Kids sometimes wake in the night complaining of leg aches or pain in their arms. The oft-heard response from parents and doctors alike: Don't worry; it's just growing pains.

But are growing pains real? Can growth really be painful?

The American Academy of Pediatrics does use the term to refer to arm or leg pain in some boys and girls, but, at the same time, the organization says that growth is not the cause of these pains. Even during an adolescent growth spurt, it notes, a child's growth is too gradual to cause any significant pain.

As Dr. Garrett Moss, a pediatric orthopedic surgeon with Mercy Medical Center in Rockville Centre, said, "We do frequently see extremity pain during peak adolescent growth spurts, but the gradual growth is not causing pain." The limb aches and pains do coincide with periods of peak growth, but they also coincide with running, jumping, playing sports and just being a kid.

Kids rarely feel sore when they're having a good time; the pain comes later when their muscles are relaxed, usually at night, Moss said.

The so-called growing pains, he said, are more likely to be from overworking muscles.

Dr. Jon-Paul DiMauro, a pediatric orthopedic surgeon at Cohen Children's Medical Center in New Hyde Park, said that the term "growing pains" may be used too frequently as a catchall diagnosis, but the pains do exist. "I think it is a real entity even though we can't pinpoint the exact cause," he said.

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Sometimes, Moss said, growing pains may be related to growth-plate strains. Growth plates are the areas of growing tissue near the ends of the long bones in children and adolescents that determine what the bones will look like in the future. When growth is complete, the plates close.

According to Moss, "different growth plates close at different times," with the growth plates around the knee usually closing a couple of years after those around the heel. But, "skeletal maturity is, on average, reached at age 14 in girls and age 16 in boys," he said.


Regardless of their cause, most growing pains are marked by pain in the lower legs, usually at night, and can be strong enough to wake the child, DiMauro noted. His prescription? A little TLC: "Some reassurance and a gentle massage can go a long way."

Moss said that rest, ice and possibly over-the-counter pain medicine is usually all that's needed.


However, it's also possible that the pain a child complains of isn't a growing pain at all but rather a red flag for something more serious.

To help parents decide whether their child should see a pediatrician about aches and pains, DiMauro and Moss said that parents should consider the child's answers to these questions:

* Is the pain so bad that the child can't participate in his or her usual activities?

* Does the child have a fever?

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* Has the child been losing weight? n Is the painful area swollen or red?

* Is there a visible deformity in the affected limb?

* Is the pain worse in the morning than the evening?

Such symptoms could be signs of a more serious condition -- infection, joint disease, a fracture or possibly even cancer.

"In the absence of red flags, I feel OK in saying these are growing pains," DiMauro said. "If any of these red flags are there, see your pediatrician for an evaluation to rule out a more serious condition." But, he noted, keep in mind that most of these serious conditions are rare.