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Growing pains are commonly found in children aged three to twelve, but they aren’t actually caused by growth. Unfortunately, we still don’t truly know what does cause them.

“They do tend to occur in children, therefore they are happening at a point in life when you are growing. But they likely don’t have a whole lot to do with the actual process of growing,” states Dr. Derek Kelly, Pediatric Orthopedic surgeon at Le Bonheur Children’s Hospital.

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Symptoms and Treatment Options

Growing pains typically show up in the evenings around bedtime, and again in the early hours of slumber. They typically affect both legs, from the knee down towards the ankle in the region of the shin bone. Some kids will only experience a mild aching pain, while others feel an intense, sharp pain that prevents them from going to sleep or staying asleep. While somewhat rare, kids may experience pain in the upper extremities as well.

The pain can last up to a few hours, but Dr. Kelly says parents generally don’t let it go on that long without intervention such as massage, heat, or an over-the-counter medication.

“As long as it’s okay for your child to take over-the-counter medicines like Tylenol or ibuprofen, those are usually fairly effective,” he notes. “I don’t recommend that my patients take them every night, but for those nights when they are really having symptoms, it’s nice to have them available.”

When to Seek Medical Care

If the aforementioned therapies fail to provide relief, or if the pain is concerning in other ways, Dr. Kelly advises parents to enlist the help of the child’s pediatrician—and possibly an orthopedic specialist.

“The concerning symptoms are if the pain only occurs in one leg, if it’s happening every single night, or if it develops at odd times in the day outside of the growing pain hours from about 8 p.m. to midnight,” he explains. “So, if the child is having pain in the mornings or throughout the school day, if there’s any redness or swelling, or any types of deformities, then of course they should seek care sooner than later.”

Potential Causes

Past research has indicated a link between growing pains and physical activity, but Dr. Kelly cautions this is not a direct correlation. “We do think they are related to the tissues around the bones where the muscles, tendons, and ligaments attach. We know that kids like to run and play and jump, and perhaps the stress of repeated activity creates some pain in those areas. But, it’s not always that way. Kids can have growing pains on days when they are fairly relaxed.”

One theory proposes the pain appears at night because kids have slowed down; their minds are relaxing and they may be paying more attention to their pain—whether consciously or subconsciously. Another has to do with growth hormone levels. “One of the reasons we thought growing pains were related to growth was that growth hormone levels tend to rise at night,” adds Dr. Kelly. “That’s probably not true. It’s multifactorial. In the end, I don’t know that we really know why night is the worst time.”

Will my Child Suffer from Growing Pains?

Studies conducted to this point suggest anywhere from 10-30 percent of kids will have some experience with growing pains. The severe pains, the ones that are so bad the family seeks care, account for approximately 5-10 percent. Regardless of pain level, Dr. Kelly recognizes how disruptive growing pains can be to the entire family.

“It can be miserable, and it is certainly very distressing for the families who have a child in severe pain and who is difficult to console. So, yes, it’s really quite a challenge for many families.”