Growing pains: symptoms, cause, treatment and prognosis

Growing pains in children are common. Growing pains are a difficult and annoying complaint and can occur in children from about three to four years of age. About thirty percent of children between the ages of 2 and 13 suffer from it to a greater or lesser extent, girls more often than boys, but it is not clear why this happens. Growing pains usually occur in two periods of life. Firstly in children between about 3 and 5 years old (toddlers), then later in children aged 8 to 12 years. Growing pains are a painful, as yet unexplained condition, without demonstrable abnormalities. There is an intermittent progression. Sometimes a child will have growing pains for several nights in a row and then not for weeks afterwards. Growing pains are completely harmless and disappear on their own after one to two years. Rubbing the sore muscles and stretching exercises can ease the pain.

  • What are growing pains?
  • Who suffers from growing pains?
  • Symptoms of growing pains
  • Cause of growing pains
  • Growing pains have nothing to do with growth
  • What causes growing pain pain?
  • When to contact the GP?
  • Examination and diagnosis
  • Treatment of growing pains in a child
  • Measures
  • Exercises and activities to ease the pain
  • Self-care
  • Prognosis

 

What are growing pains?

Growing pains can occur in children from about three years of age. When a child complains of deep pain in both legs, it is called growing pains. It mainly occurs at the end of the day and at night. During the day the child is often not bothered by it.

Who suffers from growing pains?

It turns out that about 30% of children suffer from growing pains, usually between the ages of 4 and 10. There are more girls than boys with growing pains. This pain can consist of pain in both legs, usually around the knees, calves, shins or thighs. The pain is sometimes so bad that the child may wake up screaming in pain.

Symptoms of growing pains

The pain often comes in attacks that last about fifteen minutes. The child experiences sharp pains deep in the leg and sometimes also in the arms. This usually takes 10 to 15 minutes. Growing pains can be accompanied by headaches, stomach aches, crying fits or fatigue. Growing pains are harmless and will disappear on their own.

Cause of growing pains

Growing pains have nothing to do with growth

It is said that during growth spurts there is great elongation of muscles and tendons at their attachment to the bones, because bones grow faster than muscles. This stretch then gives rise to pain complaints. Yet growing pains probably have nothing to do with physically growing. Some arguments that are being put forward for this in 2023 are:

  • Growing pains are usually not localized at the growth plates;
  • although the complaint is expressed during the growth period, they do not occur specifically during the growth spurt.¹

 

What causes growing pain pain?

It is suspected that the leg muscles of the child with growing pains swell slightly, causing the membrane surrounding them to come under tension. This would cause the pain. Growing pains can worsen if the child has been active all day. There are probably also psychological factors that play a role. There are indications that the pain threshold is lower in these children.² Lively and restless children also seem to suffer from growing pains more often.

When to contact the GP?

When making the decision to call your doctor, it is important to remember that growing pains are almost always felt in both legs. Pain in only one leg can be a sign of a more serious condition. In that case, contact your skin doctor. It is also important to remember that growing pains affect muscles and not joints. And growing pains do not cause fever and do not cause the child to limp or limp.
Contact your doctor if leg pain occurs with the following symptoms (which are not symptoms of growing pains):

  • injury, such as a fall
  • fever
  • loss of appetite
  • limping or difficulty walking
  • skin rash
  • red, warm, painful, swollen joints
  • fatigue
  • weakness
  • general malaise
  • weight loss

 

Examination and diagnosis

Growing pains are completely harmless and will disappear on their own after one to two years. However, it is wise to consult the doctor if pain persists in the child’s arms or legs, so that other causes can be ruled out. The doctor will investigate whether it is really growing pains. Differentially diagnostically, a number of syndromes are eligible, such as the benign hypermobility syndrome. With this benign condition, a child can also experience pain in the legs, which also occur at the end of the day. However, this pain is localized in the joints and does not disturb sleep.
A doctor can usually diagnose growing pains by examining the child and asking questions about his or her medical history and symptoms. If the child suffers from growing pains, the doctor will see nothing abnormal during the physical examination. Blood tests and X-rays are usually not necessary in this case.

Paracetamol has an analgesic and fever-reducing effect / Source: Martin Sulman

Treatment of growing pains in a child

Measures

If a child suffers a lot from growing pains, a number of measures can be taken:

  • Administer a simple painkiller (paracetamol).
  • Give a light massage (rubbing the sore muscles can ease the pain).
  • Perform muscle stretching exercises (these exercises ensure better blood flow in the muscles and this can ease the pain).

 

Exercises and activities to ease the pain

Certain exercises and activities can help relieve pain. Here are some possible exercises you can try:

  • Stretching exercises: Simple stretching exercises can help relax the muscles and joints. When it comes to growing pains, we usually focus on the legs and feet. A simple stretch for the calf muscles is to stand against a wall with your legs straight, place your hands against the wall at shoulder height and push your feet forward. Hold this position for a few seconds and repeat a few times.
  • Cycling: Cycling is a great activity to strengthen the muscles in the legs and keep the joints flexible. Let your child cycle regularly to promote blood circulation and reduce growing pains.
  • Swimming: Swimming is another effective exercise for children with growing pains. The water provides weightlessness and reduces pressure on the joints. Additionally, swimming helps strengthen muscles and improves flexibility.
  • Massage: A gentle massage of the legs can help improve blood circulation and relax the muscles. Use a little massage oil and gently rub the legs in upward movements.

 

Self-care

10 tips to use if your child suffers from growing pains:
Heat treatment: Apply a warm compress or hot water bottle to the painful area to relax the muscles and reduce pain.

  • Rest: Make sure your child gets enough rest. Avoid too much physical activity that can worsen the pain.
  • Proper shoes: Make sure your child wears comfortable shoes that fit properly. Good support can help reduce tension on the feet and legs.
  • Massaging with essential oils: Try performing a relaxing massage with essential oils such as lavender or chamomile. These oils can help relax the muscles and relieve pain.
  • Avoid heavy loads: Encourage your child to avoid high-impact activities such as jumping or running on hard surfaces, as this can worsen pain.
  • Warm bath: Let your child enjoy a warm bath before he or she goes to bed. The warm water can help relax the muscles and reduce pain.
  • Nutrition: Provide a healthy and varied diet for your child, including enough calcium and Vitamin D, which are important for healthy bones and muscles.
  • Over-the-counter painkillers: If the pain persists, you can use over-the-counter painkillers such as ibuprofen or acetaminophen, according to the correct dosage for children and after consulting a doctor.
  • Adequate sleep: Make sure your child gets enough sleep, as lack of sleep can worsen pain. Create a restful sleep environment and set a regular sleep schedule.
  • Positive support: Offer your child positive support and understanding during periods of growing pains. This can help you tolerate the pain better and maintain a positive mindset.

 

Prognosis

Growing pains are not associated with other serious diseases and usually disappear in late childhood. Normally, growing pain episodes become less severe and decrease in frequency over time. Many children grow out of it within two years. Frequent episodes can have a substantial effect on the child’s life.
Notes:

  1. Dr. JAH Eekhof, Dr. A. Knuistingh Neven, Dr. W. Opstelten: Minor ailments in children. Elsevier Healthcare, Maarssen, second edition 2009, p.223,
  2. Philip J Hashkes, Orit Friedland, Lutfi Jaber, Herman A Cohen, Baruch Wolach, Yosef Uziel: Decreased pain threshold in children with growing pains. J Rheumatol 2004;31:610-3.

 

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