By Drs. Sally Robinson and Keith Bly

Between the ages of 3 and 5, many children begin to have pains in their limbs, mainly in their legs, at night for no apparent reason. These pains, known as ‘growing pains,' affect about one in 10 children. Boys and girls experience them equally. Growing pains are not caused by bone growth, as many people think and the pain may come and go for many years, but will normally end during the teen years.

Though the exact cause of growth pains is unknown, it may be linked to several things, including tiredness in the muscles, poor posture, or stress, though each of these suspected causes is not present in every child who suffers from growing pains.

Symptoms of growing pains include:

· Aching in both legs, normally in the calf, behind the knee and the front of the thigh (pain may occur occasionally in the muscles of a child's arm, as well).
· Moving the legs does not make the pain any better or worse (this shows that the pain is not in the joints).
· Inconsistent pain - it may occur every night for a week, or just occasionally.
· Pain begins around late afternoon or evening.
· Pain worsens during the night, especially at bedtime.
· Pain wakes the child from sleep.
· Massaging makes the pain feel better (a child with a medical condition does not want the area that is hurting to be touched because moving it tends to increase the pain).
· No pain when the child wakes in the morning.

Growing pains do not cause children to limp or make it hard for them to run or play normally. If your child is limping, complaining of pain during the day, feels ill, or if his leg is sore, then you should call or visit your pediatrician, as your child may be injured or have an infection.

Some things that may help to decrease the pain include:

· Massaging the area.
· Reassuring the child that the pain will be gone by morning.
· Stretching the muscles in the legs or arms.
· Placing a heating pad, or warm, wet towel on the area.
· Giving your child a warm bath.
· Giving ibuprofen or acetaminophen.
· Don't tell your child that the pain is caused by playing or growing, as the child may become afraid of both.
 

Call your child's doctor if he or she experiences any of the following:

· Intense pain.
· Pain that last through the morning.
· Swelling or redness in one particular area or in a joint.
· Pain associated with an injury.
· Fever.
· Limping or limited movement of the limb.
· Unusual rashes.
· Tiredness or weakness.
· Loss of appetite.
· Strange, uncharacteristic behavior.

Growing pains are normal for some children to experience and they do not normally point to serious illness, but they can be upsetting to a child or a parent. Because the pain is gone by morning, some parents feel that the child was pretending to be in pain. Reassuring and comforting your child when she experiences growing pains will help her relax.

Check with your child's doctor to make sure that the pain that your child is experiencing is not the result of a more serious health problem.
Dr. Sally Robinson is a pediatrician in the division of children's special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB. This column is not intended to replace the advice of a physician.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email jskoloen@utmb.edu.