As children grow, it’s common for parents to hear complaints like, “My legs hurt!” often at night or after a long day of play. But how can you, as a parent, tell whether this is just a normal part of development or a sign of an underlying injury or condition?
Understanding the difference between growing pains and more serious musculoskeletal issues can help prevent unnecessary anxiety and ensure timely medical attention when needed.
What Are Growing Pains?
Growing pains are one of the most frequent causes of limb discomfort in healthy, active children. Despite the name, they are not directly caused by bone growth. Instead, they represent a type of musculoskeletal pain that occurs during childhood, typically between ages 3 and 12, due to muscle fatigue from daytime activities, such as running, jumping, or climbing.
What do Growing Pains Look Like?
The following are some features of growing pains:
- These pains appear in later parts of the day, late afternoon, evening, or at night, often waking the child from sleep.
- Affect both legs, particularly the thighs, calves, or behind the knees.
- These pains are intermittent, which means they come and go without any consistent pattern.
- Growing pains do not cause swelling, redness, or limping.
- Growing pain often improves with gentle massage, warmth, or stretching.
Children with growing pains are otherwise healthy and active during the day. The pain typically appears in later parts of the day and resolves on its own by morning, and the child resumes normal activities without discomfort.
What are the other painful injuries or conditions in children?
Pain in limbs may sometimes be due to other serious injuries or conditions that require medical attention. Some of these can be.
Muscle Strain: Overuse or overstretching of muscles can result in strain and, thereby, pain.
Sprain: Tearing or overstretching of ligaments, usually around joints, is called a sprain.
Fractures: Cracks or breaks in the bone are fractures. These can occur from trauma or repeated stress (stress fractures).
Overuse Injuries: Repetitive activity (like sports) may lead to stress injuries, especially in the knees and ankles. These can also be present in children who have been vigorously trained for a sport.
Joint Inflammation (Juvenile Idiopathic Arthritis): If joint pain is persistent, especially with swelling, stiffness, or morning discomfort, it may indicate an inflammatory condition such as Juvenile Idiopathic Arthritis (JIA). Early diagnosis is important to prevent long-term joint damage.
Bone or Joint Infections (Osteomyelitis or Septic Arthritis): Infections in the bone or joint can cause severe pain, redness, swelling, and fever. These conditions require immediate medical attention.
Orthopedic Growth Disorders: Conditions like Perthes disease (affecting the hip) or Slipped Capital Femoral Epiphysis (SCFE) can cause hip or thigh pain, limping, and restricted movement. These need evaluation by a pediatric orthopedic specialist.
Vitamin Deficiencies: Lack of Vitamin D or calcium can weaken bones, leading to conditions like rickets, which cause bone pain and deformity in the legs.
Nerve-Related Pain: In rare cases, nerve compression or inflammation can lead to tingling, burning, or radiating pain in the limbs.
Leukemia or Other Systemic Illnesses: Though uncommon, persistent limb pain accompanied by fatigue, pallor, or fever could signal more serious conditions like blood disorders and must be promptly evaluated.
Each of these conditions presents with its own specific symptoms. The comparison given below can help a parent distinguish them from growing pains.
How to Distinguish Growing Pains from Injuries in Children?
Timing of Pain
Growing Pains usually occur at night or after physical activity; the child is pain-free by morning. In other Injury or Condition, pain continues during the day and may worsen with movement.
Location of Pain
Growing Pains are typically felt in both legs, areas include the thighs, calves, or behind the knees. In case of other injury or condition, the pain is usually localized to one leg or a specific area.
Presence of Swelling or Redness: While in growing pains, there is no swelling, redness, or visible changes; in case of other conditions, swelling, redness, or tenderness may be present.
Mobility: In case of growing pains, the child can walk, run, and play normally. The pain specifically disappears by the morning. But in other conditions, limping or restricted movement may be seen.
Response to Touch: Growing pain often eases with gentle rubbing or massage. If the child has another condition, then the pain may increase when the area is touched or pressed.
Duration of Pain: Growing pains come and go; they last from a few minutes to a few hours. But the pain of a specific condition or injury doesn’t go on its own; it persists for several days or weeks.
