What is the duration of growing pains?

Duration of Growing Pains in Children

Growing pains typically last from early childhood until around age 12, with episodes occurring intermittently for months to years during this period. 1, 2

Characteristics of Growing Pains

Growing pains represent a common, benign pain syndrome affecting up to one-third of all children. Despite the name, these pains are not actually related to growth 1. Key features include:

• Age range: Most commonly affects children aged 2-12 years 2
• Pain pattern:
  • Bilateral lower extremity pain (knees, thighs, calves or shins)
  • Occurs late in the day, evening, or at night
  • Pain episodes typically last 10-15 minutes but can be intense 3
  • Pain is not caused by activity and does not cause limping 4
  • Self-limited episodes that recur intermittently

Duration of Individual Episodes vs. Overall Condition

It's important to distinguish between:

1. Duration of individual pain episodes: Typically 10-15 minutes of intense pain 3
2. Duration of the overall condition: Can persist intermittently for months to years during childhood, generally resolving by early adolescence 1, 2

Diagnostic Approach

When evaluating a child with suspected growing pains, look for:

• Bilateral pain (unilateral pain is a red flag)
• Normal physical examination
• Absence of systemic symptoms
• Pain that occurs in the evening or at night rather than during activity

Red Flags Requiring Further Investigation

• Unilateral pain
• Morning stiffness
• Joint swelling
• Systemic symptoms (fever, weight loss, malaise)
• Allodynia, focal tenderness, or decreased joint range of motion
• Pain that causes limping 1, 4

Management

Since growing pains are self-resolving with time, management focuses on symptom relief:

• Simple analgesics (acetaminophen, ibuprofen) during pain episodes
• Massage of the affected areas
• Reassurance to both child and parents about the benign nature of the condition 1, 3

Prognosis

The prognosis for growing pains is excellent, with complete resolution expected over time 2. Most children will outgrow this condition by early adolescence with no long-term consequences.

Common Pitfalls

1. Unnecessary testing: When history and examination are classic for growing pains, laboratory and imaging studies are not needed 4
2. Misdiagnosis: Growing pains are sometimes confused with more serious conditions like juvenile rheumatoid arthritis or rheumatic fever 5
3. Overlooking red flags: Failing to recognize signs that warrant further investigation can lead to missed diagnoses of more serious conditions

Growing pains represent a diagnosis of exclusion that should be made only after careful evaluation to rule out other potential causes of limb pain in children.