Growing pains are real - and can really hurt

It was 4 a.m. on a weekend when the 5-year-old's mother paged me to discuss her son's disturbing symptoms. She had become alarmed when her usually healthy little boy woke from a sound sleep, crying with severe thigh pain.

We reviewed recent events, and though the child had been exposed to cousins with a summer virus, the boy himself showed no obvious signs of illness. He had been perfectly fine the day before, active and playful as usual, with no known injury to his bones or joints.

Since the little boy was fever-free and mom saw no hint of warmth, redness or swelling of any part of his lower extremities, we talked about the likely possibility of growing pains. I advised over-the-counter pain medications such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil), as well as gentle massage to the thighs. Mom agreed to call back within the hour if symptoms were not improving. The child ended up doing well.

Do growing pains really exist as a bona fide medical diagnosis? The answer is yes. Experts at the American Academy of Orthopaedic Surgeons explain that growing pains are most often seen in the 2- to 5-year-old age group, but also occur in older kids. Boys are affected more often than girls.

Though the cause of growing pains has not been definitively proven, orthopedists note that these leg aches often occur after a period of heavy physical activity, implying that the pain results from muscular strain.

Pain is usually felt in the calf, but children with growing pains can also complain of aches in the thighs as well as the knees, ankles and feet.

It's most reassuring if the pain occurs at the close of the day or overnight and disappears by morning; responds to minimal treatment such as acetaminophen and massage; affects both legs or alternating legs on alternating nights; and is not accompanied by worrisome signs and symptoms such as fevers, night sweats or swollen joints.

Growing pains are real, but the diagnosis is both a clinical diagnosis based on history and exam as well as a diagnosis of exclusion. Medical tests are usually not needed, but physicians consider and discard other more serious diagnoses before settling comfortably on growing pains as the likely cause of their young patient's leg discomfort.

If your youngster's leg pains don't fit the typical pattern of benign growing pains, discuss the symptoms with his physician. When indicated, X-rays and other radiologic procedures can be used to rule out serious pathology such as tumors, fractures and infection. Blood tests can also be ordered if findings suggest a high probability of a systemic disease such as arthritis or leukemia.

•Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.