Are Growing Pains Real, and When Should You Worry?
Growing pains are real. They are a recognised pattern of aching leg pain that affects children, usually in the evening or at night. They are not caused by actual growth and are not a sign of disease. Most children grow out of them. You should worry if the pain is one-sided, comes with swelling, fever or a limp, or stops your child from playing normally during the day.
Key takeaways
- Growing pains are common between the ages of about 3 and 12.
- They affect both legs and happen mostly in the evening or at night.
- The child moves and plays normally during the day.
- Pain that is one-sided, persistent, or paired with swelling, fever or a limp needs a GP review.
- Imaging is only needed when something about the pattern does not fit.
What are growing pains exactly?
Growing pains are recurrent aches in the legs that affect children during periods of active growth, most commonly between the ages of 3 and 12. Despite the name, the pain is not caused by bones getting longer. No one is entirely sure what triggers them. Current thinking points to muscle fatigue after an active day, lower pain thresholds in some children, and possible links to hypermobility syndrome.
The term has been used for over 200 years and is recognised by the NHS, the Royal College of Paediatrics and Child Health, and paediatric orthopaedic bodies worldwide. It is a diagnosis of exclusion, which means a doctor rules out other causes first and then identifies the pattern.
What do growing pains feel like?
Growing pains follow a distinctive pattern. Recognising it can save a lot of worry.
The aching comes on in the late afternoon, evening or during the night, and is gone by morning.
Pain typically affects both legs, in the thighs, calves or behind the knees. It is not limited to one spot.
Your child runs, jumps and plays normally during the day. There is no limp.
The legs look completely normal. There is no joint swelling, redness, warmth or bruising.
A child with this typical pattern, examined by a GP, usually does not need any scans or blood tests.
What causes growing pains in children?
No single cause has been proven. Research suggests several contributing factors working together.
Active days of running, climbing and sport may leave developing muscles tired and achy.
Some children simply feel pain more intensely, and may be more sensitive to normal muscle signals.
Children with flexible, hypermobile joints may experience more leg aching after activity.
Growing pains run in families. If you had them as a child, your child may be more likely to experience them too.
When should you worry about a child's leg pain?
Most childhood leg pain is harmless. But certain signs mean you should speak to a doctor rather than assume growing pains. Know when to see a specialist.
- Both legs affected
- Pain in the evening or at night
- Gone by morning
- Normal walking and running
- No swelling, redness or bruising
- Child is otherwise well
- Pain in only one leg or one joint
- Swelling, redness or warmth over a joint
- Limping or refusing to walk
- Fever alongside the pain
- Pain that is there every day, including mornings
- Unexplained weight loss or fatigue
Important. If your child has sudden, severe leg pain with numbness or weakness, or cannot bear weight at all, seek urgent medical attention. Call your GP, 111, or go to A&E. Do not wait to book a scan.
How can you help a child with growing pains?
Growing pains are not dangerous and do not cause lasting harm. Most children simply need comfort and reassurance. Your GP can advise on simple measures such as gentle massage, a warm bath before bed, or age-appropriate pain relief if needed.
Keeping a brief diary of when the pain happens, which legs are affected, and what your child did that day can be useful. If you notice the pattern changing, becoming one-sided, or appearing during the day, bring the diary to your GP.
If your child also has very flexible joints, they may benefit from being assessed for hypermobility syndrome, which can contribute to leg aching.
Does a child with growing pains need a scan?
In most cases, no. A child with the typical pattern of bilateral evening leg pain, normal daytime activity and no other symptoms usually does not need any imaging. The diagnosis is made clinically by a GP or paediatrician.
Imaging becomes useful when the picture does not fit. If pain is persistent, one-sided, worsening, or paired with a limp or swelling, your doctor may request X-rays or other scans to rule out other causes.
Where standing, weight-bearing imaging is helpful, ScanAlign, low dose standing imaging uses EOS technology, which delivers about 90% less radiation than a standard X-ray, around ten times less. Because the child stands during the scan, the image shows how their bones and joints align under their own body weight, which lying-down scans cannot show. You can find out more about paediatric imaging at ScanAlign.
When MRI is better. EOS imaging shows bones, joints and alignment clearly. For soft tissue, discs, nerves or suspected infection, MRI is usually the better tool. Your doctor will guide which scan is right for your child.
If your GP or specialist has recommended imaging, or you are unsure whether your child needs a scan, you can talk it through at no cost.
Book a free video consultationFrequently asked questions about growing pains
No. Despite the name, there is no evidence that bone growth itself causes pain. The term dates back to the 1820s and has stuck, but the aching is more likely linked to muscle fatigue and activity levels.
They most commonly appear between the ages of 3 and 5, and again between 8 and 12. Most children grow out of them by mid-adolescence.
They can come and go over weeks or months, but they are not usually present every single night. Pain that happens every night without a break, or that is there in the morning too, should be reviewed by a GP.
If the pain fits the typical pattern, a routine GP visit is sensible for reassurance. If there is anything unusual, such as limping, one-sided pain, swelling or fever, see your GP promptly.
Classic growing pains affect the legs. Persistent arm or back pain in a child should be assessed by a doctor, as it is less likely to be growing pains and may have a different cause.
There is no specific test. Growing pains are diagnosed by recognising the pattern and ruling out other causes. Blood tests or scans are only used when the symptoms do not fit the typical picture.
Not necessarily, but there is an overlap. Children with hypermobile joints are more prone to leg aching after activity. If your child is very flexible and has frequent pain, mention it to your GP.
EOS uses about 90% less radiation than a standard X-ray, around ten times less. This makes it a low-dose option when standing imaging of the whole body or legs is needed.
You can self-refer. However, for children with growing pains specifically, we would always encourage a GP assessment first. Most children with typical growing pains do not need imaging at all.
You can book a paediatric assessment to discuss whether imaging is appropriate. A free video consultation lets you talk through your child's situation before committing to anything.
Not sure if your child needs a scan?
A free video consultation lets you talk through your child's symptoms with our team. No obligation, no pressure.
Book a free video consultationWritten by Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- NHS. "Growing pains." nhs.uk, last reviewed 2022.
- Evans AM. "Growing pains: contemporary knowledge and recommended practice." Journal of Foot and Ankle Research, 2008;1:4.
- Uziel Y, Hashkes PJ. "Growing pains in children." Pediatric Rheumatology Online Journal, 2007;5:5.
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.