Health condition · Clinically reviewed
Growing pains, common, benign, and almost always self-limiting.
Real pain, and a real pattern - bilateral, in the evening or at night, gone by morning. This guide explains the picture, the red flags that are not growing pains, and what actually helps at home.
Why trust this guide
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Clinically reviewed
Written by our editorial team and reviewed by a UK-registered paediatric clinician before publication.
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Sourced from guidance
Checked against NICE, RCPCH and peer-reviewed paediatric rheumatology sources you can see at the end.
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Current for 2026
Reflects current UK primary-care advice and red-flag guidance for paediatric limb pain.
Key facts
Growing pains at a glance.
The essentials, in plain English - what growing pains are, who gets them, and how they behave.
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What it is
A common, benign, self-limiting pattern of intermittent bilateral leg pain in children, most often between three and twelve years.
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How common
Around 30 to 40 per cent of children experience episodes at some point in childhood.
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What it is not
Not truly caused by growth. Bones do not grow fast enough or painfully enough to explain it.
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Where it hurts
Calves, shins, thighs, behind the knees or arches of the feet - muscle territory, not joints.
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When it hurts
Late afternoon, evening or during the night - sometimes waking a child from sleep. Never on waking in the morning.
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How it settles
Reassurance, gentle massage, warmth and simple analgesia. Children are entirely well between episodes.
Why this guide matters
Confident reassurance, and a clear line between benign and not.
Growing pains are common and harmless - but the label is only correct once specific red flags are excluded. The three points below shape everything else on this page.
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The pattern is specific
Bilateral, muscular, evening or night-time only, gone by morning - and the child is entirely well between episodes.
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Red flags are non-negotiable
Unilateral pain, joint symptoms, morning stiffness, limp or systemic upset are not growing pains and need review.
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Reassurance is the treatment
Simple comfort measures, occasional analgesia and confident reassurance are usually enough - and the picture resolves by adolescence.
How the diagnosis is made
From first episode to a settled home plan.
Growing pains are a clinical diagnosis. The steps a UK GP or paediatrician will normally follow, in order, so you know what to expect.
Phase 1 · Assessing
History, examination and red-flag screen
Phase 2 · Confirming
Selective bloods, imaging and referral
Phase 3 · Managing
Home plan and safety-netting
- 01
Assessing
A careful history
Timing, laterality, duration, response to comfort, and whether the child is normal between attacks - the diagnosis is largely clinical.
- 02
Assessing
Full physical examination
Joints, gait, growth and a general systemic check - looking for anything that does not fit a benign pattern.
- 03
Assessing
Screen for red flags
Unilateral pain, limp, joint swelling, morning stiffness, fever, weight loss, pallor, bruising or night sweats need investigation.
- 04
Confirming
Bloods only if indicated
Full blood count and inflammatory markers when red flags are present - not routine for classical growing pains.
- 05
Confirming
Imaging when warranted
X-ray or ultrasound for post-trauma pain, apophysitis or suspected growth-plate injury - never a screening test.
- 06
Managing
Paediatric specialist review
Rheumatology or orthopaedics if the picture is atypical, refractory or has features suggestive of JIA or bone disease.
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Managing
A written home plan
Simple written advice for parents on what to do during episodes and when to come back - reduces anxiety and unnecessary return visits.
Typical timeline: a single consultation is usually enough to make the diagnosis and settle the plan.
Symptoms
What growing pains actually look like.
A remarkably consistent pattern - and the specific features that should make you pause and ask for review.
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Bilateral leg pain
Both legs, in muscle territory - calves, shins, thighs, behind the knees or in the arches.
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Late-day or night onset
Pain arrives in the late afternoon, evening or during the night - occasionally waking the child.
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Well between episodes
Completely normal on waking, no limp, no morning stiffness and full participation in daily activities.
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Short attacks
Typical episodes last 15 to 30 minutes and settle with comfort measures - days or weeks may pass between them.
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Responsive to comfort
Massage, warmth, a cuddle and simple pain relief usually resolve the episode.
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Age three to twelve
Most common in pre-school and primary-school years, tailing off around adolescence.
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Family pattern
Often runs in families - a parent may remember something similar as a child.
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Red flag - anything unilateral
One-sided pain, joint pain, morning stiffness, limp or systemic symptoms are not growing pains and need review.
Treatment
How growing pains are managed at home.
Simple, consistent comfort measures - and a clear route back to your clinician if the pattern changes.
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Reassurance
The single most important intervention - a benign, self-limiting condition that resolves by adolescence in almost every child.
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Gentle massage and warmth
A warm bath, heat pad or firm rub of the calves and thighs settles most attacks within 15 to 30 minutes.
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Simple analgesia
Paracetamol or ibuprofen at age-appropriate doses for occasional severe episodes - not a nightly routine.
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Stretching before bed
Gentle calf, hamstring and quadriceps stretches in the evening reduce the frequency of episodes in many children.
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Supportive footwear
Well-fitted shoes with proper arch support - especially if flat feet or hypermobility are contributing.
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Activity balance
Adequate rest after very active days, plus good hydration and sleep - avoid over-restricting normal play.
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Selective supplements
Vitamin D, magnesium or calcium only where a genuine dietary or biochemical deficiency is identified - not routine.
