Growing pains or something else?

Growing pains are common and harmless. But when your child is in pain, it can be hard to know when it will get better on its own and when to call the doctor. Zurisadai Gonzalez Castillo, M.D., Pediatric Neurologist at Children's Health℠ and Assistant Professor at UT Southwestern, offers advice.

“As parents, it's our job to worry – and it's so easy to go straight to the worst-case scenario or fear that we’re missing something,” Dr. Gonzalez Castillo says. “Growing pains are very common and are not harmful to your child. And if you’re worried, you can always talk to your pediatrician."

What are growing pains?

“Growing pains” are a common type of pain some kids experience at night. They are:

• Benign. They may be painful, but they are benign (harmless), which means they don’t do any damage to your child’s body.

• Not caused by an underlying disease. They are not related to an illness or injury.

• Temporary (self-limited). They will go away on their own without specific medical treatment.

Signs of growing pains

Growing pains usually:

• Happen in children around ages 3-12

• Happen in the evening and improve by morning (they may wake a child from sleep)

• Cause mild to severe pain, often described as aching, throbbing or cramping, in both legs

• Affect muscles (quads, calves), not joints (knees, ankles)

• Have no swelling, redness or warmth

• Don’t stop a child from their usual activities (they can still run, jump and play sports)

• Are intermittent, meaning kids may have pains some nights but not every night (kids may get these pains occasionally for months or even years, but they are not constant – they come and go)

• Do not cause any abnormalities on a physical exam

Signs your child’s pain may be something else

The following symptoms are not usually related to growing pains:

• Pain during the day

• Pain in one leg only

• Joint pain (knees, ankles, elbows and wrists)

• Swelling, warmth, bruising or redness of the skin

• Pain that limits a child’s ability to do their usual activities

• Pain that’s constant or gets worse over time

• Limping or walking on toes

• Seeming off balance or falling frequently

• Muscle weakness

If it's not growing pains, what could it be?

Pain in a child’s arms or legs at night is fairly common after an accident or injury. Less common conditions that can cause similar pain include:

• Infections

• Restless leg syndrome and related disorders

• Rheumatologic disease

• Muscle or nerve disease (acquired or hereditary)

• Certain types of neuropathy

• In very rare cases, cancer

“Growing pains are very common, while these conditions are quite rare – and almost always have symptoms beyond just muscle pain at night,” Dr. Gonzalez Castillo says.

When to seek care for growing pains

If you’re worried about your child’s pain, contact your pediatrician. They can help you understand whether your child is having growing pains or pain from an injury or illness. They can also help you know what to do to help ease your child’s pain.

If a child shows symptoms consistent with typical growing pains and has no signs of illness or injury, doctors may simply monitor symptoms without performing tests. An x-ray might be done if a child has a history of injury in the area where they’re experiencing pain.

“If the X-ray is normal and there are no red flag symptoms, we don’t usually recommend further imaging or blood tests,” Dr. Gonzalez Castillo says. “Studies show that in the absence of red flags or atypical symptoms, doing additional imaging or bloodwork is not necessary.”

How to relieve growing pains

If your child has muscle pain in their legs in the evening or wakes up complaining of muscle pain, you might try:

• Massage

• A heating pad

• Gentle stretching

• Over-the-counter pain relievers

“I always encourage parents to take note of how often they are giving their child over-the-counter pain medicine,” Dr. Gonzalez Castillo says. “If it's once-in-a-while, that’s OK. But if it's happening every night, talk to your pediatrician."

Find care

Children's Health Primary Care offers comprehensive health care for children from birth through young adulthood. Our pediatricians combine quality care with evidence-based practice to meet your child's medical needs. Learn more and find a pediatrician.

Rarely, leg pain in kids can be related to a neuromuscular condition. Learn more about the Neuromuscular Program at Children’s Health.