Dr. Alan Greene on Growing Pains

Is there such a thing as growing pains?


My 3-year-old daughter is always complaining of pains in her legs during the night. Could these be growing pains?


    During childhood the human body goes through an amazing series of changes. When babies are born, their heads, hands, and feet are proportionally much larger in relation to their bodies than at any other time in life. It's one of the things that make babies distinct and adorable. Throughout the growing-up process, the human body changes proportions many times. Sometimes long, gangly arms and legs seem to shoot out overnight! During these spurts of growth, children often complain of nighttime leg pain, hence the common label "growing pains."

    When children are plagued by episodes of recurrent, brief leg pain, it's a good idea for them to be checked once by a physician. If the physical examination results are normal, with no redness, tenderness, swelling, or limitation of movement, and if the pain is not provoked by moving or associated with any abnormal gait, then this situation is what we often call growing pains. These pains typically occur at night with no resultant daytime disability. The actual source of the pain has never been proven, but long experience has taught us that it's benign and self-limited.

    If the physical examination results are not normal, your doctor will be able to discuss other diagnoses with you, from chronic trauma to childhood arthritis.

    In children with benign growing pains, the muscles or tendons are still a little too tight for the growing long bones. Many children who suffer from benign growing pains are unable to touch their toes with their fingertips without bending their knees.

    Muscle spasms lasting from one to 15 minutes cause the pain. During a pain episode, stretching the foot and toes upward will often resolve the muscle spasm. Gentle massage and moist heat over the painful spot can also help.

    In most cases the pain can be prevented with simple, daily stretching exercises. These exercises must be continued even after the pain subsides in order to keep the muscles and tendons relaxed and able to accommodate the next growth spurt.

    Some physicians recommend giving a glass of tonic water (quinine) before bed. I have never seen any studies evaluating this suggestion, but it might help and wouldn't hurt. Plenty of fluids should make cramping less likely. An interesting article appeared in the Archives of Diseases of Childhood (1996), suggesting that some cases of growing pains may be a migraine equivalent. Adults with migraines often mention brief leg pain in association with their migraine headaches. In this study, 44 percent of the children with growing pains had a first degree relative with migraines. This is a very interesting suggestion, but to date the information should be considered only preliminary.

    Although these painful occurrences of growing up are nothing to be worried about, like all of life's growing pains, they can be quite bothersome when in the middle of an episode. It's precisely the reshaping of ourselves that causes physical and emotional growing pains -- in both situations, the pain results in our becoming more mature people.

    The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.