Growing pains are a common cause of recurring leg pain in children, particularly between the ages of three and twelve. Despite the name, they are not known to be caused by bones growing.
Typical growing pains affect both legs, develop in the evening or at night and have disappeared by the next morning. The child remains well, has no swelling or limp and can normally run and play between episodes.
Leg pain should not automatically be labelled as growing pains. Pain in one leg, pain that persists during the day, a limp, joint swelling, fever, unusual tiredness, bruising or weight loss needs medical assessment.
Seek urgent help if a child is unable to stand or walk, appears seriously unwell, has a hot and swollen joint, has severe pain after an injury or develops leg pain with significant weakness or loss of sensation.
This guide provides general information. It cannot establish the cause of an individual child’s pain or replace an examination by a healthcare professional.
What are growing pains?
Growing pains are recurring episodes of aching or throbbing discomfort, usually affecting the muscles of both legs. They are common in otherwise healthy children and do not damage the bones, joints or muscles.
The NHS describes growing pains as harmless leg pain that is common in children aged three to twelve and normally improves on its own. Symptoms may come and go for months or sometimes years.
The name is misleading. There is no good evidence that normal bone growth is painful, and growing pains do not necessarily happen during periods when a child is growing most quickly.
The cause remains uncertain. Possible contributing factors include:
- muscle tiredness after an active day;
- increased sensitivity to pain;
- joint hypermobility;
- the physical effects of running, jumping and climbing;
- differences in how some children process discomfort.
Growing pains are a diagnosis based on a typical pattern and the absence of warning signs. There is no single blood test or scan that confirms them.
What do normal growing pains feel like?
The pattern matters more than the exact words a child uses. Young children may describe pain as sore, achy, pulling, cramping or throbbing.
Typical features include:
- pain in both legs rather than consistently in one leg;
- discomfort in the calves, shins, thighs or behind the knees;
- pain that begins during the evening or after the child has gone to bed;
- episodes that sometimes wake the child from sleep;
- pain that has resolved by morning;
- pain-free days or weeks between episodes;
- normal walking, running and playing during the day;
- no swelling, heat, redness or persistent tenderness;
- a child who is otherwise eating, growing and behaving normally.
The pain may last for several minutes or a few hours. It can be mild on one occasion and more distressing on another.
Some children experience symptoms after an especially active day, although growing pains are not simply an exercise injury. The relationship with activity is not always consistent.
What is not typical of growing pains?
Growing pains should not usually cause a persistent limp, visible inflammation or pain that remains throughout the following day.
| More typical of growing pains | Needs medical assessment |
|---|---|
| Pain in both legs | Persistent pain in one leg or one precise location |
| Evening or night-time episodes | Pain regularly present in the morning or throughout the day |
| Normal activity the following day | Limping, refusing to walk or reduced activity |
| No visible physical changes | Swelling, redness, warmth, a lump or unusual bruising |
| Pain comes and goes | Pain becoming steadily more frequent or severe |
| Child is otherwise well | Fever, weight loss, poor appetite or marked tiredness |
| Comfortable joints | Persistent pain, stiffness or swelling in one joint |
The NHS advises seeing a GP when a child has pain in one leg, morning or activity-related pain, a limp, pain in one joint, swelling, unusual bruising, fever, persistent tiredness, loss of appetite or weight loss. Read the current NHS guidance on growing pains.
One atypical feature does not necessarily indicate a serious illness, but it means that “growing pains” should not be assumed without assessment.
When should you seek urgent medical help?
Contact NHS 111, an urgent treatment service or your GP urgently if the child:
- cannot stand, walk or put weight through the leg;
- develops a new and unexplained limp;
- has a hot, red, swollen or extremely painful joint;
- has severe or rapidly worsening pain;
- has leg or joint pain with a high temperature;
- appears unusually sleepy, confused or seriously unwell;
- has significant swelling following an injury;
- has a wound near a painful or swollen joint;
- develops weakness, numbness or loss of bladder or bowel control;
- has unexplained pain alongside widespread bruising or bleeding.
A child who suddenly refuses to walk with a fever needs prompt assessment. Infection inside a joint or bone can become serious and requires treatment.
Call 999 for a major injury, a visibly deformed limb with circulation problems, loss of consciousness, severe breathing difficulty or another life-threatening emergency.
If you are uncertain about the appropriate service, NHS 111 online or the telephone service can help assess symptoms and direct you to suitable care. Online NHS 111 should only be used for children aged five and over; telephone 111 can be used for younger children.
What other conditions can cause leg pain in children?
Most childhood leg pain is not caused by a dangerous condition. Nevertheless, several problems can resemble growing pains, particularly during the early stages.
Minor muscle strain or overuse
Running, jumping or starting a new sport can cause muscle soreness. This may be localised and hurt when the affected muscle is used or pressed.
