Growing pains

What are growing pains, and how common are they?

Growing pains are a common, harmless aching in the legs that affects children in early childhood¹²³. They don't cause any long-term harm¹.

The typical ache is felt in both legs, often in the muscles rather than the joints, comes on in the evening or at night, and is gone by morning². It most often affects children aged about 3 to 12, or sometimes up to 14¹⁴. Boys and girls are affected equally, with no difference found between them⁵.

The name is considered a misnomer, because the pain isn't clearly linked to growing¹³. Growing pains are common, but estimates of how many children have them vary a lot⁵.

What causes growing pains, and who gets them?

No one knows what causes growing pains, and no cause has been proven⁶⁷. Despite the name, bones growing is not thought to be the reason¹⁷. Even during growth spurts, bones add length gradually, and this gradual process is not thought to cause pain⁷.

Growing pains are said to be more common in active children, including after lots of sport². That doesn't mean activity is the cause, and no single factor has been shown to explain them⁵³.

What do growing pains feel like, and how are they diagnosed?

Growing pains usually feel like an aching or cramp-like pain in both legs, most often in the calves, shins, fronts of the thighs or behind the knees²⁵⁸. It tends to start in the late afternoon, evening or night, and it can wake your child from sleep⁵⁹. By morning it has gone⁸.

Between bad spells, your child is otherwise well, walks normally with no limp, and has no pain when active⁹⁸. Many children have pain-free days, and some only get it now and then⁵.

Growing pains can be diagnosed from a thorough history and physical examination³. When the pattern is typical and the examination is normal, blood tests and X-rays aren't needed⁵³.

What helps growing pains?

Typical growing pains with no warning signs can usually be managed at home with reassurance and simple comfort measures⁸⁹. Your child can try a warm bath, a heat pack, gentle massage or gentle stretching before bed⁴. These are simple, commonsense steps, and how well each one works isn't clear yet.

Pain relief such as paracetamol or ibuprofen can be given for the ache⁸. Follow the dosing instructions on paracetamol or ibuprofen⁸. Children under 16 shouldn't be given aspirin⁸.

Home care is only for a typical pattern with no warning signs⁹¹⁰.

How long do growing pains last, and can they be prevented?

Growing pains are harmless and usually get better on their own¹¹. They can come and go over months, even years, and they can run in families².

No proven way to stop them coming back is known. Comfort measures at bedtime can still make the aches easier to settle.

It helps to keep an eye out for anything new over time.

What can make it serious?

• Your pain is getting worse, or doesn't settle with rest, less activity or pain relief.
• You have lost weight without trying.
• You have pain at night or at rest that doesn't settle.
• Your child has a limp that hasn't improved after a week, limps without pain, or doesn't want to put weight on their foot.
• Your child has heel or ankle pain together with hip or knee pain, morning stiffness that lasts more than 20 minutes, or a foot that has started to turn outwards.
• Your child has a fever with a limp or a painful, red, hot or swollen joint, or seems very unwell with foot or leg pain.
• Your foot, or a patch of skin on your foot or leg, becomes red, hot, swollen and painful.
• You suddenly can't put any weight on your leg or foot, or have sudden severe hip pain or a change in the length of your leg.