Growing pains

--What are some other causes of growing pains?

There are other causes for growing pains that are common in active children and adolescents. Apophysitis is a common diagnosis for pain and occurs at the attachment site for muscles and their tendons. Symptoms relate to the growth area of the tendon attachment to the bone. These tendon attachments can be carefully assessed by a physiotherapist, who will then give you an exercise management plan to prevent overuse of the area during sport.

--How do I know if my child has growing pains and what do they feel like?

General symptoms of growing pains include muscular aches and pains in both legs—typically in the calf, behind the knee and the front of the thigh. Moving the legs does not make the pain better or worse and the joints are not affected. Occasionally, the muscles of the arms may be affected as well.

The pain tends to come and go and may occur in bouts throughout childhood. The onset of pain is around the late afternoon or evening and is often worse during the night. Sometimes the pain may be severe enough to wake the child from sleep, and is gone by morning. These pains don't cause a limp or make it hard to run and play normally.

--Why are adolescents likely to experience growing pains?

For some adolescents, there is more pain after increased physical activity. This pain may be due to:

• Muscular tiredness: an increase in physical activity more than usual can lead to aching muscles for some children. This is normal and muscles will adapt to change quickly. It is important to reassure your child that these pains will go away as the body becomes used to activity.
• Poor posture: standing, sitting or walking awkwardly puts greater than usual strain on the supporting muscles of the body. Encourage different postures and activity throughout the day. All physical activity will strengthen muscles and this may assist good posture.
• Emotional upset: stress or unhappiness may trigger aches and pain flares. Take time to listen and talk to your children about how they feel.

--Does everyone experience growing pains at some point?

Only some children have growing pains. Growing pains are muscular in origin and can affect boys and girls typically between the ages of three and five years, and from eight to 11 years. Some children continue to experience growing pains on and off into their teenage years, but usually they go by mid-adolescence.

Growing pains do not limit activity or cause any problems later in adulthood. Generally, there is no need for ongoing treatment apart from an assessment with a physiotherapist to rule out other conditions and to receive some exercises aimed at improving flexibility and strength.

Some younger children can report pain in the limbs at night. Occasionally there are other causes of symptoms, such as infection. If a child or adolescent has persistent pain that does not settle within a few days, consult your GP.

--Should I be worried about growing pains?

Growing pains do not affect how a child walks and runs, make a child unwell or affect growth or adulthood. If your child is limping, complaining of pain during the day, is unwell or if the leg is increasingly sore to touch, take your child to a doctor. They may have an infection or injury.

Other health problems (that are rare) that may cause pain in the legs include:

• arthritis—inflammation of joints
• infections (such as osteomyelitis) and some virus infections (such as Ross River virus)
• biomechanical problems that affect the muscles and joints (such as knock knees and very flat feet).

--How do I know if physiotherapy or other medical attention is needed?

A physiotherapist can help diagnose and manage growing pains in children. Although not requiring ongoing physiotherapy treatment, a physiotherapist can clinically assess the problem and will direct your child for further investigation with a GP if symptoms suggest other causes of pain.

Always see your doctor if your child:

• has severe pain or pain that only affects one leg or arm, or if the pain is still there during the day
• is unwell, has a fever, loss of appetite or rashes
• has swelling, reddening or tenderness of the leg or arm
• is limping
• has symptoms that are persistent and irregular.

--How can physiotherapy help with growing pains?

Occasionally, growing pains can interfere with normal daily activity and sport. When this occurs, referral to a physiotherapist can help. Often your physiotherapist will prescribe exercises to improve musculoskeletal fitness in a way that settles the growing pains. There may be another reason for the pain, in which your physiotherapist will assess the joints, muscles and coordination to determine if there are limitations in these areas that contribute to symptoms.

Not all pain is growing pain in adolescents; other growth related areas may be the cause of pain. Apophysitis is a common diagnosis for pain at the insertion of tendon onto the bone around joints. Symptoms relate to the growth area of the tendon attachment to the bone. These tendon attachments can be carefully assessed by a physiotherapist, who will then give you an exercise management plan to prevent overuse of the area during sport.

--How effective is physiotherapy for growing pains?

A physiotherapist is qualified in the diagnosis and management of musculoskeletal conditions and works with a network of health professionals, including GPs and other allied health practitioners to optimise you and your children’s health. Physiotherapists use clinically relevant tests and procedures to manage the possible causes of pain, such as tight muscles. They can also help to improve muscular fitness.

--What can I do at home to minimise the pain?

If your child is experiencing growing pains, it is important to reassure them that the pain will go away and generally be better by morning. You can also massage the painful area to ease the pain, use heat treatment (such as warm baths and heat packs) and encourage physical activity as normal to build a stronger body.

--How long until growing pains go away?

Generally, growing pains last a few nights only. If they persist longer, contact your physiotherapist or GP as this may not be the cause of the pain.