It is 9pm and your child is awake again, holding their legs and asking you to rub them. By breakfast they are sprinting around the kitchen as if nothing happened. If that pattern sounds familiar, you are likely looking at growing pains, and the pattern itself is the most reassuring part.
Growing pains are one of the most common causes of recurring limb pain in childhood. They are also surrounded by two opposite mistakes: parents who worry something serious is being missed, and parents told to dismiss every leg complaint as growing pains when a few features deserve a proper look. This article gives you both halves: the pattern that is normal, and the short list that is not.
In this article
What are growing pains?
Growing pains are recurring aches, usually in both legs, that show up late in the day or during the night in otherwise healthy children, most often between about three and twelve years of age. The shins, calves, thighs and backs of the knees are the usual spots.
Importantly, growing pains are what clinicians call a diagnosis of exclusion. There is no scan or blood test that confirms them. The diagnosis rests on the pattern fitting and the examination being normal, which is why the pattern matters so much.
What does the normal pattern look like?
The classic picture is remarkably consistent, and every feature carries weight:
Both legs, not one. Evening or night, sometimes waking the child. Settles with rubbing, cuddles, warmth or simple pain relief as advised by your pharmacist or GP. And the defining feature: the child is completely well the next morning, walking normally, running at lunch, playing sport, with nothing to find on examination.
Busy activity days are often followed by a bad night, which fits with the pains being related to activity load rather than anything sinister. If a child in the Mount Gravatt corridor is limping at school pickup, that is not this pattern, and it is exactly what our physio Mount Gravatt team is set up to assess.
How common are they?
An Australian figure
The prevalence study behind that number was run in South Australian children and published in the Journal of Pediatrics in 2004, making it one of the best local estimates available. Roughly one child in three at that age fits the picture.
So if your household is doing the 9pm leg-rub shift, you are in very large company.
Not sure the pattern fits? A children's assessment at ACE Sports Medicine in Upper Mount Gravatt checks the things that matter and gives you a clear answer, usually in one visit.
Are they actually caused by growing?
Probably not, despite the name. The research does not show that growth spurts cause the pain, and the pains do not cluster at the times or places of fastest growth. Current thinking points more towards activity load, muscle fatigue and individual pain sensitivity, with a strong family tendency.
The name has stuck because it is old and familiar, but it is worth knowing it is a label for a benign pattern, not an explanation.
What helps on a bad night?
Simple things, done calmly. Gentle massage of the sore muscles, a warm bath or heat pack before bed, reassurance, and simple pain relief if your pharmacist or GP advises it. On the prevention side, many families find that stretching the calves and thighs in the evening, sensible load management across big sport days, and supportive footwear reduce the frequency of bad nights.
Where a child has recurring bad runs, a physiotherapist can look at the whole picture, including feet, flexibility, strength and weekly sport load, and build a simple plan that the child can actually follow. Many families find the pattern eases considerably once load and recovery are balanced.
When should you seek help?
This list is the whole reason this page exists. Growing pains are benign, but they have imitators, and the imitators do not follow the pattern.
Consider getting assessed if
The pain is in one leg only; your child limps, or the pain is present during the day or in the morning; there is swelling, redness or warmth over a joint or bone; your child has a fever, night sweats, is losing weight or seems generally unwell; or the pain is getting steadily worse over weeks. Any of these takes the picture out of the growing-pains pattern and deserves a proper assessment, starting with your GP or physiotherapist.
The Quick Guide
A one-page summary you can save or print. Tap the image or the button to download the free PDF.
Helping You Perform at Your Best
Our physiotherapy team at ACE Sports Medicine in Upper Mount Gravatt assesses children and adolescents from across Brisbane's southside, from night-time leg aches through to school sport injuries. If you would like certainty rather than 9pm guesswork, we are here.