UK HealthCast: Growing pains

A parent marks the height of their daughter on a wall by using a pencil.

On this edition of UK HealthCast, we spoke with Dr. Trey Suhrstedt, a Kentucky Children’s Hospital pediatrician, about growing pains in children and how parents can address the issue.  

What are growing pains and what exactly causes them?

Dr. Suhrstedt: If we think about the term growing pains, that's actually been around since the early 1800s. And since it first appeared, there's been a lot of different diagnostic criteria and definitions. Unfortunately, the lack of concise terminology and definitions has led to some ambiguity about what they actually are and what causes them. 

Typically, the diagnosis of growing pains will be a diagnosis of exclusion, meaning that it's only made after you eliminate other identifiable, potentially more serious causes of pain.

As far as what causes them, we're really not entirely sure. Multiple etiologies and pathologies have been proposed throughout the years, including a type of bone stress injury from either overload or overuse, the actual literal physical growing and lengthening of those long bones, also muscle fatigue after long and intense activity. 

But within what available research there is, the most commonly identifiable potential causes, include a family history of growing pains, kids with a lower pain threshold, improper posture, some decreased bone strength or low vitamin D levels. But none of those have been reliably proven as a specific cause. And although these do occur in growing children, they're not common during periods of peak growth. They don't occur at the growth plates. And thankfully, they shouldn't have any long-term effects on any kids.

How common are growing pains in children?

Dr. Suhrstedt: They're actually one of the most common reasons for children seeking medical care for a musculoskeletal issue. And depending on the specific age that you look at, up to one-third of kids may experience growing pains at some point.

What ages are usually affected by growing pains?

Dr. Suhrstedt: There is a pretty wide range and some variability in the age of onset. Specifically, you would think between age three and 12. But within that, usually on the earlier side, so you're thinking more preschool, elementary, school-aged kids would be the ones that you would think about as to having growing pains. These can be short lived, but they can last for years even into adolescence.

Talk to us a little bit about what kids experience.

Dr. Suhrstedt: As far as symptoms and what they'll either tell their parents or what will be brought to the attention of the pediatrician, is more of a vague type of pain, rather than any kind of specific or discreet pain. There's likely not going to be any identifiable injuries or trauma preceding the onset of symptoms. It will be most likely to occur in the evening. It can last a few minutes, maybe a few hours, even can sometimes wake up kids from sleep, but it should be gone by the morning. 

You think of it as persistent, often occurring daily or most days of the week, but you will have some symptom-free days in between. So, it's not going to be severe enough to cause any limping or interference with daily activities or prevent them from participating in any recreational activities or sports. And up to one-third of kids can also have associated headaches and abdominal pain.

Are there any treatments available?

Dr. Suhrstedt: There isn't any specific treatment because at this point, we don't know the exact cause or mechanism for the pain, but there are some things that can provide some symptomatic relief, even if only temporary. 

Things that we recommend would be for the kids to participate in a wide variety of exercises and not focus on any one particular activity or sport. Getting adequate rest is important, especially getting enough sleep at night. Other things you could try would be a warm bath or massage, sometimes ice packs can help. You can also use appropriate weight-based acetaminophen or ibuprofen if it becomes a more common problem.

At what point should a parent be concerned about growing pains?

Dr. Suhrstedt: So, things that would say maybe it's something else other than just growing pains and they should seek care for, would be any severe pains, any joint that's swollen, warm, or has any kind of overlying redness to it, any noticeable deformity or anything that's looking asymmetric from the other side, if the child is limping or has any pain that interferes with her daily activity; pain that is accompanied by fevers, especially outside of any normal, cold or other illnesses. 
If there's any associated rash or other skin changes, any of those could indicate that it's something that would need to be evaluated.

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