Parents often call me when their kids wake up with “growing pains.” The story is usually the same. A school-aged boy or girl goes to bed perfectly fine. Then, at 2 or 3 o’clock in the morning, the child wakes up in lots of pain.
There are a few things about growing pains that are remarkably similar.
• They almost always occur at night.
• The pain is almost always in the child’s thighs or calves.
• The intensity and location of the pain varies from night to night.
• A gentle massage from Mom or Dad and/or a dose of pain medication usually gets the child back to sleep in a half hour or so.
So why the heck does it hurt to grow? The answer is that it doesn’t! Except for a few exceptions (which I’ll discuss below) growing does not hurt. So where did the concept of growing pains come from? My best guess is that in the old days, people tried to explain things without having enough information.
Well then, if growth doesn’t cause growing pains, what does? Most doctors believe growing pains are really “activity” pains. Kids like to play hard and after a day of running, jumping and banging into things, the muscles, tendons and ligaments that connect bones and muscles can become slightly inflamed. And since there are lots of nerves in muscles, this inflammation can lead to pain. In addition, muscles often get a little stiff when we are asleep, and stiff muscles hurt when they are flexed. That’s why parents often wake up in the morning with aching backs and necks.
Okay, so here are the exceptions to the “growing pains” phenomenon.
When kids are eight to ten years of age, they sometimes get heel pain that is caused by a condition known as Sever’s disease. It’s not really a disease but inflammation in the growth area of the heel. It typically occurs during the day after lots of running around. If you develop Sever’s disease, wearing special cups in your shoes can help.
Starting about age 14, some kids may develop a similar problem in their knee caused Osgood-Schlatters disease. This one isn’t a disease either, but is caused by rapid growth on the top part of a child’s tibia (that’s the big bone in your lower leg). The pain of Osgood-Schlatters disease occurs below the knee joint and typically occurs after playing sports. It is treated with ice, pain medication and rest.
Finally, when teenagers go through puberty, they typically have a growth spurt. Instead of growing two inches a year like younger kids, they can shoot up three or four inches in a year. When this happens, their feet go through a growth spurt too. The foot is a very complicated structure with lots of bones, muscles, tendons and ligaments to keep things in their proper order. During the rapid growth of adolescence, it’s thought that foot pain may be due to the realignment of structures within the foot.
First Published in the Washington Post, February 8, 2010