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Little Children and Growing Pains

By: Lourdes Nena A. Cabison-Carlos, MDLittle Children and Growing Pains

Charlie, a playful 4-year-old male, woke up in the middle of the night, complaining to mommy about ouchie legs. He promptly went back to sleep after some massaging and “sleepy time” music. The following morning, he was back to his active self, jumping and running around with no difficulty. Does the scene sound familiar to you? Painful legs are a pretty common complaint among children. If you can identify with the above scenario, here are some handy info for those achy legs.

Growing Pains

Painful legs that commonly occur at night time are often called “growing pains”. This is the most common type of episodic musculoskeletal pain that manifests in childhood. While termed “growing pains”, it’s kids from age 3-12 years who usually complain of this condition. By adolescence, most children would have outgrown growing pains. Teenagers rarely complain of this condition. 

Growing pains are usually described as follow:

  • It often appears late in the day or at night time.
  • It is often located in the shins, calves, thighs or the back of the knees. It often occurs bilaterally, meaning, both the right and the left leg are affected and joints are very rarely involved.
  • It can occur daily, every other day or once in a while. Some parents can predict when their child will have pain (on PE days, after a long stroll in the park).
  • Pain can range from intense to mild, and last from minutes to hours.

A key characteristic of growing pain is the apparent resolution of pain during the daytime. Because children are usually pain-free and active come morning, some parents might think that their child is acting out. Keep in mind that growing pains really do usually disappear in the morning, and it does not interfere with activities.

What causes growing pains

Despite the term “growing pains”, there is no evidence that links the pain to growth spurts. At present, doctors still don’t know what exactly causes growing pains. All we know for sure is that growing pains are usually benign and not associated with any serious disease and resolves on its own by late childhood. Below are some theories researchers are exploring with regards to growing pains:

  • Overuse or stress syndrome: most parents associate the occurrence of pain episodes after an activity-filled day, leading doctors to think that there might be an association between physical activity and the appearance of pain at night.
  • Low pain threshold: since growing pain is clumped under the non-inflammatory musculoskeletal syndromes, some researchers think that children with growing pains have lower pain tolerance when compared to other kids of the same age and gender.
  • Family environment: researchers are exploring the theory that pain syndromes (like growing pains, headaches and recurrent abdominal pain, for instance) in children are somatic reactions to emotional changes or disturbances in the family. Moreover, some children with growing pains have parents who have restless legs syndrome. These areas are still being studied, though.

What you can do

Given that growing pains are usually benign, they can still cause a great deal of stress and sleepless nights for both children and parents. It can, directly or indirectly, result in absenteeism for mom and child, daytime fatigue, frequent use of pain medications and can disrupt family dynamics.

Here are some tips to help make those nights more bearable:

  • Instead of being stressed about waking up, turn the occasion into a positive experience for your child. Offer your child gentle massage, sing him/her to sleep or tell a bedtime story.
  • Put a warm compress on the affected area or give your child a warm bath before bedtime.
  • Teach your child to do fun stretching exercises that he/she can do on their own.
  • If the pain is so severe, you can give your child paracetamol as a last resort (you have to check with your doctor for the proper dose and administration of ANY medicine you give your child)

Some studies suggest increasing the calcium content of your child’s diet and giving Vitamin D supplements can improve the bone status and lessen pain episodes. Others also recommend orthotics or in-shoe inserts. Check with your doctor if these can be given to your children.

When to see a doctor

As previously mentioned, growing pains are relatively harmless. Before you label your child as having growing pains, though, schedule an appointment your doctor for proper evaluation. But when your child has any of these, visit your doctor ASAP:

  • Growing pains are usually felt on both legs. If your child complains of pain in only one leg, it may be a sign of a different condition.
  • Growing pains usually affect the leg muscles, so if the joints are painful, swollen and red, visit your doctor right away.
  • If the pain does not go away in the morning and is felt throughout the day, it might be something else.
  • The presence of limping, rash and fever, whether alone or together, can also be a signal of a more serious condition.
  • If your child has had an injury or fall preceding the pain episode, it might not be growing pain at all.
  • Weakness, being tired all the time, loss of appetite and weight loss are NOT seen with growing pains so if your child has any of these, visit your doctor right away.

As with other conditions, any time you’re in doubt, consult your physician right away.

When it is something else

Painful legs can sometimes signal something more serious. One condition that can mimic growing pain is juvenile idiopathic arthritis (JIA). Yes, even kids can get arthritis. And since the symptoms of JIA wax and wane, and might not occur all at once, it might be hard to diagnose. However, growing pains, unlike JIA, do not present with joint swelling or pain (this should be your biggest red flag), and should not affect your child’s daily activities.

Another mimicker of growing pains is a bone tumor. Hence, kids who have persistent and/or severe pain should be seen and evaluated by a doctor before chalking it up as growing pain.

Few reminders

Growing pains can be a traumatic experience for a child, especially if they anticipate the coming of pain during night time. Keep in mind that every child is unique. Do not blame your child for the pain, nor compare him with other siblings. This can have a negative impact on his self-perception.

Keep an eye out for other symptoms that might indicate a more serious condition. As mentioned above, the pain might mean something more serious. Monitor the pain episodes by keeping a pain diary. Note the time of occurrence, what you did to relieve the pain, what your child did for the day, etc. This will make it easier for you to answer your doctor’s queries, and help your doctor in coming up with an accurate diagnosis. And remember that children will outgrow growing pains in time and that this, too, shall pass. As they say, growing up is painful, but your children won’t stay small forever. So enjoy every moment with your child and try to make every memory a happy one. 
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