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Growing Pains by Priyanka ,  Jul 30, 2013

Your 8-year-old son wakes up crying in the night complaining that his legs are throbbing. You rub them and soothe him as much as you can, but you're uncertain about whether to give him any medication or take him to the doctor.

Sound familiar? Your son probably is experiencing growing pains, a normal occurrence in about 25% to 40% of children. They generally strike during two periods: in early childhood among 3- to 5-year-olds and, later, in 8- to 12-year-olds.

What Are Growing Pains?

Growing pains aren't a disease. You probably won't have to go to the doctor for them. But they can hurt. Usually they happen when kids are between the ages of 3 and 5 or 8 and 12. Doctors don't believe that growing actually causes pain, but growing pains stop when kids stop growing. By the teen years, most kids don't get growing pains anymore.

Kids get growing pains in their legs. Most of the time they hurt in the front of the thighs (the upper part of your legs), in the calves (the back part of your legs below your knees), or behind the knees. Usually, both legs hurt.

Growing pains often start to ache right before bedtime. Sometimes you go to bed without any pain, but you might wake up in the middle of the night with your legs hurting. The best news about growing pains is that they go away by morning.

Occasional aches and sharp, throbbing pains are very common in children between the ages of 3 and 5 and then again between 8 and 12.

Kids most often feel growing pains in the legs, especially in the front of the thighs, behind the knees, and in the calves. They tend to strike in the late afternoon and evening and during the first hours of sleep at night. By morning, the pains are gone.

They can be mild or strong enough to wake your child up. Some kids also have abdominal pain or headaches when they're having about.

The term "growing pains" is misleading: There's no evidence that the pain is caused by growing bones. Experts don't know for sure what causes the pain, but it does seem to occur more often after a child has had an especially active day.

Growing pains are not a sign that your child is doing anything wrong or needs to slow down, however. Perfectly healthy children experience them. In fact, 25 to 40 percent of children have growing pains at some point, and they're slightly more common in girls than in boys.

Typical childhood growing pains are real, and, in the vast majority of cases, the common nighttime pain children experience in their legs is not the result of a disease or other condition and will not require a physician’s treatment. The symptoms will usually be gone by morning. Bear in mind, of course, that although they are a normal part of childhood, growing pains do hurt, and your child will benefit from your reassurance, gentle touch, and attention.

The most common childhood growing pains are sharp, throbbing pains in the legs, typically occurring at night and sometimes in late afternoon. Occasionally, the pains can be strong enough to wake a child. Between 25 and 40 percent of children between 3 and 5 years, and again between the ages of 8 and 12, experience these nighttime aches.

And when the aches are gone in the morning — or when such pains never occur during the day — they are most likely, indeed, “just growing pains.” In fact, parents should bear in mind that sometimes their children’s afternoon and nighttime muscles aches and pains are the very normal result of a day filled with more physical activity than usual.

But persistent aches in the extremities (usually the legs), pains accompanied by swelling or tenderness in a joint, a fever or rash, limping or weakness, are all signs that a more serious medical condition might exist.

If your child exhibits typical growing pains, a few simple therapies can help the episode pass quickly:

  • Massage the aching area until the pain passes
  • Apply a heating pad to the area
  • Help the child gently stretch and flex the area until the pain passes

What Causes Them?

No firm evidence shows that the growth of bones causes pain. The most likely causes are the aches and discomforts resulting from the jumping, climbing, and running that active kids do during the day. The pains can occur after a child has had a particularly athletic day.

Growing pains don't hurt around the bones or joints (the flexible parts that connect bones and let them move) — only in the muscles. For this reason, some doctors believe that kids might get growing pains because they've tired out their muscles. When you run, climb, or jump a lot during the day, you might have aches and pains in your legs at night.

Signs and Symptoms

Growing pains always concentrate in the muscles, rather than the joints. Most kids report pains in the front of their thighs, in the calves, or behind the knees. Whereas joints affected by more serious diseases are swollen, red, tender, or warm, the joints of kids experiencing growing pains appear normal.

Although growing pains often strike in late afternoon or early evening before bed, pain can sometimes wake a sleeping child. The intensity of the pain varies from child to child, and most kids don't experience the pains every day.

