Most parents have heard the term “growing pains.” Many children complain of aching legs, especially at night, and parents are often reassured that this is a normal part of childhood. In most cases, that’s true — growing pains are common, harmless, and self-limiting.
But sometimes, leg pain in children is not just growing pains. If your child’s discomfort is frequent, interferes with sleep, play, going to school, or seems to be getting worse, it may be a sign of something else that needs attention.
This guide explains what growing pains are, how to recognise them, and when leg pain may point to another cause that requires medical support.
What Are Growing Pains?
Growing pains are one of the most common causes of leg discomfort in children between the ages of 3 and 12 years. Despite the name, they are not directly caused by growth spurts. Instead, they are thought to be related to muscle fatigue, joint hypermobility, or even heightened sensitivity in the nervous system as children grow and develop.
Typical features include:
- Aches or cramps in both legs, often in the calves, thighs, or behind the knees
- Pain that occurs in the evening or at night, sometimes waking the child
- Normal activity levels during the day (children usually run and play without limitation)
- No swelling, redness, or limp during the day
Growing pains are usually self-limiting and tend to improve as children get older.
When Leg Pain Might Be Something More
Not all leg pain can be explained by growing pains. Sometimes, pain can signal another issue that deserves closer attention. These include:
- Overuse injuries from sport or repetitive activity (such as shin splints or stress reactions)
- Post-injury pain that lingers after a sprain, fracture, or surgery
- Joint or muscle conditions, such as juvenile idiopathic arthritis or hypermobility-related pain
- Nerve-related pain, where the nervous system continues to send danger messages even after tissues have healed
- Less common but serious causes, such as infection, inflammation, or bone/orthopaedic conditions
When to Seek help?
Seek medical advice if your child’s leg pain is associated with:
- Persistent or worsening pain that does not settle with rest
- Persistent or worsening pain that causes emotional distress or interferes with activities
- Swelling, redness, or warmth in the joints or limbs
- Pain that causes a limp or refusal to bear weight
- Pain occurring in only one leg
- Night pain that is severe or constant
- Systemic symptoms such as fever, unexplained tiredness, or weight loss
These signs may indicate a condition that requires medical assessment and, in some cases, urgent care. However, even if your child does not have any of these ‘red flag’ symptoms, but their pain persists and usual care does not help, a consultation with a specialist pain team can be helpful.
How Is Leg Pain Assessed?
A careful assessment includes:
- History-taking: when the pain occurs, how long it lasts, what helps or worsens it
- Physical examination: looking for joint swelling, tenderness, or muscle weakness
- Investigations: occasionally blood tests or imaging may be needed to rule out specific conditions
Often, reassurance and simple active management strategies using a multimodal approach are all that’s required once serious causes are excluded.
Treatment Options: Supporting Children with Leg Pain
The best approach depends on the underlying cause. Options may include:
Lifestyle and Home Support
- Education of the child and the parent on what pain is and how it works
- Gentle stretching and massage before bedtime
- Heat packs or warm baths for comfort
- Ensuring adequate hydration and balanced nutrition
- Encouraging normal activity, but pacing strenuous exercise when needed
Medical and Allied Health Support
- A paediatrician can help rule out serious causes and guide management
- Physiotherapists can support posture, strength, and safe return to sport
- Occupational therapists can help with school participation, pacing activities, and managing fatigue and social connection.
- Psychologists (and Occupational Therapists) can help children cope with worry or to address sleep disruption linked to pain
Advanced Options for Ongoing Pain
For a small group of children whose leg pain persists despite usual care, additional options may be considered:
- Targeted nerve blocks (such as peripheral nerve blocks) have shown benefit in selected cases of nerve-related pain
- Pulsed radiofrequency treatments may be considered in carefully selected older children with nerve-related pain, though evidence is still developing
- Non-invasive neuromodulation devices (such as vagus nerve stimulation) are being studied for their potential to reduce pain sensitivity
These treatments are always combined with occupational therapy, physiotherapy, sleep and lifestyle support, and psychological care. The goal is to provide a “window of relief” that helps children re-engage in normal activities.
Living Well: Practical Tips for Families
Parents can help by:
- Focusing on function – emphasising positive engagement in activity can reduce your child’s fear, which in turn reduces pain.
- Ensuring consistent sleep routines
- Encouraging balanced activity — neither over-restriction nor over-exertion
- Communicating with teachers so school demands can be adjusted if needed
- Offering reassurance that most leg pains improve with time and support
Final Thoughts
Most childhood leg pain is harmless and short-lived, but if pain persists, interferes with everyday life, or presents with concerning symptoms, it’s important to seek medical advice.
Early assessment can provide reassurance, identify treatable causes, and connect families with supportive care. With the right approach — from lifestyle strategies to advanced treatment where needed — children can return to play, sport, and school with confidence.
FAQs
Are growing pains normal?
Yes — growing pains are very common in children and usually harmless.
Can growing pains happen every night?
They can occur frequently but usually improve over time. If pain is constant or severe, seek medical advice.
How do I know if it’s something more serious?
Look out for other symptoms like swelling, limping, persistent one-sided pain, or fever. If you are concerned, seek help from a pain management team.
Can children outgrow leg pain?
Yes — most children do. But some need support from healthcare providers if pain keeps interfering with daily life.
What treatments are available if it’s not just growing pains?
Depending on the cause, treatments may include physiotherapy, occupational therapy, lifestyle adjustments, psychological support, and in some cases advanced options like nerve blocks or neuromodulation.