Mr. Smith’s deep sleep was interrupted by the shaking of the bed as his wife jumped to her feet and made her way into their son’s bedroom. He tried to clear his head as he looked at the clock to see what time it was. As the fog lifted from his brain, he saw that it was only midnight…and that his wife was calling him. At that same instant he realized that he heard his son crying. He rushed to the bedroom.
Jonathan, who is six years old, was sitting up in his bed and sobbing. Mrs. Smith was sitting next to him and massaging his legs. After calming him down, all that Jonathan could tell them was that his legs hurt. It wasn’t a cramp because BOTH legs hurt the same, and the muscles weren’t tight. There was no fever and the legs looked just fine. Jonathan was perfectly normal when they put him to bed at 8:30. In fact, he had a baseball game that evening and he performed spectacularly. What in the world could be going on, thought Mr. X?
As his mind was racing about all of the terrible things that this could be, Jonathan laid back in his bed and fell fast asleep. The Smith’s didn’t sleep well that night and couldn’t wait until the morning when they could see Jonathan’s doctor. In fact, they woke Jonathan up at 6:30 a.m. because they couldn’t wait until 7:00 when he usually has to get up for school. They were anxious to see how his legs were. They thought the worse: a tumor, cancer, muscular dystrophy, etc.
Jonathan awoke in a flash and was pleasantly surprised to see both of his parents there by his bed. He jumped out of his bed and in one leap jumped into his father’s arms. There was not even a hint of what he had gone through earlier that night. Much to his parent’s amazement, he didn’t even remember waking up during the night.
After seeing the doctor the very next morning, it was determined that Jonathan had growing pains. These occur in around 10% of the pediatric population and are slightly more common in females. The term “growing pains” although widely used and accepted, is not an accurate one. These pains probably do not have anything to do with growth per se. Growing pains typically occur between the ages of 4 and 12 years, not during the period of most rapid growth.
Growing pains are usually intermittent, achy pains of the leg muscles that occur predictably in the evening or late at night. It is not uncommon for them to be severe enough to awaken a child out of a sound sleep such as in Jonathan’s case. When questioned, a child with growing pains has a difficult time actually pinpointing the exact location of the pain other than to point to a thigh or a calf. These pains are NOT localized to the hips, knees, or ankles--the child does not complain of the joints at all. Growing pains can last from minutes up to hours.
For leg pains to be consistent with growing pains, there must not be any history of trauma or injury. For some unknown reason, the pains occur at night, usually after a particularly busy or active day. They are reported to occur more often when the weather is damp or cold. No matter how severe the pains may be during the night, the child is usually perfectly normal and pain free in the morning. There should not even be as much as a limp.
The diagnosis of growing pains requires a detailed history and a thorough exam. Lab tests or x-rays are of no real value because they are certain to be normal. Based on the history and exam, the doctor should be able to determine if the pains are growing pains because there are no other medical problems that can give this clinical course.
The treatment of growing pains is merely symptomatic…this means treating the symptoms to give relief. This may include massaging the legs or using a mild anti-inflammatory agent like ibuprofen as needed. The most important thing a physician can do is reassure the child and the parents that this is a completely benign condition that will go away with time, and it is in NO WAY dangerous or serious. This may necessitate re-evaluations at periodic intervals to make sure that there is no change or new symptoms that may have developed over time.