Has your young one ever complained of general aches and pains… that have you stumped? The phenomenon we call “growing pains” is one of the most common causes of recurrent musculoskeletal discomfort in children. First described by a French physician in the early 1800s, we have spent nearly two centuries trying to get a better grasp on the exact cause and best treatment for such a common problem.
What Exactly are Growing Pains?
So what are growing pains? The syndrome is described as intermittent pain, usually in the lower extremities, that occurs late in the day or early evening. The pain is typically gone in the morning and not worsened by physical activities. Discomfort with growing pains usually begins between the ages of 3 and 6, with the average age around 8 years old. Despite the coined term “growing pains,” there’s no direct connection to rapid growth.
The search for a cause hasn’t been completely successful. Theories include:
- generalized hyperlaxity (loose ligaments,)
- psychological stress that leads to somatic symptoms
- deficiency in blood flow
- low vitamin D levels
How Do I Know if Growing Pains are Something More?
The diagnosis is one of exclusion. Simply stated, “Everything checks out OK.” A few highlights:
| Characteristic | Typical Findings |
| Pain Location | Bilateral Lower Extremity (calves, thighs, shins) |
| Timing/Onset | Late afternoon/evening Resolution by morning Intermittent Not activity related |
| Severity | Improves with massage, over the counter analgesics Does not increase in severity over time |
| Physical Exam | Normal |
The first thing we’ll do is look at a full medical history with a thorough physical exam to determine any other potentially serious causes of pain. That might include fever, malaise, or decreased appetite. If your child can’t put their weight on a leg or has an altered gait (walk), we’re dealing with something beyond growing pains. Any recent viral illnesses, rashes or travel are clues to alternative diagnosis as well.
If the physical exam is normal, we typically don’t need any further workup to make the diagnosis. X-rays or bloodwork may be ordered to rule out a more serious condition. These can include developmental abnormalities, infections, growth plates conditions, or even a remote injury or trauma.
What Relieves Growing Pains?
When the diagnosis of growing pains is made, often reassurance is the only treatment rendered. Some studies have found benefit to stretching the quadriceps, hamstring, and calves. Most children get relief with massage to the areas of pain, as well as the addition of heat. Over the counter medications such as acetaminophen or ibuprofen can alleviate some the pain and discomfort.
At the end of the day, the term “growing pains” describes a specific, benign pain syndrome in young children. Even though we still don’t know much about the underlying causes, there’s no need for long-term concern. If you have any doubts whatsoever – we’re here to help you sort it out.
“Though he may stumble, he will not fall. For the Lord upholds him with His hand.” Psalm 37:24
Jason R. Determann, MD
Dr. Determann received his MD from Louisiana State University in Baton Rouge, followed by residency in Orthopaedic Surgery at the University of Alabama in Birmingham. He is Board Certified and Fellowship Trained in Sports Medicine with a specialty in Shoulder & Elbow Surgery.
