Recurrent Leg Pain in Children- "Growing Pains"

This page deals with the non-specific condition of leg pain in children, commonly called "growing pains" although it would be more descriptive to call it "recurrent limb pain in children".

The following questions are answered:

• What are growing pains?
• What causes growing pains?
• How do you know growing pains are not something more serious?
• What is the treatment of growing pains?
• When should I see a doctor?

What are "growing pains"?

"Growing pains" refers to recurrent leg pain that occurs in some children between the ages of 3 and 12 years.

It generally occurs at night and is usually not localised to any one part of the leg but rather affects both legs.

It is a benign condition and no investigations are required. Children will eventually "grow out" of the pains.

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What causes "growing pains"?

Nobody knows for sure but we do know that the leg pains are not due to growing. The most feasible hypothesis is that it is a type of overuse of the muscles in susceptible children, particularly those who are hypermobile (sometimes referred to as "double-jointed" children).

Having a foot that is pronated (rolled inwards) and having hypermobile joints (sometimes called "double jointed") make it more likely to get "growing pains". This is also referred to as Benign Joint Hypermobility Syndrome (BJHS).

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How do you know the pain is "growing pains" and nothing more serious?

That's a good question. The key things about "growing pains" that make us sure there is nothing more serious going on are:

• the pain is usually diffuse and not localised to one spot
• the pain is not associated with a limp or mobility problems - children may cry at night with the leg pain but the next day, they are back to their normal active self running around with no limp or pain
• the joints are not affected - in particular, there is no joint swelling
• there is no redness over the skin
• the child often has signs of joint hypermobility - an example of one sign is being able to touch your palms on the floor bending over with straight legs

There is no test for "growing pains" and no investigation is needed.

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What is the treatment of "growing pains"?

There is no specific treatment but the following may help:

• Paracetamol or Acetaminophen - although if your child is hypermobile (seems "double-jointed") it is better to try the treatments below
• physiotherapy for muscle strengthening - this is especially important for children with joint hypermobility where the muscle should be strengthened in the extended range of motion
• good supportive shoes or orthotic insoles - especially important if the foot is held pronated (rolled inwards)
• at night when your child is distressed, try warmth (so a hot water bottle) or massage and, of course, lots of reassurance

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When should I see a doctor?

See your doctor if the leg your child has pain in the leg and any of the following:

• limp
• there is swelling of any joint
• pain is localised to one area
• pain is located in or over a joint
• there are overlying skin changes

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