Growing Up is a Pain

Growing pains in children are enigmatic but may be much more common than previously thought.

According to recent research growing pains may occur in one third of children aged 4-6 years old. They may be slightly more often seen in girls than boys and are a common reason why young children are brought to their GP.

Growing pains are seen in children up to 12 years of age, but then they tend to go away and as yet don’t seem to be associated with any particular condition or disease.

The reason why growing pains occur is unknown and as you might expect growth has been implicated as a cause. There is, however, no conclusive evidence growth causes pain and it likely to be a misnomer calling them growing pains.

Some experts feel that growth occurs too slowly to cause any pain and mostly occurs in teenage years during puberty when growing pains tend to stop.

Growth does however occur in spurts, and may be faster at night and when we are lying down, as evidenced by research done in lambs, so it may still be involved in growing pains in some way. But growing pains do not effect the rate of growth, they don’t appear during rapid growth periods and don’t occur at sites of rapid growth.

Bone growth is unlikely to be the cause of growing pain, as it is very slow. Reduced bone strength has been shown in some individuals with growing pains and this may reflect local overuse and add credence to the view that periods of overactivity in for example sports are a trigger for bouts of growing pain.

Pain tends to be concentrated in the muscles. The muscles of the legs are the most common involvement, but growing pain can also occur in the arms when the legs are affected. The pain is usually in both legs and the front of the calves, thighs and behind the knees can be sore. There is no usually no inflammation or joint involvement and if present these need to be checked out to exclude arthritis or infection.

Onset of the pain is usually around bedtime and it doesn’t happen every night. The pains come and go and they can occur three or four nights in a row and then not at all for months. Other recurrent pains such as headache and pains in the tummy may be more common in kids who get growing pains.

The intensity of pain suffered is variable from mild pain to pain leading to complaint to pain that causes distress and crying.

Gentle massage and giving OTC pain relievers, such as paracetomol or ibuprofen, can help alleviate symptoms of pain. Stretching the affected muscle also provides relief and one study suggests it may target the cause of growing pain.

Pain in one leg or that lasts throughout the day or if the legs are inflamed may have a more sinister cause and will require further investigation.

There is evidence that 70% of those who have growing pain also have a sibling who suffered from growing pain or one of their parents had it when they were a child.

Height, foot posture, and greater than normal levels of activity were not identified as causes of the growing pain, but those who suffered from growing pain seemed to be 5% more obese than the norm.

Parents did associate growing pain symptoms with increased activity and sports in 50% of cases, rapid growth in 36% of cases and flat feet in about 7%.

Various other theories as to why growing pains occur have been mooted as causative, but have been largely discounted or remain unproven.2 These include associations with restless leg syndrome, foot posture, emotional disturbance, lower pain thresholds, vascular perfusion disorders and even lead poisoning.

Growing pain should not be dismissed nor trivialised, as they are real and steps should be taken to alleviate the suffering of those kids who get it.

Some general features of growing pains

  • Bilateral pain in muscles of both legs and may also be in arms
  • No pain in joints or inflammation
  • No sign of trauma
  • No limping
  • Pain starts around bedtime or just after they fall asleep
  • Pain has disappeared in the morning
  • Child is otherwise well
  • Pain may be linked to a lot of running around and jumping
  • Parents or siblings also had/have it

Recommended management

  • Stretches of leg muscles
  • Gentle massaging and cuddles
  • Hot water bottle on affected areas
  • OTC medications, such as paracetomol or ibuprofen.
  • Reassurance that it is not a bad thing and that it will go away

One Response to “Growing Up is a Pain”

  1. I remember having pain in my knees and lower legs when growing up and the doctor just said “Its growing pains” with no explanation! This is a very interesting and informative piece – if only this information was available then.

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