What are growing pains? We don’t actually know

They are reportedly the most common cause of muscle or bone pain in adolescents. But it’s unclear what “growing pains” are – or if they are even related to growth

By Grace Wade

The term “growing pains” is often used to refer to sore or aching limbs in children. According to a 2007 review, it is the most common cause of bone or muscle pain in adolescents. Some studies estimate it affects more than one-third of kids.

Yet for all this, there is no clear definition of what growing pains are, or what causes them. In fact, they may not be related to growth at all. A recent analysis of studies about growing pains notes that the vast majority of papers – 93 per cent – make no mention of how the symptoms of bone or muscle pain are related to growth.

“Kids and teens are being told they have growing pains, but that is inaccurate based on our findings,” says Mary O’Keeffe at the Institute for Musculoskeletal Health at the University of Sydney in Australia. Most children diagnosed with growing pains are told the pain will subside with age and that they can take children’s ibuprofen or acetaminophen to manage the discomfort if needed.

“If a health professional is giving a diagnosis, it needs to be based on sound evidence. They need to be sure that growing is the cause, but we don’t know this,” says O’Keeffe.

She was concerned that this catch-all diagnosis had little meaning, or worse, that it could potentially lead doctors to overlook other conditions that warrant further investigations. To learn more, she and her colleagues combed through medical research and identified 147 studies that mentioned growth or growing pains in adolescents. They then compared how each defined growing pains based on eight characteristics of pain: the type, location, duration, timing, severity, age of onset, relationship to activity and physical examinations.

They found contradictions in multiple areas. For example, 14 per cent of studies claimed that growing pains are persistent while 5 per cent specifically stated that they are not. Only seven studies said the condition is or could be due to growth, one said that the pain occurs mainly at the end of growth spurts as growing slows and two explicitly stated that these pains had nothing to do with growth.

The closest the research came to consensus was on pain location: 50 per cent of studies concluded that growing pains primarily affect the legs. Other studies identified the arms, back, groin or shoulders as the primary pain locations.

These many contradictions render this diagnosis basically meaningless, says O’Keeffe.

“If I was a doctor, I would stop using the term with children and their parents, as currently it doesn’t seem to serve a purpose,” says O’Keeffe. “I think we need more research and a better understanding of pain in children and teenagers.”

Journal reference: Pediatrics, DOI: 10.1542/2020-052578

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