What are the best methods for relieving growing pains in the legs?

How to Relieve Growing Pains in Legs

For growing pains in children, use simple analgesic measures including acetaminophen or ibuprofen at bedtime, combined with gentle massage, heat application, and stretching exercises, with reassurance that this is a benign, self-limited condition.

Understanding Growing Pains

Growing pains are the most common musculoskeletal complaint in children aged 2-12 years, characterized by recurrent, bilateral lower extremity pain (knees, thighs, calves, or shins) that typically occurs in the afternoon, evening, or at night 1, 2. Despite the name, these pains are not actually caused by growth 3. The typical episode lasts 10-15 minutes and occurs in an otherwise healthy, clinically normal child 1. The etiology remains unknown, but the prognosis is excellent with complete resolution expected 2.

Immediate Relief Measures

Pharmacologic Treatment

• Acetaminophen is the preferred first-line analgesic for mild to moderate pain, offering effective relief without gastrointestinal side effects 4, 5

  • Dosing should follow age-appropriate guidelines on the label 5
  • Can be given at bedtime prophylactically if pain episodes are frequent 6

• Ibuprofen serves as an alternative analgesic for pain relief 7, 6

  • Use 400 mg every 4-6 hours as necessary for pain relief in older children (dose adjusted for younger children per weight) 7
  • Aspirin has been historically used but ibuprofen or acetaminophen are now preferred 6

Non-Pharmacologic Interventions

• Gentle massage of the affected leg muscles provides immediate comfort and reassurance 1

• Heat application using warm compresses or warm baths can provide analgesia for painful muscles 8

  • Warm water therapy at approximately 86°F is effective 8

• Gentle stretching exercises of the leg muscles before bedtime may reduce episode frequency 1

Diagnostic Certainty Required

A diagnosis of growing pains can only be made after ruling out other conditions through appropriate clinical evaluation and observation over months 6. The key distinguishing features include:

• Bilateral leg pain (not unilateral) 1, 2
• Normal physical examination findings 1
• Pain occurring at rest, not during activity 2
• No morning stiffness or limping 2
• Self-limited episodes lasting minutes, not hours 1

The two conditions most commonly confused with growing pains are rheumatic fever and juvenile rheumatoid arthritis, which must be excluded 6.

Parental Reassurance

Providing reassurance to parents that this is not a serious condition is a critical component of management 1. Parents should understand that:

• Growing pains are benign and self-limited 2
• No serious rheumatic or malignant disease is present 2
• The condition will resolve spontaneously, typically by adolescence 2
• No long-term complications occur 2

Common Pitfalls to Avoid

• Do not diagnose growing pains in a child with unilateral leg pain, as this suggests alternative pathology 1, 2
• Do not dismiss persistent or progressive symptoms without appropriate evaluation for other conditions 6
• Do not confuse growing pains with restless legs syndrome, which is a different condition despite some clinical similarities 9
• Do not attribute daytime pain or pain during activity to growing pains, as these suggest alternative diagnoses 2