Injury
Bruises, sprains and fractures can cause pain, swelling and difficulty bearing weight. Children may not always remember or report a minor fall.
Joint hypermobility
Very flexible joints can be associated with muscle tiredness and discomfort after activity. Some children also experience recurrent sprains or appear less coordinated.
Transient synovitis
Temporary inflammation of the hip can cause hip, thigh or knee pain and a limp, sometimes following a viral infection. A clinician may need to distinguish it from a joint infection.
Inflammatory arthritis
Childhood arthritis can cause joint swelling, stiffness and reduced movement. Morning stiffness and persistent symptoms are not typical growing pains.
Bone or joint infection
Osteomyelitis and septic arthritis can produce severe localised pain, fever, warmth, swelling and refusal to use the limb. These require urgent medical treatment.
Foot and biomechanical problems
Foot shape, footwear, altered walking mechanics and tight muscles can contribute to activity-related discomfort. Pain linked consistently to walking or sport needs a different assessment from night-time growing pains.
Vitamin or nutritional deficiency
Vitamin D deficiency can cause muscle weakness or bone pain, but these symptoms are not specific. A supplement should not be used as a substitute for assessing persistent or atypical pain.
Our guide to vitamin D deficiency explains who may be at risk and when testing might be considered.
Does night-time pain mean something serious?
Night-time pain is a classic feature of growing pains, so waking at night is not automatically a warning sign. The complete pattern determines how reassuring it is.
Night pain is more consistent with growing pains when:
- both legs are affected;
- the pain is intermittent;
- massage or simple pain relief helps;
- the child is comfortable by morning;
- walking and activity remain normal;
- there are no other symptoms.
Arrange a medical review when night pain:
- always affects the same leg or precise point;
- becomes progressively worse;
- is also present during the day;
- causes a limp or limits activity;
- comes with swelling, a lump or persistent tenderness;
- occurs with fever, fatigue, bruising, poor appetite or weight loss.
Parents sometimes worry that night pain means bone cancer. Childhood bone cancer is rare, and intermittent pain in both legs with normal daytime activity is not its usual pattern. Persistent, localised and worsening pain or swelling should still be examined rather than repeatedly attributed to growth.
How can you ease growing pains at home?
When symptoms follow the typical pattern and there are no warning signs, simple comfort measures are usually sufficient.
You can try:
- gently massaging the painful muscles;
- applying a comfortably warm heat pack wrapped in fabric;
- helping the child perform gentle calf and thigh stretches;
- offering reassurance and helping them settle back to sleep;
- using well-fitting footwear during the day;
- allowing sensible rest after unusually strenuous activity;
- giving age-appropriate pain relief when necessary.
Never place a hot water bottle or heat pack directly against a child’s skin. Check the temperature carefully and remove it before the child falls asleep to reduce the risk of burns.
There is usually no need to prevent ordinary play or sport if the child is comfortable and moving normally. Regular activity supports strength, coordination and general health.
If one particular activity repeatedly produces pain during the activity or causes limping afterwards, arrange an assessment rather than continuing to treat it as normal growing pain.
Can children take paracetamol or ibuprofen?
Children’s paracetamol or ibuprofen can be used for growing pains when appropriate. Follow the packet instructions for the child’s age or weight and use the measuring device supplied with the medicine.
Important precautions include:
- do not exceed the stated dose or dosing frequency;
- check that another cold or flu medicine does not contain the same ingredient;
- do not give aspirin to anyone under 16 unless it has been prescribed;
- ask a pharmacist or clinician before giving ibuprofen to a child with asthma, dehydration, chickenpox, kidney problems or certain other medical conditions;
- do not give ibuprofen and paracetamol together unless a healthcare professional has advised an appropriate plan;
- keep all medicines out of children’s reach.
Read the NHS information about paracetamol for children and ibuprofen for children before use.
If pain regularly requires medicine, wakes the child frequently or is becoming more severe, arrange a GP review even if previous episodes were thought to be growing pains.
Should children have blood tests or scans?
Children with a classic growing-pain pattern and a normal examination do not usually need blood tests, X-rays or scans.
A clinician may arrange investigations when symptoms are atypical or the examination identifies a concern. Depending on the circumstances, these might include:
- a full blood count;
- markers of inflammation;
- vitamin D or bone-profile tests;
- an X-ray;
- an ultrasound scan;
- an MRI scan;
- other tests directed by the suspected condition.
Tests should answer a specific clinical question. Large private blood-test panels are not routinely necessary for an otherwise well child with typical symptoms.
A normal blood test cannot confirm growing pains, and some musculoskeletal conditions are diagnosed mainly through examination and imaging. Equally, an MRI is not automatically required because pain occurs at night.
Our guide to calcium and bone-profile blood tests explains what these measurements can and cannot show.
When should you book a GP appointment?
