Growing pains

Growing pains are pain symptoms relatively common in children. Typically, they are located in the muscles, rather than the joints, of the leg and less commonly the arm. They are usually felt on both sides, and appear late in the day or at night, wakening the child, with pain varying from mild to very severe. Pain is absent by the morning, and there are no objective clinical signs of inflammation. Pain can recur nightly or be absent for days to months. Growing pain is not associated with other serious disease and usually resolves by late childhood, but frequent episodes are capable of having a substantial effect on the life of the child. .

Diagnosis
In the absence of limping, loss of mobility, or physical signs, laboratory investigation to exclude other diagnoses is not warranted. Restless leg syndrome is sometimes misdiagnosed as growing pains.

Epidemiology of growing pains
Reported prevalences of growing pains have been between 2% and 46% of children. Growing pains are said to typically occur in two periods during a child's life, firstly, between about 3 and 5 years old, then later in 8 to 12 year olds. There are however no published epidemiological studies to support this observation.

Cause of growing pains
The causes of growing pains are unknown. They are not associated with growth spurts and some authors suggest that the term 'recurrent limb pain in childhood' be used instead. Theories of causation include faulty posture, vascular perfusion disorder, tiredness, or psychological causes. Some parents are able to associate episodes of pain with physical exercise or mood changes in the child.

Treatment
Parents and children can be substantially reassured by explaining the benign and self limiting nature of the pains. . There are no substantial studies of the effectiveness of any intervention but local massage or analgesic drugs such as paracetamol are often used.

For growing pains in dogs, see panosteitis.