Growing Pains

Your 8-year-old son wakes up crying in the night complaining that his legs are throbbing. You rub them and soothe him as much as you can, but you're uncertain about whether to give him any medication or take him to the doctor.

Sound familiar? Your child is probably experiencing growing pains, a normal occurrence in about 25% to 40% of children. They generally strike during two periods: in early childhood among 3- to 5-year-olds and, later, in 8- to 12-year-olds.

What Causes Them?

No firm evidence shows that the growth of bones causes pain. The most likely causes are the aches and discomforts resulting from the jumping, climbing, and running that active kids do during the day. The pains can occur after a child has had a particularly athletic day.

Additionally, growing pains can be the throb of healing at the locations on bones where tendons attach. Bones grow faster than do tendons, and during a period of rapid growth the tightened tendons pull so much on the bones onto which they attach (especially at the heels and just below the knees) that small �micro-fractures� can occur, especially with vigorous physical activity.

Signs and Symptoms

Growing pains always concentrate in the muscles or at tendon insertion points, rather than the joints. Most kids report pains in the front of their thighs, in the calves, just below the knees, under the heel bone, or, occasionally, behind the knees. Whereas joints affected by more serious diseases are swollen, red, tender, or warm, the joints of kids experiencing growing pains appear normal.

Although growing pains often strike in late afternoon or early evening before bed, pain can occasionally wake a sleeping child. The intensity of the pain varies from child to child, and most kids don't experience the pains every day.

Diagnosing Growing Pains

One symptom that doctors find most helpful in making a diagnosis of growing pains is how the child responds to touch while in pain. Kids who have pain from a serious medical disease don't like to be handled because movement tends to increase the pain. But those with growing pains respond differently � they feel better when they're held, massaged, and cuddled.

Growing pains are what doctors call a diagnosis of exclusion. This means that other conditions should be ruled out before a diagnosis of growing pains is made. A thorough history and physical examination by your doctor can usually accomplish this. In rare instances, blood and X-ray studies may be required before a final diagnosis of growing pains is made.

Helping Your Child

Some things that may help alleviate the pain include:

massaging the area
stretching
placing a heating pad on the area
giving ibuprofen (Never give aspirin to a child under 12 due to its association with Reye Syndrome, a rare but potentially fatal disease.)

When to Call the Doctor

Alert your doctor if any of the following symptoms occur with your child's pain:

persistent pain, pain in the morning, or swelling or redness in one particular area or joint
pain associated with a particular injury
fever
limping
unusual rashes
loss of appetite
weakness
tiredness
uncharacteristic behavior

These signs are not due to growing pains and should be evaluated by the doctor.

Although growing pains often point to no serious illness, they can be upsetting to a child � or a parent. Because a child seems completely cured of the aches in the morning, parents sometimes suspect that the child faked the pains. However, this usually is not the case. Support and reassurance that growing pains will pass as kids grow up can help them relax.