From the Guidelines
Growing pains can be managed effectively with a combination of comfort measures and pain relief, as guided by the 11 consistent recommendations from high-quality clinical practice guidelines 1. For immediate relief, apply gentle massage to the affected area, use a heating pad on a low setting for 15-20 minutes, or give a warm bath before bedtime. Over-the-counter pain medications like acetaminophen (Tylenol) at a dose of 10-15 mg/kg every 4-6 hours or ibuprofen (Motrin, Advil) at 5-10 mg/kg every 6-8 hours can help reduce discomfort, as suggested by best practice care for musculoskeletal pain 1. Always follow age-appropriate dosing on the package. Some key considerations for management include:
- Stretching exercises for the legs, particularly the quadriceps, hamstrings, and calves, performed daily can help prevent episodes
- Ensure your child maintains proper nutrition with adequate calcium (1000-1300 mg daily) and vitamin D (600 IU daily)
- Growing pains typically occur in children 3-12 years old, are benign, and usually resolve on their own by adolescence
- They're believed to result from the normal growth process, muscle fatigue from daily activities, or possibly lower pain thresholds If pain is severe, persistent, associated with swelling, redness, limping, or affects daily activities, consult a healthcare provider to rule out other conditions. Following these guidelines can improve the quality of care of musculoskeletal pain, including growing pains 1.
From the Research
Management of Growing Pains
- The management of growing pains generally consists of symptomatic care with massage and over-the-counter analgesics, as well as reassurance to children and parents about the benign, self-limited nature of this condition 2.
- A simplified stretching exercise regimen for the pelvic limbs, together with analgesics and physical therapy, may improve growing pains during an 8-week period 3.
- Reassuring words and physical relaxation exercises, in addition to massaging and stretching of the leg muscles, can cause a significant reduction in pain without medication 4.
- Mild pain medications can be employed in more severely affected patients 4.
Treatment Approaches
- Conservative treatments, including pharmacological therapy, procedures, and exercise, are being used to control chronic pain, which may be relevant to managing growing pains 5.
- A treatment regimen consisting of three stretching exercises for the adductors, the knee extensors, and the hamstrings, plus analgesics and physical therapy, was effective in improving growing pains in patients 3.
Diagnostic Considerations
- When a patient's history is classic for growing pains and physical examination is normal, laboratory and radiographic evaluation are not needed to make the diagnosis 2.
- Additional workup is warranted for children with an atypical history, systemic symptoms, or for those individuals with physical examination abnormalities 2.
- Growing pains constitute a diagnosis of exclusion, and a thorough patient history and physical examination are essential to rule out other possible causes of leg pain 4.