One symptom that doctors find most helpful in making a diagnosis of growing pains is how the child responds to touch while in pain. Kids who have pain from a serious medical disease don't like to be handled because movement tends to increase the pain. But those with growing pains respond differently — they feel better when they're held, massaged, and cuddled.

Growing pains are what doctors call a diagnosis of exclusion. This means that other conditions should be ruled out before a diagnosis of growing pains is made. A thorough medical history and physical exam by your doctor can usually accomplish this. In rare instances, blood and X-ray studies may be required before a final diagnosis of growing pains is made.

How can I tell if it's growing pains or something else?

It can be tricky to tell. Children are sometimes thought to have growing pains when something more serious is going on, so be sure to talk with the doctor if your child has unexplained pain.

Growing pains generally last only about ten to 15 minutes, and they usually affect both sides of the body similarly (although not necessarily at the same time). The pain is usually felt deep in the muscles, not in the joints. Growing pains do not cause fever, chills, redness, swelling, limping, or joint pain.

Doctors make a diagnosis largely by making sure that nothing else is causing the pain. The following symptoms may indicate that something more serious is going on, such as an infection, a fracture, a tumor, leukemia,juvenile rheumatoid arthritis, or other joint problems:

  • Pain is coming from one particular spot. (The doctor may want to do a bone scan to rule out a bone infection or tumor.)
  • Your child has a fever along with leg pain, and there's no obvious source for his fever, such as flu symptoms. (A blood test can determine whether there's an infection.)
  • He has a lot of pain in one hip, thigh, or knee—or has trouble putting weight on one leg or seems to be limping. (The doctor may order an X-ray to make sure there's nothing amiss with his bones.)
  • His pain persists during the day.
  • He doesn't want you to touch or massage the area that hurts. (If the pain is muscular, it'll feel good to be massaged. If something else is going on, though, it may hurt more if you touch it.)

What's the treatment for growing pains?

You can't prevent growing pains, but you can help relieve your child's discomfort with a heating pad or hot water bottle, massage, and the correct dose of acetaminophen or ibuprofen. (Don't give aspirin to your child. It can lead to Reye's syndrome, a rare but potentially fatal illness.)

It may help to do some gentle stretching exercises with your child each day. It may also help to encourage her to stretch while she's complaining of pain.

And if the pain is severe, it's a good idea to see her doctor to make sure there's nothing serious going on.

What Can I Do to Feel Better?

Your parent can help your growing pains feel better by giving you an over-the-counter pain medicine like acetaminophen or ibuprofen. Kids should not take aspirin because it can cause a rare but serious illness called Reye syndrome.

Here are three other things that might help you feel better:

  1. placing a heating pad on the spot where your legs hurt
  2. stretching your legs like you do in gym class
  3. having your parent massage your legs

Pay close attention to your child’s reaction to massage, heat pad application, and gentle muscle flexing. Typical growth pains are not accompanied by tenderness or sensitivity, and the child should be reassured and calmed by your touch. Typical growing pains are a muscular ache, not a joint ache or inflammation. Excessive tenderness in the joints, or a painful reaction to even gentle touches, should prompt a visit to the pediatrician.

The pain accompanying an instance of “garden variety” growing pains can be treated with over-the-counter analgesics, but remember that children under 12 should never be given aspirin, but can accommodate ibuprofen or acetaminophen if the pain is severe enough.

These classic “growing pains” are different from pain associated with the rapid growth during the time period surrounding puberty. Increased bone growth outpaces muscle and tendon flexibility, causing new stresses on attachments to certain growth areas on the bone. Pain and swelling can occur and interfere with activities and sports. Inflammation of the growth plates is called apophysitis. The most common areas affected are the knee and heel, and the pain can fluctuate during the 2 to 3 years of rapid growth. Treatment includes flexibility exercises, local ice application, and altering activities during the painful days.

Consult your pediatrician if aching legs or arms are a persistent or chronic complaint; if the pain is severe or interferes with usual childhood activities; if your child has swollen joints; if the pain is associated with a specific injury; if fever accompanies the pain; if the aching area displays redness or rash; or if your child experiences difficulty walking; significant limp; or unexpected weakness in the legs or arms.

