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Growing pains

Thomas JA Lehman, MD
Section Editor
Marisa Klein-Gitelman, MD, MPH
Deputy Editor
Elizabeth TePas, MD, MS


Recurrent, self-limited extremity pains for which the parents, child, and healthcare provider have no explanation are often called "growing pains." Such pains were first described in the medical literature in 1823 [1]. Subsequent publications attributed these pains to "rheumatism," a word synonymous with rheumatic fever at the time [2-7]. Correlations were described with digestive and sleep disorders, loose joints, poor posture, and chronic infection [3,8,9]. By the 1930s and 1940s, growing pains were distinguished from rheumatic fever and other pathologic conditions [5-7]. This distinction remains the focus of the evaluation of children with recurrent limb pain.

Growing pains are benign and usually resolve within a year or two of onset. They must be distinguished from pathologic causes of pain that require additional therapy (table 1).

The epidemiology, etiology, clinical features, evaluation, and management of growing pains in children are reviewed here. The evaluation of children with joint pain and limp is discussed separately. (See "Approach to the child with a limp" and "Evaluation of the child with joint pain and/or swelling".)


There is no consensus definition of growing pains, and, as a result, there are no specific inclusion or exclusion criteria that are uniformly applied to studies of children with complaints of growing pains. The key consideration is that clinicians not dismiss as "growing pains" a significant problem for which intervention may be appropriate.

In this regard, it is best to restrict "growing pains" to the description of children with pain awakening them at night (or from naps) who are otherwise without any manifestation of musculoskeletal problems. In contrast, children with unexplained joint pains that occur in association with activity deserve further investigation, which the child with typical "growing pains" may not.


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Literature review current through: Sep 2016. | This topic last updated: Feb 24, 2016.
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