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Are Growing Pains in Children Real

Growing pains in children are nothing new. Physicians back in the 1800s made note of them. But are they real? And if so, what are they really? If you ask the children affected by this condition, you'll know the pain is very real.

The more accurate question might be: what is causing these pains? Is it fatigue? Psychological? Or something in the joint, bone, or surrounding soft tissues? Believe it or not, even with all our current technology, we still don't really know much about the underlying pathologic or biologic cause of what we refer to as "growing pains."

Many studies have been done on this problem. It's estimated that up to half of all children between the ages of three and 14 experience growing pains. The legs are almost always the site of the painful symptoms. But the arms can be involved -- just not as often.

The pain begins most often during the night either keeping the child awake or awakening the child after falling asleep. Afternoon is another common time period when the pains are reported.

In this current study, orthopedic surgeons and pediatricians identified 30 children with a complaint of growing pains. The children were followed for a full year to get a better idea of the problem and the results of treatment.

The researchers looked at blood tests and asked about the presence of other symptoms such as fever, joint swelling, limp, or other abnormal symptoms. X-rays were ordered only when the physician judged them to be necessary. Characteristics of pain were also measured and recorded including intensity, frequency, and duration.

They found that most children experienced pain lasting anywhere from 10 to 30 minutes. The frequency (how often pain occurred) was much more variable. A small number of children (five percent) reported pain every day. Most of the patients either had pain once a week (45 per cent) or once a month (35 per cent). Afternoon and night pain was very common.

In this group, the location of pain was limited to the lower legs (shins) and thighs. The pain was severe enough to wake the child up and cause crying in 40 per cent of the group. All lab values were normal. Massage and over-the-counter pain medications were enough to relieve symptoms. Some children had to rest and limit their activities before the pain would go away.

What can we tell from the results of this study? The fact that only leg pain was reported (no arm pain) may suggest overuse and bone fatigue as a possible cause of "growing pain" in some children. A large number of the younger children (who haven't reached a rapid growth phase yet) experienced leg pain, so the theory that the bones are growing faster than the soft tissues may not be valid.

Whether there is an emotional or psychologic aspect to growing pains could not be confirmed by the results of this study. Likewise, the theory that some children have a lower pain threshold could not be proven or disproven with this group. Some experts propose that the way the pain comes on suddenly points to a lack of blood circulation but nothing in this study could support or disprove this idea either.

It was clear that growing pains are real. They are distressing and depressing to both mother and child. Treatment may give the parents something to do but most studies (including this one) show that the pains go away as the child moves into the teen years.

If anything helps at all, it's stretching of the muscles of the legs with analgesics (pain relievers) for comfort. A way to predict who will develop growing pains and prevent them has not been determined.

Reference: Vito Pavone, MD, et al. Growing Pains: A Study of 30 Cases and a Review of the Literature. In Journal of Pediatric Orthopaedics. July/August 2011. Vol. 31. No. 5. Pp. 606-609.