Almost everyone has heard of growing pains but there is no evidence that growth hurts. In a review article by Dr. Mary O’Keeffe et al in Pediatrics the question of how to diagnose growing pains is evaluated because of the uncertainty of why there is pain.
Up to one third of children may be diagnosed with growing pains. It is one of the most common causes of recurrent musculoskeletal pain in children. It is described as an ache or throb in the legs, often of the thighs, the calves or behind the knees. Growing pains tend to affect both legs and occur at night. They may even wake a child from sleep. This pain is recurrent, does not cause any physical findings and does not limit activity. There is no clear relationship to growth. So why do only one-third of growing children complain of pain?
Many causes have been suggested such as problems in the bone or muscles or psychological. Some causes of pain may be overuse of muscles of very active, competitive children. The first thing a parent or doctor has to do is to make sure there is no serious cause of the pain. When there is nothing to see such as redness or swelling the question continues as to why there is pain. Individuals not feeling the pain have a hard time believing the complaint.
Children having “growing pains” are more likely to also complain of stomachaches or headaches. This leads to the question of the tremendous variability of the experience of pain. Over 2000 years ago Plato said the “No two persons are born exactly alike: but each differs from the other in natural endowments”. The experience of pain is personal and there is no objective measure to determine how much it hurts.
While no one wants to have pain it is a very important function of survival. If you touch something hot you need to be able to remove it as fast as possible. We know that the almost instantaneous removal of your hand involve an impulse along the nerve to the brain and them back to the muscles. These impulses are caused by excitation of the nerve cell which leads to the chair reaction. The excitation is caused by a biochemical pump that shifts molecules (primarily sodium and potassium) to start the impulse. There are different pumps for the different cells (nerve, muscle, bone) to work. These different pumps have different genes that program them. Scientists are working on how to target the specific genes that are related to pain in the bone or muscle to help with pain control.
Genetic factors contribute to the experience of pain. So maybe there is a genetic difference in those third of children having growing pains but it doesn’t make it less real.
When a child has severe pain, swelling, fever, a persistent lump in a muscle, is limping, has redness or warmth of the skin over the muscle, it is time to call the doctor.
By Sally Robinson, MD
Keeping Kids Healthy
University of Texas Medical Branch (UTMB)
Published October 2023