A Blog from Your Kaiser Permanente Pediatricians in Northern California

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Help for Growing Pains in Your Child’s Legs

What are growing pains? When I was a resident training for a couple of months at a famous orthopedic hospital, I also had a 4-year-old son who complained some nights that his legs hurt.

So one day I asked the chief of staff that very question. She told me that as a child she too had mysterious leg pains in the evening, and – unlike many of her colleagues – she knew they were real. Her words gave me a great deal of relief. Most pediatricians I asked seemed to think these “growing pains” were created by my son to avoid going to bed because he missed his mom!

What doctors call benign nocturnal limb pains of childhood can cause achy or throbbing pains in the calves, or behind the knees or the thighs. The pain tends to affect both legs, and occurs in the afternoons, evenings before bed, or after sleeping an hour or two.

The affected limb appears completely normal – it’s not red, bruised, or swollen – but the muscles may be tender when touched at the time of pain. The pains are gone in the morning and throughout the day. Affected children aren’t otherwise sick.

It’s a bit of a mystery what causes about 10 to 20% of kids ages 2 to 12 to have these leg pains. Since growth – even at its most rapid phase – occurs super slowly, it’s unlikely to cause pain. Also, these pains occur when kids are actually in one of their slower phases of growth (they don’t occur during the faster growth of puberty and they’re most common in 4- to 6-year olds).

However, we do know these pains aren’t just a behavioral trick to get out of bed! Instead, the pain is thought to be caused by muscle fatigue. Growing pains tend to occur after busy, active days.

What helps?

  • Stretching. This can really make a difference! Try to get your kid started on a stretching program, both before any sports activities and before bed. You can have fun doing this together as part of your bedtime routine.
  • Massage. Even when the muscles feel tender, some gentle rubbing helps most kids.
  • Heat or cold. Try a heating pad or a cool pack. Some kids feel less pain with one or the other. A warm bath can help the pain and calm a child down before bed.
  • Medicine. Sometimes a child may need some acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to calm the pain.

When to see your doctor? It’s okay to email, call, or come in anytime you’re worried about your child! Be sure to see your pediatrician if the pains occur:

  • After an injury.
  • On one side or in one specific place.
  • In a joint.
  • During the day and affect your child’s activity.
  • With a limp.

Also contact the doctor if the pains are associated with:

  • Visible changes like redness or swelling.
  • Signs of illness such as fever, rash, weakness, decreased energy or appetite, or weight loss.
  • Dark, brownish urine especially after an active day.

Growing pains go away as mysteriously as they start. There’s unfortunately no treatment to make them go away faster. But they cause no long-lasting problems.

And be assured they’re also not caused by a child wanting to stay up later because his mother is working long hours!

Disclaimer: If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.