Parents of school-aged children are often summoned to a child's room at night by their cries of pain. The parents rush into the room, flip on the lights and find their child rubbing his legs in discomfort. After massaging his legs and giving him a hug for reassurance, the ache subsides. The child returns to sleep and feels fine in the morning. This phenomenon is known as "growing pains" and occurs in 4 to 15 percent of school-aged children.
Dr. Catharine Shaner, pediatrician and pediatric advisor to the American Safety & Health Institute (ASHI), explains that growing pains are the most common cause of recurrent limb pain in children. There are several typical characteristics that parents can look for to determine whether or not their child has growing pains.
- The pains wake the child from sleep.
- The pains occur at the end of the day.
- The pains are deep and achy.
- The pain resembles a restless feeling in the legs.
- The pains are often in the front of the thighs or the back of the calf.
- The pain occurs in both legs, not just one.
- The pain lasts one to 15 minutes.
Although the child may experience the pains for two or more years, the pains are intermittent and do not generally occur every night for that entire time period.
Dr. Shaner often hears from parents: "Doctor, I had pains like this when I was a child and they went away. Could this be growing pains?" When a child experiences growing pains, usually one or both of the parents experienced them as children. "Few of my patients were surprised by a diagnosis of growing pains, because one or both parents had experienced the same in childhood," Dr. Shaner says. "Pain syndromes in general tend to be familial. For example, families with growing pains may also have members with chronic headaches, recurrent abdominal pains, fibromyalgia and the like."
What Causes Growing Pains?
Although there is little known about growing pains, they often occur during early childhood and through the elementary years. Many children experience moderate discomfort, but for some children the pain is severe.
Typically growing pains occur at night while a child is off his feet and lying in bed. Strenuous activities throughout the day often contribute to these painful leg cramps at night. Even though there are countless children who suffer from leg pains, many physicians believe there's little connection between these pains and growth spurts except that they usually occur during a period of rapid growth.
The body goes through an amazing series of changes during childhood. In children with growing pains, the muscles or tendons are still a little too tight for the longer bones that are growing. Many of these children are unable to touch their toes with their fingertips without bending their knees because their tendons are so short.
Because of the shortness, it is thought that the muscle spasms. The tremor can last from one to 15 minutes and cause pain. "Currently, most doctors feel that growing pains are not actually due to growth itself," says Dr. Shaner. "But the name sounds benign and is therefore reassuring to families."
After doctors rule out other causes for the pains, they usually attribute the discomfort to growing pains. If the child's exam is normal, most often no further exams or tests are needed. Parents can review the following characteristics to determine if their child is experiencing something other than growing pains and needs more extensive medical testing.
Growing pains do not:
- Involve only one leg
- Involve joints
- Cause the child to limp
- Have stiffness, redness or swelling
- Accompany a rash or fever
- Feel worse by touching or moving the painful area
- Cause loss of appetite, weakness or fatigue
Children experiencing any of these signs or symptoms should promptly visit a pediatrician for a thorough examination.
Relieving the Pain
For pain relief, parents can try the following suggestions:
- During a painful episode children can stretch the feet and toes upward.
- Apply moist heat to the aching area.
- Gently massage the muscles.
- Encourage the child to drink plenty of fluids during the day.
- Have the child do daily stretching exercises. These exercises should be continued after the pain subsides in order to keep the muscles and tendons relaxed and able to handle the next growth spurt.
Parents can also reassure their child that the pains are not harmful and will not last forever. Most children outgrow the pains by age 9. If a parent experienced the same pains as a child, it will comfort their little one if they share that information with them.
To head off the pains before they start, a warm bath, stretching and an analgesic before bedtime might be helpful. Parents who have noticed a correlation between very active days and leg pains in their children should help the child take these extra steps at the end of a particularly busy day.
Time to Worry
Dr. William Felman, pediatrician and editor of The 3 a.m. Handbook, understands the complexities of growing pains. Dr. Felman believes parents should not worry themselves because growing pains will pass as the child matures. "Growing pains should never be a sign of concern," Dr. Felman says.
However, there are a few simple guidelines parents can follow to determine if the pains their child is feeling are actually growing pains. If any of the following symptoms are present, a parent should contact their pediatrician:
- Abnormal gait
- Redness around the joints
- Swelling around the legs
- Persistent limp
- Pains that persist beyond the morning
- Tender bones
A physician should also evaluate children who are troubled by frequent, recurrent episodes of leg pain. If the examination is normal, this situation can be labeled as growing pains.
Just as it is with many phases children experience, growing pains will pass with time. Until the child's body matures, parents can provide massages, warm baths and plenty of patience. With these simple comforts, both parents and child can survive growing pains.