Are growing pains really caused by growing?

What we often hear

• "My child often wakes up at night saying their legs hurt."
• "People say it's because they're growing. Is that true?"
• "It gets better when I massage their legs, but then it happens again."

Are growing pains really caused by growing?

Despite the name, the evidence that they're directly linked to growth itself is unclear. It also hasn't been confirmed that they hurt more during periods of fast growth.

The name causes misunderstandings. Some parents assume pain means their child is growing and leave it alone, but children can grow well without pain and may not grow even with pain. The two should be looked at separately.

What do typical growing pains look like?

Typically, both legs hurt mainly in the evening or at night, and by morning the child is fine and running around. There's no swelling or fever.

The sore spots are often not the joints themselves but muscle areas, such as the front of the thighs, the calves, or the back of the knees. A massage makes them feel better, and after sleeping they act as if nothing happened.

When should it be looked at differently?

If only one side hurts, a joint is swollen, there's a fever, the child limps, or the pain continues into the morning, we don't consider it growing pains.

If your child is losing weight, seems listless, or keeps waking up at night from pain, get it checked quickly. It could be an infection, a joint condition, or rarely another illness, so seeing a pediatrician comes first.

If they're typical growing pains, what do we do?

Most cases don't need any special treatment. For many children, massaging their legs and keeping them warm in the evening is enough.

If there's something for us to look at, it would be how much the child ran around during the day, what their shoes and foot shape are like, and whether their calf muscles are overly tight. Among children who hurt unusually often, some have strain concentrated in their feet and gait.

What are the limits of this assessment?

The cause of growing pains has not been clearly identified. So the most accurate thing we can offer is "ruling out other illnesses."

To be honest, we have no confirmed evidence on which treatments help growing pains. The purpose of this article is to separate cases where you can feel reassured from cases that need checking.

Summary for parents

1. Pain isn't needed to grow, and pain doesn't mean they're growing.
2. If both legs hurt at night and they're fine in the morning, that's the typical pattern.
3. If only one side hurts, it's swollen, or they limp, we don't consider it growing pains.
4. If there's a fever or they keep waking up at night, see a doctor first.
5. Typical growing pains often pass without special treatment.

We start by checking where your child is right now. We won't rush you, and we'll tell you, based on evidence, whether it's fine to wait or not.

If you're not sure whether to wait or act now, come see us. We'll check where your child is right now, and we won't rush you.

How we respond differs from child to child depending on the pattern of pain and the cause.