Associated Symptoms: In case of growing pains, the parent would not notice any other symptoms, and the child otherwise feels well overall. But in other injuries or conditions, the parent may notice fever, fatigue, or weight loss along with the pain. These are signs that indicate a possible medical problem requiring attention.
If your child wakes at night with aching legs but wakes up cheerful and active, it’s most likely growing pains. However, if your child continues to complain of pain during the day, shows visible swelling, or develops a limp, then it’s advisable to consult a pediatric orthopedic surgeon.
Treatment for Growing Pains in Kids
Treatment for growing pains focuses on relieving discomfort and reassuring parents, since the condition is self-limiting and not harmful. Here is what can be done at home.
- Gentle Massage:
Massaging the affected muscles often provides quick relief. Applying gentle pressure or stretching can soothe muscle tension.
- Warm Compresses:
Using a warm towel or heating pad on sore areas helps relax muscles and ease pain before bedtime.
- Adequate Hydration and Nutrition:
Dehydration and electrolyte imbalance can worsen muscle aches. Ensure your child drinks enough water and consumes a balanced diet rich in calcium and vitamin D.
- Pain Relief Medication:
If pain is severe, over-the-counter medications may be used, only under a pediatrician’s guidance, as the dosage of these medications is decided based on the weight of the child.
- Comfort and Reassurance:
Growing pains can be distressing for children, especially when they disrupt sleep. Gentle reassurance and physical comfort from parents can go a long way.
- Stretching and Light Exercise:
Simple stretching exercises for the legs, especially before bedtime, can help prevent recurrence.
- Proper Footwear:
Supportive, well-fitting shoes can reduce stress on growing muscles and joints and reduce growing pains.
- Adequate Rest:
Ensure your child gets enough sleep, especially after intense physical activities. It’s advisable to follow a good sleep hygiene and bedtime routine.
Treatment of Other Conditions
When limb pain is caused by an injury or underlying condition, treatment depends on the specific cause. Muscle strains or sprains may require rest, ice, compression, and elevation to reduce pain and swelling. Fractures need prompt medical evaluation and may be managed with casting or splints to ensure proper bone healing. Overuse injuries often improve with activity modification, physiotherapy, and gradual return to sport. If pain is due to inflammatory, infectious, or orthopedic disorders, targeted medical or surgical treatment may be necessary. Early diagnosis and proper management are essential to prevent long-term complications and ensure full recovery.
When to Consult a Doctor?
Most growing pains are harmless and resolve on their own. However, you should consult a pediatric orthopedic specialist if additional symptoms are noticed or in case of doubt.
- The pain is persistent, severe, or localized to one limb.
- There is swelling, redness, or warmth in the affected area.
- Your child has difficulty walking or starts limping.
- The pain is associated with fever, fatigue, or unexplained weight loss.
- The pain interferes with daily activities or sleep for several nights in a row.
Early consultation helps rule out other orthopedic or systemic causes and ensures your child receives timely, appropriate care. Pediatric orthopedic surgeons specialize in evaluating growing bones and identifying conditions that may mimic growing pains, ensuring proper growth and development.
Growing pains, though common and harmless, can be confusing and worrying for parents. Recognizing the difference between typical nighttime aches and true injuries helps ensure children receive the right care.
At Ankura Hospital’s Pediatric Orthopedic Department, our team of experienced pediatric orthopedic surgeons specializes in diagnosing and managing bone, joint, and muscle problems in growing children. With early evaluation, personalized care, and compassionate guidance, we ensure every child moves, plays, and grows confidently, pain-free.
FAQs
- Yes, growing pains are common and considered a normal part of development in many children. They usually occur in the legs during the evening or night and go away by morning without causing lasting problems.
- Growing pains most often affect children between 3 to 12 years of age, though some may experience them earlier or later. They are less common during adolescence.
- While they can’t be completely prevented, ensuring your child gets proper rest, gentle stretching after physical activity, and maintaining hydration can help reduce discomfort.
- You should consult a doctor if the pain is persistent during the day, affects only one leg, causes swelling, redness, or limping, or is accompanied by fever or fatigue. These signs may indicate an injury or another underlying medical condition.
- If the pain continues or you suspect an injury, it’s best to see a pediatric orthopedic specialist. They can assess for fractures, joint issues, or other conditions that may require targeted treatment.
