or bruising
• Loss of appetite or weight loss
• Pain doesn't respond to comfort measures
• Pain interferes with daily activities
• Unusual fatigue or weakness
Important: These symptoms may indicate a condition other than growing pains that requires medical evaluation, such as juvenile arthritis, infection, or other issues.
What Growing Pains Are NOT
Understanding what growing pains don't include helps differentiate them from other conditions:
❌ Not Associated With:
- • Visible swelling
- • Redness or warmth
- • Limping
- • Joint problems
- • Morning stiffness
- • Fever
- • Weight loss
- • Daytime pain
❌ Not Located In:
- • Joints (knees, ankles, hips)
- • Bones
- • Feet
- • Arms (rarely)
- • Back
- • One leg only
- • Front of shins
- • Over specific bones
Prevention Tips
While you can't completely prevent growing pains, these strategies may reduce their frequency and severity:
🏃 Activity Management
- • Encourage regular breaks during intense play
- • Avoid sudden increases in activity level
- • Ensure proper warm-up before sports
- • Cool down and stretch after activities
- • Balance active play with quiet time
👟 Proper Footwear
- • Well-fitting, supportive shoes
- • Replace worn-out shoes regularly
- • Consider orthotics if recommended
- • Avoid shoes that are too tight
- • Athletic shoes for sports activities
🧘 Regular Stretching
- • Daily leg stretches, especially before bed
- • Focus on hamstrings, calves, and quadriceps
- • Make stretching part of bedtime routine
- • Hold stretches for 20-30 seconds
- • Never force or bounce during stretches
💧 Hydration & Nutrition
- • Ensure adequate water intake
- • Balanced diet with enough calcium
- • Sufficient vitamin D
- • Magnesium-rich foods (may help muscle function)
- • Don't skip meals
😴 Adequate Sleep
- • Age-appropriate sleep duration
- • Consistent bedtime routine
- • Calm, relaxing pre-bed activities
- • Comfortable sleep environment
- • Avoid overstimulation before bed
What to Expect: Prognosis & Outlook
✅ Completely Harmless
Growing pains don't cause any lasting damage to bones, muscles, or joints. They don't lead to other health problems and don't indicate any underlying disease.
⏰ Natural Resolution
Most children outgrow growing pains by age 12, though some may experience them into their teen years. The frequency and intensity typically decrease over time.
🏃 No Activity Restrictions
Children with growing pains can participate in all normal activities, sports, and physical education. The pains shouldn't limit what your child can do during the day.
📊 Intermittent Nature
Growing pains come and go. Your child may have pain for several nights in a row, then be pain-free for weeks or months. This unpredictable pattern is completely normal.
Frequently Asked Questions
Q: Are growing pains real or just seeking attention?
Growing pains are very real! Children experiencing them are genuinely in pain and need comfort and support. These pains are not imagined, exaggerated, or attention-seeking behavior. The pain can be quite severe and distressing for children.
Q: Should I wake my child to give pain medication?
If your child wakes up in pain, you can give pain medication at that time. However, don't wake a sleeping child to give medication "just in case." If your child has predictable nightly pains, you might give medication before bedtime preventively, but this isn't necessary every night.
Q: Could the pain be from my child's growth spurt?
No. Despite the name, growing pains have nothing to do with growth spurts or bone growth. Bones grow slowly and steadily, which doesn't cause pain. The term "growing pains" is a misnomer that has stuck historically.
Q: Can children have growing pains in their arms?
While rare, some children do experience similar pains in their arms. However, typical growing pains affect the legs. If your child has arm pain, especially if it's frequent or severe, it's worth discussing with your doctor to rule out other causes.
Q: When will my child outgrow these pains?
Most children outgrow growing pains by late childhood or early adolescence (around age 12). However, the timeline varies—some children may stop having them earlier, while others may experience them into their teen years. The good news is that they always eventually resolve.
⚠️ Medical Disclaimer
This article provides general information about growing pains and is not intended to replace professional medical advice, diagnosis, or treatment. If your child's symptoms don't match the typical pattern of growing pains, or if you have any concerns, consult with your pediatrician. Some symptoms that seem like growing pains may indicate other conditions that require medical attention.