Growing pains are one of the most commonly reported causes of musculoskeletal pain in children between the age of 4 to 12, but usually resolve by adolescence. This pain appears without any prior indication and is described as an aching or throbbing feeling in the thighs, calves, or back of the knees. The pain is usually felt in both legs and appears in episodes in the late afternoon or at night, between intervals of pain-free days.
Even though the child may continue their normal activities without any indication of discomfort, it can be especially worrying for parents who have to comfort the child due to the intense bouts of pain that wake them up during the middle of the night.
Possible Causes
There is much debate about the exact cause of growing pains. Some studies speculate that it is due to the growth of muscle at a different rate to that of bone, which causes excessive tension and pain at the tendon insertion. However, this difference should not be significant enough to suggest that growth causes pain at all. Growing pains are thus termed because they occur during the growing period.
Some suggested causes of growing pains are:
Pronation of feet
Pronation refers to the natural movement of the arch during movement to support the body. Overpronated or supinated feet can affect shock absorption and lead to excessive forces being placed on the arches during ground impact. As such, this strain on the supporting muscles of the body can cause great discomfort and affect one’s posture.
Joint hypermobility
Children with joint hypermobility are more likely to experience musculoskeletal pain. The tissues in the body vary by degree of elasticity, which can cause some muscles and joints to stiffen and others loosen after exercise. This places a greater strain on the ligaments and can lead to tiredness and pain.
Localised biomechanical overload
Pain may present after an acute injury to the leg which causes certain tissues and joints to receive greater impact, causing overload.
Overuse of soft tissues
Pain can present after physically demanding activities and may be due to muscular tiredness.
Psychological factors
Those with a lower pain threshold may experience a greater sensitivity towards pain, and negative feelings such as stress and unhappiness may also affect the way they respond to it.
Although these may be possible reasons for growing pains, it is important to note that many children often experience pain without any obvious cause or trauma as well.
Symptoms
Professional advice and a diagnosis can be sought if there is concern over the child displaying the following symptoms:
- Persistent pain that usually presents in the evening/at night but is gone by morning
- Intervals of joint pain
- Recurrent headaches and stomach pains
Seek immediate help if your child is displaying other symptoms that may be present due to other underlying issues or more serious conditions such as:
- Fever or a rash
- Pain that only presents in one leg
- Loss of appetite
- Weakness or fatigue
- Limping or difficulty walking
- Presence of swelling, redness, or tenderness in the joints
MRI imaging of the lower limb is usually not required in the first step of a diagnosis but may be performed if the child is showing significant signs of distress.
Managing growing pains
Be sure to check with your podiatrist so an accurate diagnosis and plan can be made to ease growing pains.
Foot orthotics
Customised foot orthotics or customised paediatric ankle orthotics can help with underlying biomechanical issues such as overpronation or supination and provide the required arch support as the child grows. This can realign and stabilise the way their feet are placed before the growth plates close.
Extracorporeal Magnetotransduction Therapy (EMTT)
EMTT therapy can be used to promote pain relief, aid in reducing tightness, and speed up the healing of overuse injuries in the joints and muscles.
Exercise regime
Your podiatrist can recommend stretching exercises to encourage the gentle lengthening of your child’s tissues and muscles. This can help in strengthening the leg muscles by making them strong and flexible.
Massage and Heat
The application of a heating pad and a warm bath with Epsom salt before bed can help soothe sore muscles and relieve swelling.
Make sure to give your child plenty of reassurance and love during this period, especially when they are going through bouts of pain. This helps to ease fear and discomfort around growing pains which can be physically and emotionally taxing for your child.
