Growing pains in children can affect up to a quarter of all children at some stage. The condition can be distressing, but is self limiting and goes away on its own eventually. The real concern about the diagnosis is that the term is often used as a throw away term for any leg pain in children and there are a few potentially serious problems that can be dismissed as growing pains.
The true syndrome of growing pains is a bad cramp like pain in the upper calf muscles just behind the knee that usually wakes the child from sleep and lasts around 20 minutes. It is most common in the 4-5 years age group, but can occur up to 12 years of age. The pain does not affect activities the next day. The pains do not occur during the day and if they do, something else needs to be considered. The pain is also not deep in the bone or in the knee joint and if it is, something else needs to be considered. There is also no specific tender spot, so if there is something else needs to be considered.
If the symptoms do not match the classic criteria for growing pains (in the upper calf and at night), then the differential diagnosis needs to consider a juvenile type of arthritis in the knee joint; a pain referral from the hip; or a bone cancer if the pain is deep in the bone.
The cause of the problem is not known with a number of theories being proposed, including biochemical disturbances, hormonal imbalances and musculoskeletal fatigue. No evidence has been found yet to support any cause.
Parents and the child need to be reassured about the benign and self-limiting nature of this condition. When a child wakes with the pain, then simple rubbing or massage of the leg is usually all that is needed to get the child back to sleep. In severe cases, anti-inflammatory drugs at bed time can help. The condition is self limiting and will resolve on its own eventually.
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