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Question: Can you explain growth-related pain, and how this differs from an injury? Nicole, Naples, FL
Dr. David Westerdahl: Growth-related pains, or "growing pains," are typically self-limited pains in the legs. Growing pains are not caused by injuries, and affect up to 15% of children. Most children complain of pain that occurs late in the day or awakens them at night, which means the pain can interrupt normal activity and sleep. Growing pains are intermittent, with symptom free periods, and often last for three months or more. Growing pains generally begin in children between 2 and 12 years of age, and are somewhat more common in girls than boys. Growing pains occur predominantly in both legs, and pain is felt deep in the thighs or calves of the legs.
The cause of growing pains is not known. The physical exam, laboratory data, and imaging studies are normal. Even though we label this syndrome as growing pains, it does not necessarily coincide with periods of rapid growth, and growing pains have no impact on the child’s ultimate growth and development. The diagnosis of growing pains is restricted to children who experience evening or nighttime pain, and who have no other symptoms or signs of musculoskeletal problems. Children with growing pains do not complain of joint pain during activity.
Best medical practice is for a sports medicine physician or orthopedist to evaluate children who develop muscle and joint pain during physical activity, and not to simply assume that such pain represents growing pains. Best medical practice also includes physician evaluation if children have unexplained fevers, weight loss, one-sided leg pain, pain during the day, or limping. Best medical practice treatment guidelines for growing pains begin with parent and child education. Massage, heat, stretching, and pain relievers such as acetaminophen or ibuprofen are sometimes prescribed. In most cases, children can continue normal activities.
About the Author
David N. Westerdahl, MD, FAAFP is a Staff physician for the Department of Orthopedics at Cleveland Clinic Florida. He completed a Primary Care Sports Medicine fellowship in the Department of Orthopedic Surgery at Cleveland Clinic's main campus in Cleveland, Ohio.
With a background in primary care and sports medicine, Dr. Westerdahl manages a wide range of non-operative orthopedic and sports medicine injuries. His specialty interests include sports injuries, medical orthopedics, exercise related medical disorders, musculoskeletal ultrasound, nutritional supplements, and wilderness medicine. www.clevelandclinicflorida.org