growing pains After headache, growing pains appear to be the most frequent form of pain in otherwise healthy schoolchildren. They have been found to affect around one in every six children aged 6–11 years, more girls than boys, and affect many fewer children over the age of 13. However, the pains usually described as ‘growing pains’ probably have little to do with growth other than that they usually do not persist after a child reaches his or her final height. The process of growth in a child is so slow at any given time (at a daily rate only perceptible to the most highly accurate precision measuring devices) that the process of growth alone would be unlikely to cause pain. This is supported by the fact that many millions of normally-growing children do not develop such pains. Nor do the pains increase or ‘grow’ as the child increases in size.

The child usually complains of intermittent and frequently quite incapacitating pain localized deeply in the arms and/or legs. The pain is not situated at or near any of the joints (ankles, knees, hips, elbows) and if it is, should mean that the child is seen by a doctor to rule out more serious causes of such pain. Growing pains are sometimes accompanied by feelings of restlessness in the arms or legs, but if there is tenderness, redness or swelling, the pain will again need to be assessed and perhaps treated medically. The pain in the legs should not be made worse by walking and the way the child walks should be normal, without any limp.

The vague, nebulous discomfort of ‘growing pains’, for which no cause can be found, ranges from a mild ache, sometimes associated with tiredness, to severe pain that may even waken the child from sleeping. The pain or ache is commonly situated in the front of the thighs, in the calves, and behind the knees. The groin is sometimes affected. The pain is usually felt on both sides may come on suddenly or gradually, and does not usually occur every day. The pains typically occur late in the day and in the evening. When the child wakes up in the morning, the pain has usually disappeared.

These pains most commonly occur in children and young adolescents, but they may commence in early infancy and disappear once the child reaches maturity. In older children, the pain may resemble what adults more accurately describe as cramps in the legs, creeping sensations, or restless legs. Growing pains may be made worse by running during the day. In contrast to growing pains, the pain of fatigue, which may occur with or without excessive physical activity, disappears after rest.

It was once said that emotional growth can be painful but physical growth is not. Perhaps it is simply best to admit ignorance about the cause(s) of such pains and recognize that (except in the uncommon situations described above) they are harmless and self-limiting.

Donald C. Brown, and Christopher J. H. Kelnar

grow·ing pains • pl. n. neuralgic pains that occur in the limbs of some young children. ∎ fig. the difficulties experienced in the early stages of an enterprise: the growing pains of a young republic.