Growing Pains in Children: Normal or Something More Serious?

Many parents ask about growing pains in children. Are growing pains normal? Or something more serious? As an orthopaedic surgeon with a focus on paediatric conditions, I see this often. The good news is that growing pains in children are common and usually harmless. However, some signs do need a closer look

What are growing pains?

“Growing pains” are episodes of aching or cramping in both legs. They are most common in children aged 4–12 years. The pain often comes in the late evening or at night. Your child may wake up, but feels fine again by morning. There is no fever. There is no swelling. There is no limp the next day.

Typical features of growing pains in children

• Pain on both sides, often in the thighs, calves, shins, or behind the knees.
  
• Worse in the evening or at night; settles by morning.
  
• Comes and goes; pain-free days are common.
  
• No redness, warmth, swelling, or joint stiffness.
  
• Normal walking and running during the day.
  

If this sounds like your child, it is likely growing pains in children.

Why do they happen?

We do not have one single cause. However, muscle tiredness after a busy day, tight muscles, and low pain threshold may play a role. Growing pains are not caused by the growth plate itself. They are also not a sign of bone damage.

When it may be something more serious

Please seek medical advice if you notice any “red flags”:

• Constant pain during the day, not only at night.
  
• Pain in one leg only, or a clear limp.
  
• Swelling, redness, warmth, or the joint looks deformed.
  
• Fever, weight loss, night sweats, or your child seems unwell.
  
• Pain after a fall or injury.
  
• Pain in the hip or groin, or your teenager refuses to bear weight.
  
• Back pain with tingling, numbness, or weakness.

These signs may point to other causes of child leg pain, such as a stress fracture, growth plate injury, infection, inflammation, or—in teenagers—hip problems like Slipped Capital Femoral Epiphysis (SCFE).

Conditions that can mimic growing pains in children

• Sever’s disease (heel pain). Pain at the back of the heel, worse with sports.
  
• Osgood-Schlatter disease. Pain and a bump below the knee in active kids.
  
• Stress fracture or overuse injury. Pain with activity, tenderness to touch.
  
• Flat feet or poor footwear. Leg fatigue after walking long distances.
  
• Viral aches after illness.
  
• Less common but important: joint infection, juvenile arthritis, or blood disorders.
  

If you are unsure, it is safer to get your child checked.

How an orthopaedic surgeon assesses paediatric leg pain

The assessment begins by listening to the child’s history, focusing on the timing, pattern, and triggers of the pain. A physical examination then assesses the child’s hips, knees, ankles, feet, and spine. Most children experiencing growing pains will have a normal examination. Tests are rarely necessary. However, if red flags are present, X-rays or blood tests may be performed to rule out other problems.

Simple care for growing pains (at home)

• Reassure your child. Growing pains in children are not dangerous.
  
• Massage the sore area for a few minutes.
  
• Warm compress or a warm bath before bedtime.
  
• Gentle stretches for calves, hamstrings, and thighs.
  
• Supportive footwear for daytime activities.
  
• Balanced activity. Encourage play, but avoid sudden jumps in training volume.
  
• Pain relief like paracetamol may help if needed; follow the label and your doctor’s advice.
  

If pain is frequent, a short daily routine of stretching after school and before bed can help. Good sleep habits also make a difference.

Can nutrition help?

A balanced diet with enough calcium and vitamin D supports bone health. Sunlight exposure in safe amounts is useful. If you suspect deficiency, speak to your doctor. Avoid starting supplements without advice.

When should I bring my child to see a doctor?

• The pattern does not fit typical growing pains.
  
• Pain is getting worse, or there is a limp.
  
• Pain is one-sided, or there is swelling or stiffness.
  
• Your child has a fever or looks unwell.
  
• There was a recent injury.
  
• Teenagers with hip or groin pain, especially if overweight or after a growth spurt.
  

An orthopaedic surgeon can guide you on the next steps and give peace of mind.

Key takeaways

• Growing pains in children are common, short-lived, and usually harmless.
  
• Pain is typically both legs, at night, and gone by morning.
  
• Watch for red flags: daytime pain, swelling, limp, fever, or one-sided symptoms.
  
• Simple measures—massage, warmth, stretching, supportive shoes—often help.
  
• When in doubt, get your child assessed by a paediatric-focused orthopaedic surgeon.

Conclusion

Most growing pains in children are part of normal development and settle with time. Yet, because leg pain can have many causes, it is wise to look for warning signs. If anything does not add up, seek a proper check-up. Early review helps rule out serious problems and gets your child back to happy, active play.