The OPEN minute newsletter / Growth Pain
May 31, 2023

Growth Pain

There is no consensus definition of growing pains. It is the most common form of episodic childhood musculoskeletal pain. GP is not associated with musculoskeletal or organic disease and usually resolves by late childhood. But frequent episodes may have a major impact on the child’s daily routine, including absences from school and reduced physical activity. The etiology is unknown.


The prevalence varies from 3 to 37 percent. Growing pains are slightly more common among girls than boys and usually begin between ages 3 to 12 years. The clinical features include the following: the pain is usually nonarticular; in 2/3 of children, it is located in the shins, calves, thighs, or popliteal fossa, and is almost always bilateral. The pain usually appears late in the day or is nocturnal, often waking the child. The duration ranges from minutes to hours. The intensity can be mild or very severe. By morning the child is always pain-free. Often parents can predict when the child will have pain on days of increased activity. Pain is relieved by massage and heat and is not specifically related to the joints. The physical examination during and after the episodes is normal. There are no sensitive or specific laboratory tests. If the child appears ill, complains of pain during the day or with activity, or if pain worsens or persists, the diagnosis is unlikely to be growing pains.


Treatment is usually symptomatic and must include education. The most important intervention is to explain the benign natural course of the GP, thus decreasing anxiety and fear. Local massage therapy during pain episodes is used. Some children need to chronically use medications, especially acetaminophen or other non-steroidal anti-inflammatory drugs (NSAID) (It is important to remember that overuse or misuse of NSAID can lead to unwanted side effects). Muscle stretching exercises may relieve chronic symptoms (Hamstrings, Quadriceps).

Hope this helps!

Best regards,

Dr. Davit Sekoyan, Pediatric Orthopedic Surgeon, “Wigmore” Medical Centre

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