Growing pains in children: symptoms, causes and what helps

The NHS describes growing pains as a term for leg pain that is common in children aged 3 to 12. It says the pain is harmless and usually gets better on its own.

Sheffield Children's NHS Foundation Trust describes them as pains, discomfort or aches that mainly occur in the legs at night and are mostly seen in children of primary-school age. It says they are very common and can be distressing for the whole family.

Patient.info, a UK health information site, says up to half of all children may experience growing pains at some point, and that they usually start between the ages of 3 and 12.

The NHS says the symptoms can come and go over months, even years. The pain is usually an aching or throbbing in the muscles or joints of both legs, in the evening or night-time, and goes away by morning.

Sheffield Children's adds that a child may complain of pain just before bed and may wake after some hours with pain around the ankles, shins or knees. It tends to affect both legs at the same time and can less commonly affect the arms. Despite disturbed sleep, the child wakes pain-free and can continue normal activities, and symptoms can happen several times a week.

Patient.info lists the calves, shins, ankles and the front of the thighs as common places, and says the pain is usually felt in the areas between the joints rather than in the joints themselves.

The NHS says it is not known what causes growing pains. It is not caused by growing and is not a sign of anything serious. Growing pains are more common in active children and can happen after playing lots of sport. It is also common in children with very flexible joints (joint hypermobility).

Sheffield Children's says the exact cause is unknown but is debated to be a result of the child's growth rate, joint flexibility and activity levels. Aches may arise at night from the normal jumping, climbing and running of the day. It adds that the child is otherwise healthy and that there are no reported links to a risk of developing conditions such as arthritis.

Patient.info says various theories have been tested but none proven, and notes that growing pains may also be more common in children with flat feet. It says some research has looked at vitamin D levels, but many children with growing pains have normal levels.

The NHS suggests gently massaging your child's legs, putting a covered hot water bottle or heat pack on the painful area, and giving children's ibuprofen or paracetamol. It says not to give aspirin to a child under 16 unless a doctor prescribes it.

Sheffield Children's suggests several further steps.

• Reassure your child that the pains are not serious but that you understand what they are experiencing.

• Keep a diary of when the pain occurs, so you can see if a particular activity brings it on more than others, and modify that activity or tell your doctor.

• Check that footwear is supportive and well fitting, with firm fastening of laces or Velcro straps.

• Try preventative painkillers on nights you predict from the diary will be worst, after discussing this with your doctor, using sugar-free medicines to prevent tooth decay.

• Try massaging the muscles and joints when your child complains of pain.

The NHS says symptoms can come and go over months, even years. Sheffield Children's says most growing pains settle with time, often months, and that normal childhood activities will not do any damage to the legs or arms.

Patient.info says that growing pains settle of their own accord and may last a few months or even years, coming and going during that time before settling completely. It adds that there is no evidence showing which treatment works best, so use whichever option seems most comforting.

The NHS lists the situations in which a child with leg pain needs to see a GP, because the pain may have another cause. Sheffield Children's says to take your child to see their GP as soon as possible, or attend A&E if more urgent or out of hours, if there are signs of limping, fever, weight loss, joint swelling, physical injury or infection.

Patient.info says usually no tests are needed and a doctor can usually diagnose growing pains from the description and an examination, with nothing unusual found. Blood tests and X-rays would be normal and are not needed unless there are symptoms or signs suggesting another cause.

Sheffield Children's says diagnosis is generally made following a consultation, taking a medical history, doing a physical examination and excluding other conditions, and that a child may need an X-ray and blood tests, though these are not always needed. A child is usually discharged back to the care of their GP.

Growing pains are usually recognised and managed by a GP, with reassurance and simple pain relief. If features suggest another cause, a GP can refer a child to a paediatrician or children's rheumatology service on the NHS.

Some families choose a private paediatric opinion for reassurance, usually after a GP or consultant letter. Your child's health visitor, school nurse or pharmacist can also advise on pain relief doses.