Is it growing pains or something else?

If your child begins complaining of aching legs at night around age 4, you may remember having similar pain as a child. These aches are commonly known as growing pains. While growing pains are usually harmless and go away on their own, leg pain isn’t always caused by growing pains. Other conditions affecting your child’s joints, tissues and bones can cause similar symptoms.

So, how do you know when growing pains are harmless or when your child needs medical attention? Barbara Minkowitz, MD, a pediatric orthopedist with Atlantic Health who treats conditions affecting bones, tissues, muscles and joints, explains the differences and when to seek medical care.

What do growing pains feel like?

Children often describe growing pains as a cramping, throbbing or achy pain in the legs. Most children experience growing pains between ages 3 and 14.

Growing pains often:

• Affect both legs, often in the calves, shins, behind the knees or in front of the thighs
• Aren’t associated with other symptoms
• Come and go, and can last for a few minutes or several hours
• Don’t stop your child from doing the things they love
• Occur in the late afternoon, evening or overnight
• Go away by morning
• Occur more commonly after a day filled with running, climbing or jumping
• Wake your child at night

How to relieve growing pains in legs

To relieve growing pains in legs at night, the best thing you can do is make your child more comfortable. This may include:

• A heating pad on a low setting or a warm compress
• A warm bath
• Gentle massage
• Leg stretches
• Over-the-counter pain medication

It’s also important to make sure your child is well hydrated and they’re getting enough calcium, potassium and magnesium. If your child is low in these nutrients, they may experience muscle pain and spasms.

When should I worry about growing pains?

“If your child is experiencing continued pain, it is a good idea to visit the pediatrician who may refer you to an orthopedist,” Dr. Minkowitz says.

Schedule an appointment with your child’s doctor if the pain:

• Affects only one leg
• Appears related to sports or from a sports injury
• Exists along with other symptoms, such as a rash, fatigue, weakness, limping, swelling or tenderness
• Is present all day
• Persists into the morning
• Prevents your child from participating in activities
• Worsens with time

“If your child does not feel better with conservative treatment at home, contact their pediatrician, especially if they’re older than 5,” she says.

What can be mistaken for growing pains in kids?

Several conditions affecting the tissues and joints (rheumatologic) or bones (orthopedic) can cause leg pain that resembles growing pains. These include sports or overuse injury, infection, nutritional deficiency and juvenile arthritis.

“No matter the age, many patients do not have pain during their appointment,” Dr. Minkowitz says. “A careful examination and listening to the patient and family can help determine the cause. If a child has knee pain, the answer may be as simple as stretching the hamstrings, which often tighten during growth spurts.”

Children who have flat feet (little or no arches), knock knees (legs angle inward) or bowlegs (legs angle outward) may also experience leg pain that can be considered growing pains. As a child grows, this pain may worsen, especially in the knees, ankles and feet.

“Some pain can be attributed to overuse, particularly in children who participate in multiple sports,” she says. “Osgood-Schlatter disease (pain and swelling below the knee in adolescents) and Sever’s disease (pain and swelling in the growth plate in the heel in growing children) are common.”

When a parent is concerned about leg pain, a discussion about bone health is helpful, including a balanced diet and getting enough nutrients, such as calcium and vitamins D, K2 and C, to strengthen bones.

“Our goal is to help children stay active and healthy,” Dr. Minkowitz says.