Ask the Doctor: The Long and Short of Growing Pains

April 17, 2020
Doctor measuring height of small child

Parents naturally may become alarmed if their child wakes up in the middle of the night, complaining of pains in their legs and arms. In this Q&A, Pediatrician John Lepore, DO, talks about why “growing pains” are not figments of the imagination and how the pain should be treated.

Q: Are growing pains real?

The pain is definitely real. There is some correlation with times of rapid growth; however, growing pains may be related to the muscles being stretched by lengthening of the bones. Typically, the bones in the body grow first, then everything else follows. Sometimes what is thought to be a growing pain may actually be tenderness caused by overworked muscles, particularly after a day of especially active play.

Q: Do growing pains have specific symptoms?

Yes. They’re usually felt on the right and left sides, centering in the thighs, calves and behind the knees. The pains tend to be more intense in the evening and go away in the morning. Typically, growing pains affect children from 3 to 5, or 8 to 12 years of age. Growing pains can also occur in children outside of the typical age ranges. When they do, or when trauma or infection accompanies the pain, parents should see a doctor to have their child evaluated.

Q: How can parents help ease growing pains?

We recommend over-the-counter pain relievers* and light massage. This is something one of the parents can do in the evening when the child is relaxing. If the child has a particularly active day with lots of running or jumping, he or she should take it easy and not engage in vigorous activities for a day or two. Parents can also call for periods of rest during intense play. A warm bath before going to bed might also help.

Q: What else is important for parents to know?

The most important thing is recognizing when to be concerned. If your child complains of pain that does not meet the criteria for growing pains, see your doctor. This is especially true if the pain is accompanied by a fever, rash, swelling that doesn’t decrease or that grows worse after 24 hours, or if the child is limping or cannot walk. These or any other signs of illness require a visit with a healthcare provider for immediate evaluation.

*The U.S. Surgeon General, U.S. Food and Drug Administration, Centers for Disease Control and Prevention, and American Academy of Pediatrics recommend products containing aspirin not be taken by anyone younger than 19 years during fever-causing illnesses.