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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Coping with your child’s ‘growing pains’

Melinda Wenner Moyer Slate

NEW YORK – I’m lucky: When I hear the phrase “growing pains,” I think of Kirk Cameron, not night aches. I never suffered from growing pains as a child, and as far as I can tell, my 2-year-old doesn’t have them yet either.

So sometimes I wonder: Are growing pains real? If so, what causes them? And how do I make sure my kid never has them, because I really don’t need another reason for screamy 3 a.m. wake-ups?

Growing pains are real – in fact, they’re pretty common. One Australian study found that as many as 37 percent of 4- to 6-year-olds experience these recurring aches, which typically afflict a child’s legs in the afternoon or at night.

Bizarrely, though, growing pains actually have nothing to do with growing – more on that later. And while they are nothing to worry about and usually disappear by the age of 14, growing pains can be confused with more serious health problems – so it’s good to know what they are and what they aren’t.

The term “growing pains” first appeared in a book penned in 1823 by a French doctor, but since then physicians have realized that the peak of these pains, which is around age 6, doesn’t correspond to a period of rapid growth. So it’s unlikely that growth has anything to do with growing pains, at least directly. But despite attempts to come up with more accurate monikers (such as “noninflammatory pain syndrome of early childhood”), the old name stuck.

How frequently kids experience growing pains varies – some never get them, a handful of poor souls have them every night.

But timing-wise, there are a few general rules. First, growing pains usually first appear during the preschool years.

“If a child is 8 and all of a sudden has pain at night, it is not growing pains,” said Barbara Ostrov, a pediatric rheumatologist at Penn State University.

Second, growing pains only happen in the afternoon or at night. Most of the time, the pains disappear by around age 14.

Growing pains are “bilateral,” too, in that they typically affect both sides of the body. This doesn’t mean that both sides have to hurt every time, but kids who only ever get pains on one side probably aren’t having growing pains.

And growing pains aren’t visible. Your kid might be screaming his head off about his shin, but you should never actually see anything wrong with his shin. If you do – if you see redness or swelling or bruising, for instance – you should take your little one to the doctor, pronto.

So, the definition of “growing pains” is based on when and where the pain happens, not on what causes it. And even today, no one is sure what produces growing pains, but there are several theories backed by (limited) research.

One possibility is that kids who get growing pains have abnormally low pain thresholds. In a 2004 study, Philip Hashkes, at the time a pediatric rheumatologist at the Cleveland Clinic, tested the pain thresholds of 44 children with growing pains by putting pressure on various parts of their bodies. After conducting similar tests on 46 children who didn’t have growing pains, Hashkes found that much less pressure was needed to incite pain in the children who had nightly growing pains.

Growing pains could in part be the result of overactivity, too. This theory meshes with parental observations that growing pains are often worse on nights after sports practices.

In another study, Hashkes measured, using ultrasound, the bone densities and qualities of 39 kids who experienced growing pains and found they were lower than average. The density and quality of bone drops when it has been overused without having a chance to recover, so the findings suggest that some growing pains may be associated with too much running around.

So, when your kid wakes up in the middle of the night screaming her head off about pain in her legs, how can you be sure she is experiencing growing pains and is not suffering the onset of some horrible disease?

Generally speaking, if pains conform to the strict definition of growing pains – if they happen only at night, if they’re on both sides, and if they’re invisible – your kid is probably fine.

Benign bone tumors, often confused with growing pains, usually only cause pain on one side; arthritis usually causes redness or swelling and often is worst in the morning. Restless legs syndrome is characterized by a strong desire to move the legs that is sated once that’s been done. Parents who are worried about their kids may want to ask for X-rays and blood tests to rule out other problems, but the vast majority of time, growing pains are growing pains – they’re harmless.

This doesn’t necessarily mean they have to be suffered night after night, though. Painkillers like acetaminophen often do the trick.

Massaging the aching area can help. It might be worth stretching your kids’ legs in the morning and at night to see if it makes a difference, too.

But if nothing works, keep reassuring your child – and yourself – that growing pains do one day go away. Just like the television show. Hey, at least your child doesn’t have to endure that.