From the Guidelines
Growing pains are not actually caused by growth itself, despite their name, and their exact cause remains unknown. These pains are typically characterized by deep, aching sensations in both legs, usually occurring in the late afternoon or evening and sometimes waking children at night. Several theories exist, including the possibility that growing pains result from the fatigue of muscles after intense physical activity during the day, as suggested by various studies on pediatric chronic pain 1. Another theory suggests they may be related to psychological stress or lower pain thresholds in some children. Some research points to potential connections with vitamin D deficiency or decreased bone strength. It's worth noting that the prevalence of pediatric chronic pain appears to be on the rise, with an increase of 831% in the rate of pediatric chronic non-cancer pain inpatient admissions observed from 2004–2010 1. However, growing pains are benign and self-limiting, typically affecting children between ages 3-12, and they don't cause any long-term damage or indicate any serious underlying condition.
- Treatment usually involves comfort measures like:
- Gentle massage
- Heat application
- Over-the-counter pain relievers such as acetaminophen or ibuprofen at age-appropriate doses
- Reassurance that the condition is temporary and harmless
- Factors outside of the immediate family environment, such as living in walkable neighborhoods or having nearby parks, may also play a role in reducing the risk of developing chronic pain in youth 1.
From the Research
Causes of Growing Pains
The exact cause of growing pains is still unknown, but several factors have been proposed as potential contributors:
- Mechanical factors, such as joint hypermobility and flat feet 2
- Decreased pain thresholds 2, 3, 4
- Reduced bone strength 2, 3, 4
- Emotional factors involving the patient's family and other social stressors 2
- Genetic susceptibility 4
- Psychological factors 4
- Vitamin D deficiency has been investigated, but its role is still unclear 4
Theories on Growing Pains
Several theories have been proposed to explain the etiology of growing pains, including:
- Lower pain threshold theory, which suggests that children with growing pains have a lower pain threshold than healthy controls 3, 4
- Reduced bone strength theory, which suggests that children with growing pains have reduced bone strength in the affected areas 3, 4
- Anatomical/mechanical theory, which suggests that mechanical factors such as joint hypermobility and flat feet contribute to growing pains, but this theory has not been supported by evidence 4
- Vascular theory, which suggests that changes in vascular perfusion pattern contribute to growing pains, but this theory has not been supported by evidence 4