When her eight-year-old son complained of leg pain for more than a week, Sandhya Nair, a mother from Bengaluru got worried and consulted a doctor. However, there was no history of a fall or an injury, but the pain persisted. On examination along with X-ray, Nair was told by her doctor that the boy had no severe issues, but it was just the growing pains, commonly seen in children of the age group 3-9 years.
“Interestingly, the pain would develop nearing bedtime and disappear in the morning,” said Nair and the boy required no treatment. This occurred during 2021, when the boy started outdoor games after being physically inactive for more than a year during the pandemic.
Growing pains is commonly seen in different parts of the legs including, the front of the thigh, back of the knee, shin bone, and calf muscle, explains Dr Gangu Hiral Shivashankar, consultant orthopedics, Aster Whitefield Hospital, Bangalore.
Growing pains in kids: Common age groups
“The belief that the growing pains is caused by growth spurts is a misnomer,” clarifies Dr Gangu Hiral Shivashankar, consultant orthopedics, Aster Whitefield Hospital, Bangalore. “Unlike growing pains in kids, growth spurts that are caused due to the musculoskeletal development in children occur between 10 and 14 years of age.”
Typically, the pain develops during the resting time at night. “Severe pain may cause the child to wither the legs rapidly or complain of muscle cramps,” adds Dr Shivashankar. It is termed as harmless muscular pain.
Typical symptoms of growing pains
The pain typically develops in the night and vanishes in the day. “The most common symptom is withering of legs in sleep,” explains Dr Bijal Srivastava, pediatrician, Dr LH Hiranandani Hospital, Mumbai. When the pain is discomforting or severe, the child has a troubled sleep. “In these cases, they would express verbal complaints about the pain, and unreasonable crankiness. In severe cases, they may refuse to play and move around the next day,” she adds.
Occasionally some kids may experience growing pains in the arms too, along with the legs, but they would not have the pain only in the arms.
What causes growing pains in children
New physical activities such as jumping ropes, running, and cycling could cause knee pain or leg pain, describes Dr Shivashankar. He adds, “The severity of the pain is directly proportional to the type or duration of physical activity, the child engages in for that day.”
A new physical activity pressurizes certain muscle joints. To function, the engaged muscles recruit numerous fibers and send multiple signals to the brain. This pressure could develop joint pain, explains Dr Shivashankar.
He adds that collagen is the cause of high mobility in joints. “Children with high collagen in their joints have excess mobility and elasticity of muscles and joints. This increases the capability of the muscles to contract and the consequent energy is expelled,” said Dr Shivashankar.
Dr Srivastava explains another cause for the growing pains in children is Vitamin D deficiency. This could be due to insufficient sun exposure.
Children whose vitamin D3 levels in the blood test are below 30 ng/mL are deficient in vitamin D, she adds.
Pain more in a girl child
Girls have higher incidences of growing pains than boys, points out Dr Shivashankar. He rationalizes, “It could be attributed to higher levels of collagen in girls than boys.”
Joint mobility is more for a girl child due to the higher amount of collagen in the knee joint. However, this can vary from one child to another.
Treatment
These episodes of harmless muscular pain recur for brief periods. They also subside by age 12, says Dr Srivastava. The pain that starts in the night will disappear in the morning, in typical cases of growing pains in children. Also, if the child has vitamin D deficiency, doctors do prescribe vitamin D3 supplements.
Also, positive reinforcements through conversations, hot showers before bedtime, help manage pain, she adds. However, doctors warn against self-medication of painkillers. Gentle oil massage or heat application can alleviate pain significantly, adds Dr Shivashankar.
Dr Shivashankar advises that one must encourage children to continue the new physical activity along with muscle-strengthening exercises. He cautions against excessive exercising for sports or other events if the child complains of persistent pain.
What can be mistaken for growing pains?
Dr Srivastava warns that parents must be vigilant of the following symptoms which are not growing pains in children:
- Difficulty in mobility
- Pain and weakness in the limbs
- Fever with body ache
- Feelings of pain throughout the day
- Abnormal gait
- Pain following an accidental fall or a trauma
Dr Shivashankar adds a few more symptoms require immediate clinical examination. They include, continued muscle soreness beyond morning, lump in the muscle of the painful area, and joint pain during movements.
Takeaways
- Growing pains in children between 3-9 years is a common occurrence.
- Most often the cause is high collagen levels in the knees and joints.
- The issue is temporary and will subside by 12 years of age.
