What Are Growing Pains?

Has your child's legs been in pain, especially later in the day or at bedtime, but you can't figure out the cause? Depending on their age, it could be growing pains. But what are growing pains and why do they happen?

What Are Growing Pains?

Growing pains are cramping and achy muscle pains that some preschoolers and preteens feel in both legs. Growing pains always concentrate in the muscles, rather than the joints.

"Growing pains usually begin in children between 3 and 12 years of age," said Katy Grismore, NP, pediatric nurse practitioner with Franciscan Physician Network Heartland Crossing Pediatrics in Mooresville.

What Causes Growing Pains?

Children's growth occurs at a rate that is too gradual to be considered painful, even in the teen years, according to the American Academy of Pediatrics.

"The definite cause of growing pains has not been identified," said Grismore.

Minter gives some possible causes of growing pains that include:

• Family history
• Lower pain threshold
• Foot posture
• Reduced bone strength
• Low vitamin D
• Psychological disturbances
• Overlap with restless leg syndrome
• Fatigue
• Orthopedic or postural abnormalities
• Hypermobility
• Overuse

How Are Growing Pains Diagnosed?

Growing pains are a diagnosis of exclusion, meaning that a healthcare provider should see the child and complete a complete history and physical to make sure that something more serious isn't occurring.

"In many instances the diagnosis of growing pains can be concluded by physical exam and usually doesn't require further diagnostic testing. The physical exam during and after an episode is normal," said Grismore.

"Children that have recurrent complaints of lower extremity should be evaluated by a healthcare provider. Children should have a complete history and physical."

What Are Symptoms Of Growing Pains?

Common symptoms that children and teens experience include:

• Pain occurring in the lower extremities with pain usually located in the calf, thigh, or shin
• Pain happening suddenly and at times be severe
• Pain being described by an older child as being crampy or restless leg sensation
• Pain happening during the evening or at night and may interrupt sleep, daytime complaints are unusual and rarely interrupt activity
• Pain developing after increased activity

Minter noted that there are some symptoms that should be concerning.

• Systemic symptoms (fever, weight loss, decreased activity)
• Persistent, increasing pain
• Unilateral pain
• Daytime pain
• Limping or limitation of activities
• Decreased range of motion, warmth, tenderness, swelling, or redness at the site
• Isolation of pain to the upper extremity, back, or groin

According to Kids Health, growing pains often strike in late afternoon or early evening before bed, pain can sometimes wake a sleeping child. The intensity of the pain varies from child to child, and most kids don't have the pains every day.

How Long Do Growing Pains Last?

Growing pains tend to occur in episodes.

"They typically occur at least once per week," Grismore said. "The duration of growing pains may last years and may continue into adolescence. There may be symptom-free periods between episodes."

How Are Growing Pains Treated?

Minter noted that there are ways that growing pains can be treated.

"Pain is often relieved by massage, heat, or analgesics such as acetaminophen or ibuprofen."

"Some children with growing pains are deficient in vitamin D or iron," said Grismore. "If this is the case, supplementation of vitamin D or iron can sometimes alleviate growing pains. Iron deficiency has also been indicated as a possible cause of restless leg syndrome."