Growing Pains In Children: What You Need to Know

    Growing pains or “idiopathic nocturnal pains of childhood”, are some of the most commonly reported limb pains that can occur in up to one third of children.

    How to find out about growing pains in children?

    Hayley, an eight year old girl, complained of pain under her knee joints nearly every night before bed for two months. Each evening, her mother had to massage her legs and apply warm compresses to relieve the discomfort and so she could sleep. During the day, it didn’t seem to affect her activity, so Hayley’s mother thought nothing of it, until she brought her to see the doctor and mentioned it in passing. After an assessment, the doctor told her that Hayley suffered from growing pains.

    If this story sounds familiar to you? You are not alone.

    Growing pains or “idiopathic nocturnal pains of childhood”, are some of the most commonly reported limb pains that can occur in up to one third of children. Moreover, their onset can be from as young as three years and are slightly more common in girls than boys.

    Often, we don’t know why they occur and its diagnosis needs to be made after excluding other causes like trauma, infections, fractures, tumours or even school phobia. To sum up, many have attributed it to emotional and psychogenic illness but this is not well studied.

    How do growing pains affect children?

    Children with higher activity levels are affected by growing pain; with one study showing evidence of local overuse as a contributing factor. They usually affect the legs, calf and muscles more but can sometimes affect the arms as well. There are a number of features that make it more likely, which include the following:

    • Pain occurs later in the day or awakens the child
    • Pain is not specifically limited to the joints
    • Pain occurs at least monthly for at least 3 months
    • Pain is intermittent, with symptom-free periods of days
    • Pain is accentuated by increased activity on the day
    • Normal physical examination and/or investigations

    Paediatrician Assessment

    During the assessment, the paediatrician would assess the nature and timing of the pain, its location, associated activities that trigger it and any associated symptoms (e.g. Fever, swelling, weight loss or weakness, headaches or stomach ache). In addition, any family history of joint or rheumatological problems and also whether the child has an adequate intake of calcium or vitamin D may also be relevant. How the pain affects his or her function in life and in sports would be important to gauge.

    The paediatrician would examine the child’s gait and joints as well as muscle strength and range of movement for each joint. If anything was abnormal, an X ray or some blood tests may be necessary to further exclude or make a diagnosis, though they would be expected to be normal in growth pains.

    To relieve the pain, here are a number of things you can do:

    • Analgesics like paracetamol or ibuprofen may be effective analgesics
    • Massaging with some menthol creams like deep heat rub may also be useful, but do take care as some are not licensed for use on children under 12 years of age
    • Heat packs or hot water bottles can be applied to the painful areas for 15-20 minutes at a time which may help to soothe the discomfort
    • If the pain occurs during sports the child should stop the activity and rest until he or she recovers from it, but activity can be resumed after the pain goes away
    • Muscle stretching exercises can sometimes help with these pains
    • Braces may help to improve posture and abnormal stresses to the joint, which may reduce the pain occurrence, though should be applied with the advice of a doctor
    • If a child is found to have low vitamin D levels, vitamin D and calcium supplements may help in the long term
    • If the pain recurs often, it would be prudent to have it checked by your doctor
    • Parents should be mindful that growth pains are genuinely painful and try their utmost to understand and manage the pain together with the child, without criticising or scolding them for it. Care should be taken not to let it affect the child’s life or limit their options for activity and sports. With time, all children grow out of it but your care, love and sympathy will go a long way in helping them to cope and manage it.

    or refer to an other article on our website

    Hawksley JC. Race, Rheumatism and Growing Pains. Arch Dis Child. 1931; 6(35):303
    Naish JM, Apley J. “Growing pains”: a clinical study of non-arthritic limb pains in children.
    Evans AM, Scutter SD. Prevalence of “growing pains” in young children. J Pediatr. 2004;145(2):255
    Friedland O et al. Decreased bone speed of sound in children with growing pains measured by quantitative ultrasound. J Rheumatol. 2005;32(7):1354
    Frazer CH, Rappaport LA. Recurrent Pains. In: Developmental behavioral pediatrics, 3rd ed, Levine MD, Carey WB, Crocker AC (Eds), WB Saunders, Philadelphia 1999. p. 357.
    Baxter MP, Dulberg C. “Growing pains” in childhood – a proposal for treatment. J Pediatr Orthop. 1988;8(4):402

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