Growing pains

If your child is under 12, and otherwise healthy, look out for these signs of growing pains:

• If your child wakes up from sleep due to aching limbs, chances are he/ she is experiencing growing pains. 
• This pain mostly affects the muscles rather than joints. Typically, it affects both the legs together.
• The pain is felt as an ache or throbbing sensation in the legs, usually in the front of the thighs, the calves or behind the knees. Some children may also get headaches and abdominal pains during this period. 
• The bouts of pain begin in the afternoon or during late evening, before bedtime.

Read more: Sleeping problems in children

There is no known cause for growing pains. Some suggest that they occur due to overexertion of muscles during the day. Others have argued that they may be linked to restless leg syndrome, which is characterised by an uncontrollable urge to move the legs. A review of evidence done in 2017 showed that lowered pain threshold in children may be linked to growing pains.

Medical opinion is split on whether “growing” pains are the result of aches from jumping, running, climbing, etc., that kids indulge in during the day (supported by the fact that the pain usually starts after the child has had an athletic day).

Indeed a 2019 meta-analysis showed that researchers had looked into family history, vitamin D deficiency, electrolyte balance, the presence of melatonin hormone, lower pain threshold, vascular perfusion, foot posture, bone strength and somatosensory disorders, among other causes. None of them provided conclusive evidence, according to the analysis.

The good news is that growing pains are usually benign or harmless and you can help the child with simple home remedies like using a hot water bottle or massaging the legs—especially the calves, back of the knee and front thighs, where the pain usually is.

Growing pains are usually nothing to worry about. You could bring them up in your next visit to, or talk with, your paediatrician, of course. He/she may ask a few questions about the child's symptoms and when the pain arises, etc.

Based on the child's symptoms, the doctor may give him/her a clean bill of health or recommend a physical examination to check for allodynia (pain at a touch that should not normally cause pain), joint swelling, or decreased range of motion in the joints.

In rare cases, the doctor may order a few tests to rule out other conditions that may be causing the aches and pains. These conditions include:

• Juvenile idiopathic arthritis
• Postinfectious arthritis
• Osteomyelitis (bone infection)
• Septic arthritis
• Viral or bacterial myositis
• Abscess
• Sickle cell disease
• Deep vein thrombosis
• Osteosarcoma
• Leukaemia
• Ewing sarcoma
• Stress fracture
• Nerve injury
• Vitamin D deficiency
• Fibromyalgia
• Restless leg syndrome

It's important to remember that these conditions have nothing to do with growing pains, they are just conditions that may also present with leg pain, and for which growing pains may be a differential diagnosis.

It can be quite confusing for first-time parents when their child goes through growing pains, giving rise to feelings of helplessness. The degree of pain varies from child to child. Here are a few things that you can do to ease their discomfort: 

• Place a warm cloth or heating pad on your child’s limbs
• A warm bath might also help some children feel better
• To comfort your child, give a backrub or massage his/her legs. This may help them fall asleep faster
• Help the child stretch their limbs as they might be too young to do so on their own
• If the pain is still severe, consult your doctor about giving over the counter medication for pain relief (never give children aspirin without a doctor’s recommendation, as aspirin use has been linked to Reye’s syndrome)

While growing pains are not serious, it is important to pay attention to the symptoms your child may be showing. In case you notice the following, consult a medical practitioner instantly. 

• Swelling or redness in one particular area or joint is not a symptom of growing pains and should not be ignored. 
• If the pain is accompanied by fever, it would be wise to get the child examined by a doctor.
• If the child starts limping while walking
• Loss of appetite due to pain
• Unusual tiredness and weakness
• Aching limbs even during the day

Growing pains can be tedious for the child and the parent, both. It’s important to pay attention, even if you think that the child is lying about the aches. It is important to reassure and be supportive of the child during this period.

Growing pains is not a serious condition and is not associated with any diseases. However, parents need to be vigilant about the child’s symptoms in order to be sure that the aches are indeed growing pains.