Growing pains

Summary

• "Growing pains" generally affect children between the ages of four and nine.
• Growing pains have nothing to do with periods of growth.
• They are treated by reassurance and simple measures.
• They are a self-limiting condition.
• They are not associated with any underlying organic disease.

Definition

Children between the ages of four and nine often complain of vague pains usually in the thighs or calves, and often at night. These are inaccurately called growing pains because they often occur during periods when there is no growth.

An important fact is that the child’s normal physical activity is in no way affected during the day.

Despite the child’s complaints, examination of the legs fails to show any evidence of muscle or joint disease.

Diagnosis

The diagnosis is based on the typical history and failure to show any pathological process on the examination. No investigations are needed.

Treatment

Reassurance is most important. It is essential not to create the idea in the child’s mind that there is a chronic illness. This would be best achieved by a sympathetic yet firm attitude on the part of the parents.

Initially, an analgesic such as paracetamol could be used. Simple procedures such as massaging the legs or warming them by use of extra blankets may help. Caution must be exercised if using a heating appliance not to burn the child.

When to see the doctor

Leg pain could be caused by a number of serious diseases such as osteitis (infection of the bone) or rheumatoid arthritis.

Contact a health professional if the child has:

• Fever.
• Pain limited to a joint.
• Swelling of the joints or muscles.
• Extreme tiredness, loss of appetite or weight loss.
• Limping.
• Pain on waking in the morning.
• The child’s daily activities are affected.

Reviewed by Dr John D. Burgess, FCPaed (CMSA), Senior Specialist, Red Cross Children's Hospital