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Specialist paediatric referral
Rheumatology or orthopaedic review when features are atypical, refractory or suggest an alternative diagnosis.
What this guide is based on
The sources behind every claim on this page.
UK national guidance and specialist paediatric society standards, current at the time of last review.
Key references
Guidelines and standards we relied on.
A quiet reminder
This guide is for information, not medical advice.
Your GP or paediatrician knows your child and their history and can tell you which parts apply. If in doubt, get seen.
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NICE CKS. Musculoskeletal pain in children - assessment and referral.
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Royal College of Paediatrics and Child Health (RCPCH). Assessment of the limping child.
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British Society for Paediatric and Adolescent Rheumatology (BSPAR). Red-flag guidance for paediatric musculoskeletal presentations.
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Peer-reviewed reviews on benign nocturnal limb pain of childhood (2020 to 2025).
Red flags
What is not a growing pain.
Most childhood leg pain is benign. These are the features that are not - and where a specialist opinion is needed.
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Unilateral pain
Pain in only one leg is not a growing pain - consider infection, tumour, apophysitis or an orthopaedic cause and arrange review.
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Joint pain, swelling or redness
Points to inflammatory or septic arthritis rather than growing pains - needs urgent paediatric review. See /conditions/arthritis/.
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Morning stiffness
Stiffness on waking suggests juvenile idiopathic arthritis (JIA), not growing pains - refer to paediatric rheumatology.
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Limp or refusal to weight-bear
A child who limps or refuses to walk needs same-day assessment - never label this as growing pains.
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Night sweats, weight loss or pallor
Systemic symptoms with limb pain can indicate leukaemia. Urgent bloods and paediatric review are essential. See /conditions/childhood-leukemia/.
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Fever, bruising or rash
Any systemic upset alongside limb pain needs prompt evaluation for infection or haematological disease.
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Family history of inflammatory disease
A close family history of RA, ankylosing spondylitis or JIA raises the threshold for reassurance - refer earlier.
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Recent trauma or growth-plate concern
Post-injury pain deserves imaging to exclude a physeal fracture. See /conditions/growth-plate-injuries/.
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Localised bony tenderness
Tenderness over the tibial tuberosity or heel can indicate Osgood-Schlatter or Sever’s disease - a paediatric orthopaedic opinion is helpful.
Living with it
A phase, with a plan for the difficult nights.
Four things that make the biggest difference - a shared name for the pain, an evening ritual, a sensible activity balance and a clear route back if anything changes.
A quiet reminder
Reassurance done well is a treatment.
A confident explanation, delivered calmly, reduces both the frequency and the impact of episodes over time.
- 01 Reassure
Name it, and normalise it
Explain to your child that the pain is real, harmless and always goes away - words that reduce fear reduce pain.
- 02 Routine
A calm evening ritual
A warm bath, gentle stretches and a short massage before bed can prevent many episodes over time.
- 03 Balance
Rest and hydration on busy days
After a very active day, encourage water, an early night and a supportive shoe the next morning.
- 04 Return
Come back if anything changes
New limp, joint swelling, morning stiffness or systemic upset means the pattern has changed - book an appointment.
Frequently asked
Everything parents ask us about growing pains.
Quick answers on the pattern, what helps, and when to worry.
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What are growing pains?
A benign, self-limiting pattern of intermittent bilateral leg pain in children, most often between three and twelve years. The pain is felt in the calves, shins, thighs, behind the knees or in the arches - muscle territory, not joints - and the child is entirely well between episodes.
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Are growing pains actually caused by growing?
No. The name is historical. Bones do not grow fast enough or painfully enough to explain the symptoms. The cause is not fully understood, but overuse, biomechanical factors such as flat feet or hypermobility, and a lower pain threshold in some children all appear to contribute.
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How do I tell growing pains from something serious?
Growing pains are bilateral, evening or night-time only, muscular in location and completely gone by morning. Anything unilateral, any joint swelling, any morning stiffness, any limp or refusal to weight-bear, and any systemic symptoms such as fever, weight loss, pallor or night sweats are not growing pains and need a clinical review.
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What helps during an episode?
A warm bath or heat pad, a firm massage of the calves and thighs, a cuddle and simple age-appropriate paracetamol or ibuprofen if the pain is severe. Most attacks settle within 15 to 30 minutes.
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Do supplements help?
Not routinely. Vitamin D, magnesium or calcium can be considered where a genuine deficiency is suspected or confirmed, but they are not a first-line treatment for classical growing pains.
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When should I see a paediatrician?
If pain is one-sided, involves the joints, is present in the morning, comes with a limp, follows an injury, or is accompanied by fever, weight loss, pallor, bruising, night sweats or a rash, book an appointment promptly. Persistent or unusually severe symptoms also warrant a specialist review to rule out JIA, apophysitis, growth-plate injury or, rarely, more serious diagnoses.
Related content
Keep reading.
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Growth plate injuries
When post-injury pain is not a growing pain.
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Growth plate fractures
Physeal fractures and how they are managed.
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Ehlers-Danlos syndrome
Hypermobility that can amplify childhood pain.
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Flat feet
A biomechanical contributor worth checking.
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Febrile seizure
Another common, benign childhood presentation.
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Physiotherapy clinic
Related treatment option.
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DEXA scan
Related treatment option.
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Private MRI scan
Related diagnostic test.
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