There's no cure for growing pains. You can make your child more comfortable by putting a warm heating pad on the sore muscles and massaging them. For most children, growing pains stop once they reach their teens. While growing pains are harmless, some types of leg pain in children may be caused by underlying conditions that can be treated.

When to Go to the Doctor

If you have a fever, are limping when you walk, or your leg looks red or is swollen (puffed up), your parent should take you to the doctor. Growing pains should not keep you from running, playing, and doing what you normally do. If the pain is bothering you during the day, talk to your parent about it.

You might never feel any growing pains, but if you do, remember that before you know it, you will outgrow them!

Your pediatrician will be alerted to a variety of factors and conditions including:

  • Juvenile arthritis: Affecting about 300,000 children in the United States, juvenile arthritis has symptoms that include persistent limping, swelling of ankles, wrists and other joints, lethargy, and pain in the joints. Your pediatrician can refer you to specialists, including rheumatologists.
  • Lyme disease (a tick-borne illness during summer months; be attentive to tick bites or implanted ticks on your children)
  • Rare diseases and conditions, including lupus, scleroderma, fibromyalgia, and others — all of which will prompt referral to a specialist if needed.

Fortunately, though, most growing pains are just that — small aches that go away quickly, and can be helped on their way by a parent’s tender touch and attention. And by bringing an informed eye and alert touch to your child, you’ll know whether a trip to the pediatrician is called for. 

Growing Pains: When Should Parents Worry?

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WebMD Feature Archive

By WebMD Feature

Like mumps and measles, growing pains are a rite of passage, a sign of growing up. Most parents take it in stride. "It's just growing pains," they tell their crying child.

But what exactly are these pains? Why do some kids get severe pain, while others get none? Could the pain mean something is really wrong? How can parents know?

Growing pains typically occur between ages 3 and 7. Doctors say the pain is triggered when bones grow, stretching the bone's thick covering, explains Larry Vogler, MD, a pediatric rheumatologist at Emory University School of Medicine in Atlanta.

According to the American Academy of Pediatrics, these pains have been linked to particularly active days and not growth. Growing pains are real discomforts for many children; often growing pains can awaken children from sleep.

Some kids are predisposed to getting growing pains. If dad had them, his child will, too. The pains seem most intense after a day of vigorous jumping and running. Kids typically feel the pains at night, then they disappear in the morning. "Be reassuring, give a massage, and give Tylenol with a little food if you think you need to," Vogler tells WebMD.

If your child develops certain symptoms, it's wise to notify your child's doctor. Worrisome symptoms that might indicate that something other than growing pains and something more serious may be going on include:

  • Persistent pain, pain in the morning or swelling, tenderness, and redness in a joint
  • Joint pain associated with an injury
  • Limping, weakness, or unusual tiredness

If a child wakes up in the morning with leg pains -- then feels relief after moving around -- it may be juvenile rheumatoid arthritis (JRA), says Thomas J. A. Lehman, MD, chief of pediatric rheumatology for the Hospital for Special Surgery at Weill Medical College of Cornell University. Lehman is the author of It's Not Just Growing Pains.

"Those pains need to be investigated by a doctor," Lehman tells WebMD. "They should not be simply dismissed. It may not be anything serious, but it needs to be evaluated."

Arthritis Often Missed

Lehman regularly sees young patients with all types of arthritis, but especially juvenile rheumatoid arthritis. It's an unpredictable disease with symptoms that can worsen or disappear without clear reason, he explains. In general, children with JRA have one or several symptoms including joint pain, joint swelling, and joint stiffness early in the disease. Most children have good and bad days.

He's seen it too many times: "Virtually every child with arthritis has been dismissed as 'just having growing pains,'" Lehman tells WebMD. "And because proper diagnosis is delayed -- sometimes for months -- there are irretrievable circumstances."

Most children with juvenile rheumatoid arthritis (70% to 90% of them) will recover without any serious disabilities. But some symptoms can continue into adulthood, such as stiffness, pain, limits on physical activity, and chronic arthritis

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