What are the causes of idiopathic nocturnal pains in children?

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Last updated: April 29, 2025View editorial policy

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From the Research

Idiopathic nocturnal pains in childhood, commonly known as growing pains, are benign, self-limiting musculoskeletal pains that typically affect children between 3-12 years of age and can be effectively managed with reassurance, gentle massage, and over-the-counter pain relievers such as ibuprofen (5-10 mg/kg/dose) as needed, as supported by the most recent and highest quality study 1.

Key Characteristics of Growing Pains

  • Typically occur in the late afternoon or evening, often waking children from sleep
  • Primarily affect the lower extremities (calves, thighs, and behind the knees)
  • Bilateral pain is more common than unilateral pain
  • Pain is not caused by activity and will not cause a limp

Management and Treatment

  • Parents should provide reassurance that these pains are not harmful and will resolve with time
  • Simple measures include:
    • Gentle massage of the affected area
    • Application of heat using a warm compress
    • Over-the-counter pain relievers such as ibuprofen (5-10 mg/kg/dose) for significant discomfort, which has been shown to be more effective than acetaminophen in some pain conditions 2
  • Stretching exercises before bedtime may help prevent episodes

Importance of Diagnosis of Exclusion

  • Growing pains are a diagnosis of exclusion; persistent pain, pain that occurs during the day, unilateral pain, pain associated with limping, swelling, redness, or fever warrants medical evaluation to rule out more serious conditions
  • The exact cause of growing pains remains unknown, though theories include muscle fatigue from daily activities, rapid growth spurts causing tension on bones and muscles, and possible psychological factors, as discussed in the context of pediatric pain and sleep disturbances 3

Long-term Prognosis

  • Most children outgrow these pains by adolescence without any long-term consequences
  • Effective management and reassurance can help improve the quality of life for children experiencing growing pains, as emphasized by the importance of addressing pain and sleep disturbances in pediatric populations 3

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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