Growing Pains

Information for Families – Recurrent Nocturnal Limb Pains

Introduction
These aches and pains are often called “growing pains” or “idiopathic” (of unknown cause) limb pains. They are relatively common in children from ages 2-8 years.

Symptoms
They are typical after an active day, the child falls to sleep normally but wakes after a few hours with pain in the legs, This is usually in the shins but sometimes can be centered on the knees or the ankles. Much less commonly there may be some pain in the arms as well.

Cause
The cause remains unknown. It’s not clear where the pain originates from or what causes it. The most likely explanation is that the aches and discomfort arise from normal jumping, climbing and running activities earlier in the day.

Investigations
The characteristic history and the lack of clinical findings in the clinic are typical that the diagnosis can usually be made confidently without subjecting the child to any uncomfortable tests. Joints affected by more serious pahology are usually swollen, red, tender, or warm, whereas the joints of children experiencing growing pains appear normal. If there is any doubt at all, more serious arthritic and other conditions can be excluded with simple blood tests and an X-ray of the painful areas.

Treatment
It is important for the child and the family, to understand that although the pains may be severe and distressing, they are not harmful and will go away in time. When the pain occurs most children find local warmth and massage of the affected area soothing and that may be all that is needed. If the pattern is for the pain to persist more than a few minutes it is wise to give a dose of paracetamol (calpol) as soon as the pain occurs, this usually brings relief in about 15 minutes. Parents can sometimes predict which nights the child is likely to get pain, dependent on the activities that day. If that is the case it is safe to give some pain relief before bedtime. Use the recommended doses for the age of your child.

Outlook
Growing pains virtually never evolve into any serious form of arthritis or other disease. They may remain troublesome for a while but they seem to disappear as mysteriously as they came.