Arrange a routine or prompt GP appointment if:
- you are unsure whether the pattern is typical;
- pain consistently affects one leg;
- one spot remains painful or tender;
- symptoms occur in the morning or during activity;
- the child develops a recurring limp;
- a joint appears stiff, swollen or difficult to move;
- episodes are increasingly frequent or severe;
- pain repeatedly disrupts sleep;
- the child stops activities they previously enjoyed;
- home measures are no longer sufficient;
- you remain concerned despite an earlier assessment.
Keep a short symptom diary before the appointment. Record:
- which leg and exact area hurts;
- the time of day symptoms begin;
- how long an episode lasts;
- whether activity seems related;
- any swelling, stiffness, rash or bruising;
- whether the child limps;
- any fever or other symptoms;
- what relieves the pain.
A photo or short video of swelling, unusual walking or reduced movement may be useful if the symptom has disappeared by the appointment.
What happens during the medical assessment?
The clinician will ask about the pattern of pain, general health, recent illness, activity, injuries and family medical history.
The examination may include:
- watching the child stand and walk;
- checking hip, knee, ankle and foot movement;
- looking for swelling, redness or bruising;
- pressing gently along the muscles, joints and bones;
- assessing strength and reflexes;
- checking leg length and alignment;
- examining other parts of the body when appropriate.
If the history and examination fit growing pains, reassurance may be all that is needed. The clinician should also explain which future changes would require reassessment.
When the diagnosis is unclear, the child may be referred to paediatrics, paediatric orthopaedics, rheumatology, physiotherapy or another appropriate service.
Families considering self-funded assessment can read our guide to private paediatrician consultation and test costs.
Can growing pains be prevented?
There is no proven way to prevent all growing pains because their underlying cause is uncertain.
General measures that may help some children include:
- regular age-appropriate physical activity;
- gradually increasing new sports or training;
- wearing comfortable, correctly fitting shoes;
- gentle stretching after active days;
- adequate sleep and recovery;
- a balanced diet containing sufficient calcium and vitamin D;
- avoiding pressure to continue sport through pain or a limp.
Special insoles, supplements and repeated treatments should not be purchased solely because they are advertised for growing pains. They may be appropriate for an identified deficiency or biomechanical problem, but that requires an individual assessment.
If symptoms consistently follow sport and remain localised, consider a strain or overuse injury. Our guide to sports injuries and recovery explains why rest and rehabilitation should be matched to the injury.
Frequently asked questions
What age do growing pains start?
They are most commonly described in children between three and twelve years old. Similar symptoms outside this range should not automatically be considered abnormal, but the pattern should be reviewed if there is uncertainty.
Do growing pains happen every night?
They normally come and go. Some children have several episodes close together followed by weeks without pain. Pain every night, particularly when worsening or localised, deserves medical review.
Can growing pains affect only one leg?
Typical growing pains affect both legs, although both may not hurt equally during every episode. Persistent pain in one leg should be assessed by a GP.
Can growing pains cause a limp?
No. A child with typical growing pains walks and plays normally during the day. A limp, refusal to bear weight or reduced activity is a reason to seek medical advice.
Can growing pains happen during the day?
They usually occur in the evening or at night and disappear by morning. Pain that regularly occurs during activity or persists throughout the day may have another cause.
Where are growing pains normally felt?
They commonly affect the calves, shins, thighs or areas behind the knees. Persistent pain located directly in one joint or a precise point on a bone is less typical.
Can growing pains wake a child from sleep?
Yes. They can be uncomfortable enough to wake a child, but the child should normally be pain-free and active the following morning.
Do children get growing pains in their arms?
The usual pattern involves both legs. Recurrent arm pain should not automatically receive the same label and may require assessment depending on its severity and associated symptoms.
Are growing pains caused by a growth spurt?
There is no convincing evidence that bones growing causes the pain. “Growing pains” is a traditional name for a recognisable childhood pain pattern rather than an explanation of its cause.
Does magnesium help growing pains?
There is not enough evidence to recommend routine magnesium supplements for growing pains. Supplements can cause side effects and should only address an identified need.
Could low vitamin D cause leg pain?
Vitamin D deficiency can contribute to muscle weakness and bone discomfort, but pain alone cannot diagnose it. A clinician can decide whether risk factors or other symptoms justify testing.
How long do growing pains last?
An individual episode may last minutes or hours. The overall pattern can recur intermittently for months or years, but it normally resolves without causing lasting damage.
When should I worry about leg pain at night?
Arrange an assessment if night pain is consistently one-sided, localised, worsening or accompanied by daytime pain, limping, swelling, fever, bruising, tiredness, poor appetite or weight loss.
Should my child stop sport?
Not when they are comfortable, moving normally and have typical growing pains. Stop the activity and seek advice if exercise causes pain, swelling or limping.
Can growing pains damage the legs?
No. Typical growing pains do not damage bones, joints or muscles and do not interfere with normal growth.
