Leg, foot and ankle pains of unknown cause in children are often called “growing pains”. The term “growing pains” defines a harmless condition of unknown cause affecting between 10 and 20 percent of growing children. Despite the name, growing pains don’t occur during the time of the most rapid growth, do not occur at specific sites of growth, and do not affect the growth of children who have them.
Although leg and ankle pain in children is not well defined, there has been some interesting recent research on the treatment of growing pains. In a 2003 study, children who had both leg pain and flat feet were given orthotics to support the flat feet. Both the children and the parents were asked to grade the pain level with and without the orthotic devices. All of the children improved with orthotics. In fact, 100% of the pain was relieved with orthotic treatment. Also, when orthotics were removed, the pain returned4.
Growing pains often occur in children three to 12 years old. Pain usually occurs in both legs, especially thighs and calves, but can affect one leg at a time. Which leg or part of the leg is affected can vary at times. Interestingly, pain happens almost exclusively in the evenings and at night, and can even cause awakening during the night. Pain does not generally occur consistently during daytime activities or interfere with the child’s usual recreational activities. Growing pains do not cause limping, nor do they cause symptoms of general illness like fever or weight loss.
Other red flags that make the diagnosis of growing pains improbable include: pain specific to a single joint, pain that worsens over time, pain that interferes with your child’s usual daily activities, or restricted motion, redness, swelling, warmth or tenderness in joint areas.
Growing pains are one of the more common conditions that we treat in kids. If you think your child might have growing pains, contact us today for an appointment in our Seattle foot and ankle clinic.
The first thing we will do is to rule out other problems. If our exam is normal and your child has no tenderness, redness, limitation of motion or swelling, then we can usually diagnose growing pains.
What are Growing Pains?
Growing pains is a common pain syndrome most often affecting the legs that occurs in children aged 2 -12 (most common between ages 8 – 12). Pain is often sharp and achy, usually affects both legs and often occurs at night. There is a family history about 20% of the time.
What Causes Growing Pains?
No one is 100% sure, but growing pains do not seem to be caused by bone growth – at least there is no evidence of that. More likely, growing pains seem to be due to overuse of the leg muscles and bone growth centers that occur when kids are active. So do children really have growing pains? The answer is a bit complicated. Kids do have periods of rapid growth. And pain in the feet, ankles and legs can be associated with the growth centers. But again, it does not seem to be the growth itself that causes the pain. More likely it is stress on these areas.
Which Kids are Most Likely to Get Growing Pains?
Growing pains seem to be most likely in three groups. The first is simply kids who are very active. In fact, one study showed that over 78% of growing pains occurred after intensive exercise. In addition, growing pains seem to be more common in kids who have flat feet and in kids who are overweight.
Treatment of Growing Pains The first thing we evaluate when determining treatment is whether or not there is a mechanical problem causing your child’s growing pains. For example, kids who have flat feet often develop growing pains from overuse of the muscles on the inside of the leg that act to support flat feet. In these kids, we can often use either a custom orthotic or a prefabricated orthotic with some inexpensive modifications to reduce the stress on the muscles and eliminate the growing pains. There are other mechanical problems besides flat feet can also cause growing pains and be treated with simple orthotic therapy.
In other situations the problem is not due to foot function. In these cases it is often just overuse that causes the problem. In this case, these treatments often are beneficial:
- Massage the legs until the pain passes
- Do stretching exercises several times per day and before bed (we can show you the best stretches)
- Use warm bath or heating pads to help calm sore muscles
- Over-the-counter pain relievers can be used, but always consult with your pediatrician first
Rule Out More Serious Problems
The following symptoms are not due to growing pains and could be a sign of more serious problems: Pain that lasts all day, limping, swelling, redness, weakness. If your child is experiencing these problems, have them evaluated.
Growing pains are common in young kids during their years of growth and development. There are often easy ways to treat and prevent growing pains. We specialize in chidlren’s foot problems. If your child is experiencing growing pains, make an appointment for them to see us in our Seattle foot and ankle clinic.
References for Growing Pains
- Lowe RM, Hashkes PJ. Growing pains: a noninflammatory pain syndrome of early childhood. Nat Clin Pract Rheumatol. 2008 Oct;4(10):542-9. Epub 2008 Sep 2.
- Pavone V, Growing pains: a study of 30 cases and a review of the literature. J Pediatr Orthop. 2011 Jul-Aug;31(5):606-9.
- Kaspiris A. Growing pains in children: epidemiological analysis in a Mediterranean population. Joint Bone Spine. 2009 Oct;76(5):486-90. Epub 2009 Sep 29.
- Evans AM. Relationship between “growing pains” and foot posture in children: single-case experimental designs in clinical practice. J Am Podiatr Med Assoc. 2003 Mar-Apr;93(2):111-7.
Note: https://www.pamf.org/preteen/parents/growingpains.html was used as a reference in article.
