Growing pains are pains that usually appear in childhood in the evening or at night, are often felt in both legs, and tend to disappear by morning. Although they are considered harmless, signs such as one-sided swelling, joint redness, limping, or pain that continues during the day may suggest other causes.

What are growing pains?

Growing pains is a term used for leg pains seen mostly in children between ages 3 and 12 that usually appear in the evening or at night and tend to fade by morning. Even though the name includes “growing,” it has not been clearly proven that these pains are directly caused by height growth. Still, because they are common in childhood and usually follow a harmless course, families know them by this name. ^[1][2][5]

Typically, the pain is felt in both legs at the same time; it is usually described in muscle-heavy areas such as the front of the thighs, the calves, around the shins, or behind the knees. The pain may wake the child from sleep at night, but by morning the child usually walks, plays, and functions normally during the day. This feature is one of the important clues that helps distinguish growing pains from more serious orthopedic, rheumatologic, or infectious causes. ^[1][3][4]

Which signs are typical?

The most typical picture is a child who is active during the day saying in the evening or at night, “my legs hurt.” The pain may come and go; in some children it happens a few times a week, while in others it may appear intermittently for months. The pain is expected to be felt in the muscles, without swelling in a joint and without morning stiffness. The child may look completely fine the next day. This fluctuating pattern can surprise families, but it is very characteristic. ^[1][2][4]

During a painful episode, gentle massage, warmth, light stretching, or simple pain relievers at the dose recommended by a doctor may be soothing. Some sources note that muscle fatigue after heavy activity at the end of the day may contribute to the pain. The important point, however, is this: if the pain does not impair the child’s daytime function, there is no limping, and the examination is normal, the picture is usually benign. ^[2][3][4]

What causes it?

The exact cause of growing pains is not known. Because of the name, people often assume that bone growth itself causes pain, but there is no strong evidence clearly confirming this. Experts think that muscle fatigue after intense physical activity, individual differences in pain perception, or benign musculoskeletal sensitivity in childhood may play a role. In other words, although the term is well established, the biological mechanism has not been fully explained. ^[2][4][5]

This uncertainty does not mean growing pains are “made up.” The child really does feel pain; the point is that the pain can occur even when there is no dangerous underlying cause. Still, if pain is severe every night, clearly concentrated in one leg, or limits daytime activities, it should not automatically be labeled as growing pains. There are other causes of leg pain in children, including fracture, infection, inflammatory joint disease, or neurological problems. ^[1][3][5]

When can it be considered normal, and when is evaluation needed?

In growing pains, the child is normal during the day, there is no joint swelling or redness on examination, the pain is bilateral, and it has disappeared by morning. On the other hand, pain that continues during the day, limping, swelling, redness or warmth in a joint, fever, weight loss, marked fatigue, rash, or persistent one-sided pain requires medical evaluation. These warning signs suggest there may be another reason besides simple growing pains. ^[1][3][4]

Families sometimes ask, “My child cries a lot at night but is fine in the morning—should I still see a doctor?” The answer depends on the pattern, frequency, and associated findings. Even if the pain looks typical, a pediatric evaluation can still be helpful if it recurs frequently, worries the family, or limits the child’s activity. The goal is not to panic every time pain appears at night, but to distinguish typical from atypical features. ^[1][2][5]

How is it diagnosed?

There is no special laboratory test for growing pains. The diagnosis is usually made through the history and physical examination. The pediatrician asks about the location, timing, duration, daytime effect, and accompanying findings. If the examination is normal and the pattern is typical, extra tests may not be needed. But if there are atypical findings, blood tests, imaging, or evaluation by orthopedics or pediatric rheumatology may be requested. ^[1][3][5]

The reason for this approach is that growing pains gain meaning through exclusion. In other words, if there is no clue suggesting more serious causes such as infection, trauma, growth plate injury, joint inflammation, or malignancy, and the picture is typical, growing pains are considered more likely. More extensive evaluation is needed especially if there is one-sided bone tenderness, night sweats, swelling, or fever. ^[1][3][5]

What can be done at home?

Gentle massage, warmth, regular sleep, adequate fluid intake during the day, and letting the child rest on days of heavy activity may help. Some sources note that light stretching exercises for the leg muscles can be beneficial. If a pain reliever is going to be used, medical advice is important to make sure it matches the child’s age and weight. Giving adult medication or random doses to children is not safe. ^[2][3][4]

The most important point is not to dismiss the child’s pain. Instead of saying, “There is nothing wrong with you, you are exaggerating,” it is more helpful to comfort the child, observe the pattern, and know the warning signs. Growing pains decrease over time in most children; however, if the pattern changes, reassessment is needed. The safest approach is both to avoid unnecessary fear and not to miss atypical symptoms. ^[1][2][5]

Follow-up and a short reminder for families

Growing pains are usually benign, but they can still be exhausting for parents. Keeping a small pain diary—recording the time, location, whether the pain is one-sided or both-sided, and whether fever or limping are present—can be very useful during a doctor visit. These notes may support a typical pattern or make atypical details more visible. Even if the pain becomes stronger, if its behavior moves outside the usual pattern, planning a new examination is the safest approach. ^[1][2][5]

Personal medical evaluation is important for symptoms that are prolonged, progressive, or clearly affecting daily life; this content does not replace diagnosis and treatment. ^[1]

3) FAQ

Are growing pains really caused by getting taller?

A definite mechanism has not been shown. The term is widely used, but it is not clear that the pain comes directly from height growth. ^[2][4][5]

Where are growing pains usually felt?

Most often in both legs, especially in the thighs, calves, around the shins, or behind the knees. Swelling of a joint is not typical. ^[1][3][4]

When should a doctor be consulted?

Evaluation is needed if the pain is one-sided, continues in the morning, causes limping, or is accompanied by fever or swelling. ^[1][3]

Can growing pains wake a child from sleep?

Yes, they typically occur in the evening or at night and may wake the child. But the child is expected to return to normal by morning. ^[1][4]

Is massage at home harmful?

Gentle massage and warmth can be soothing for most children. However, if there is swelling, redness, or severe tenderness, medical evaluation first is more appropriate. ^[2][3][4]