Quick answer: Growing pains — intermittent limb pain in toddlers and young children, typically at night — are one of the most common pain complaints in childhood.
Growing pains — intermittent limb pain in toddlers and young children, typically at night — are one of the most common pain complaints in childhood. They’re real, benign, and manageable, but it’s worth knowing what they actually are (and aren’t).
Are Growing Pains Real?
Yes, growing pains are a real phenomenon — but the name is misleading. The pain is not caused by bones growing (bone growth is not painful) and doesn’t correlate with growth spurts. ‘Growing pains’ is the accepted clinical term for benign, idiopathic (no known cause) limb pain in children aged 3–12 years, with no underlying pathology. The actual cause is unclear — proposed mechanisms include: muscle fatigue from an active day, altered pain sensitivity, reduced bone density, and psychological factors. They affect approximately 25–40% of children at some point.
What Growing Pains Feel Like
Classic features: Location: Both legs, typically in the calves, thighs, and behind the knees. Never in the joints (knee pain or hip pain is different). Timing: Almost exclusively at night, often waking the child from sleep in the evening or first half of the night. Never during the day. Severity: Can be severe enough to cause crying and seeking comfort. Duration: Usually resolve within an hour, often with massage. Pattern: Come and go — not every night, often with pain-free periods for days or weeks.
What It Isn’t: Red Flags to Rule Out
Growing pains should be distinguished from pathological causes of limb pain in children. Seek evaluation for: pain during the day (true growing pains only occur at night), pain localised to a joint (joint pain is not growing pains), swelling, warmth, or redness around a joint, pain on one side only (growing pains are bilateral), limping during the day, fever alongside pain, tenderness over a bone (not muscle), or pain that doesn’t respond at all to simple analgesia.
Management
- Massage: firm massage of the affected muscles is the most effective immediate relief
- Warmth: warm flannel, warm bath, or heat pack on the painful area
- Paracetamol or ibuprofen: appropriate doses if massage and heat aren’t sufficient
- Stretching exercises during the day — some evidence that daily calf and thigh stretches reduce frequency
- Reassurance: knowing the pain is benign and will pass helps children (and parents) manage it
Frequently Asked Questions
My 18-month-old seems to have leg pain at night — could it be growing pains?
Growing pains are rare below age 3 — the typical age range is 3–12 years. Leg pain in an 18-month-old warrants evaluation to rule out hip problems (transient synovitis, Perthes disease, developmental dysplasia), infection, and other causes. Don’t attribute limb pain in a toddler under 3 to growing pains without professional assessment.
Do growing pains predict anything about height?
No — growing pains don’t predict adult height, growth rate, or bone health. The name is a historical misnomer that has persisted despite being inaccurate.
Should I take my child to a doctor for growing pains?
If the pattern is classic (bilateral leg pain, only at night, responding to massage, no daytime symptoms, no joint involvement), a doctor’s visit is not urgent. However, if you’re uncertain, if your child has had several episodes, or if there are any atypical features, a GP assessment is worthwhile — particularly to document that other causes have been considered.
When to take growing pains seriously
Growing pains are typically bilateral (both legs), occur in the late afternoon or evening, resolve overnight, and leave no trace by morning — no limp, no swelling, normal activity the following day. Pain that is localised to one specific spot, associated with swelling, redness or warmth, present in the morning, or accompanied by fever or limping is not growing pains and warrants a GP assessment. The differential includes juvenile idiopathic arthritis, stress fractures, bone tumours (rare), and referred hip pathology. A child who is limping on waking, reluctant to weight-bear, or consistently protecting one limb should be seen promptly.
Related Reading
- 12 month old baby: first birthday milestones & 1-year check-up
- Baby not meeting milestones: when to worry, when to wait
- Developmental delay: what early intervention looks like
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