Growing Pains

Growing pains in children

Fast Facts

  • Growing pains are the most common cause of musculoskeletal pain in children.
  • Up to 50% of children can experience growing pains.
  • “Growing pains” is a poor description because they are not associated with fast growth or a growth spurt. Benign nocturnal pain of childhood is a better name for this condition.
  • Treatment for growing pains is focused on helping the child manage pain.

Growing pains are deep cramping or aching pains that are most often in the shins, calves, thighs or back of the knees. They most commonly occur in children from ages of 3 to 14 years. The pain usually occurs late in the day or at night, and the pain can awaken children from sleep. Usually, growing pains alternate between both sides of the body. For some children, the pain happens every day, and for other children, the pain can be intermittent. The episodes of pain last for a few minutes to hours and often resolve by the next day. Usually a child’s activity is not limited.

What causes growing pains?

The exact cause of growing pains is unknown. Possible causes of growing pains include:

  • Increased activity or overuse leading to pain in the muscles.
  • Mechanical pain caused by hypermobility in the joints or flat feet.
  • Low vitamin D levels leading to decreased bone strength.
  • Psychosocial stress contributing to the development of pain.
  • Growing pains are not associated with any serious disease. There is no evidence that growing pains are actually associated with rapid growth or a growth spurt.  

How are growing pains diagnosed?

A diagnosis of growing pains is based on the characteristic symptoms. On physical exam, a child may have increased range of motion in his joints consistent with hypermobility or flat feet, but otherwise, the exam will be normal. There are no specific laboratory or imaging tests for growing pains. If your child has previously had any laboratory or imaging testing, the results will be normal in a diagnosis of growing pains. If your child has any of the following symptoms, you should talk with your doctor about evaluation for other conditions: continuous and increasing pain, pain that stays in the same location, joint stiffness in the mornings, swelling or redness over the affected areas, or limping.

How are growing pains treated?

There is no specific treatment for growing pains. Supportive treatment for growing pains is individualized and based on helping your child manage the pain. These strategies can include:

  • Comforting your child during the episodes of pain.
  • Local massage of the affected areas.
  • Over-the-counter pain medications such as acetaminophen, ibuprofen or naproxen.
  • Increasing physical activity through programs like physical therapy.
  • Physical therapy can also help with strength if your child has hypermobility.
  • Learning pain coping strategies through services like psychology or counseling.
  • Orthotics (shoe inserts) can help if your child has flat feet.

The pain episodes resolve on their own by later childhood.

Living with growing pains

It is very important for families to know that growing pains are not dangerous. Although growing pains are a benign condition, they can have an impact on the child and the family. You and your child can discuss with your rheumatology provider about the best ways to manage the pains.

Updated December 2020 by Robert W. Richardson, PT, FAPTA, and reviewed by the American College of Rheumatology Communications and Marketing Committee.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.

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