A parent's guide: How to tell if it's growth pain?

September 24, 2025 •

3 min read

According to the American Academy of Pediatrics, between 25-40% of children experience growing pains at some point during childhood. This authoritative guide will help you understand the symptoms and characteristics of these common aches to determine how to tell if it's growth pain, distinguishing it from more concerning issues.

Quick Summary

Growth pains are typically a benign, bilateral muscle ache in the legs, most often occurring in the evening or at night without visible signs of injury like swelling. Recognizing the pattern of intermittent, nocturnal pain that doesn’t cause a limp is crucial for distinguishing it from other conditions that might require medical attention.

Key Points

Differentiate by Time and Location: Growing pains usually occur in the evening or at night, affecting both legs' muscles, not the joints [1, 2, 4].
Look for Associated Symptoms: Typical growing pains have no visible signs like swelling or redness; their presence suggests a different issue [1, 2, 4].
Observe Daytime Activity: A child with growing pains will be active and pain-free during the day, with no limping or stiffness [1, 2, 4].
Trust Your Instincts and Seek Help: If you notice red flags like persistent pain, limping, fever, or pain in a single joint, consult a doctor promptly [1, 2, 3, 4].
Provide Comforting Home Care: Simple measures like massage, warmth, and stretching are often effective for relieving growing pains [1, 2, 3, 4].
Understand the Cause: The pain is not directly from growth but likely from muscle fatigue due to a child's active play [2, 3, 4].

What are growing pains?

Growing pains are common, harmless muscle aches in children's legs, usually occurring between ages 3 and 12 [3, 4]. They are not caused by growth itself but may be related to muscle fatigue from active play [2, 3, 4]. These pains often appear in the late afternoon, evening, or night and typically resolve by morning [1, 2, 4].

Key indicators of growing pains

Growing pains present with specific characteristics. The pain is usually felt deep in the muscles of both legs (calves, shins, thighs, or behind the knees), not the joints [1, 2, 4]. It tends to occur in the evening or night, sometimes waking a child, and disappears by morning [1, 2, 4]. The pain is intermittent, lasting from minutes to hours, and may occur over weeks or months [1, 2]. Typically, both legs are affected, though intensity may differ [1, 2, 4]. Children with growing pains have no pain or physical limitations during the day and can engage in normal activities without limping [1, 2, 4]. Simple measures like massage or warmth often provide relief [1, 2, 3, 4].

What do growing pains feel like to a child?

Children often describe the pain as a deep ache, throbbing, or cramping [4]. It can be mild to severe, and comforting actions like massage can help [2, 4].

Distinguishing growing pains from other conditions

It's important to differentiate growing pains from other potential causes of leg discomfort. Growing pains are in the muscles of both legs, occur at night, and have no visible signs like swelling or redness [1, 2, 4]. More concerning pain may be localized in a single joint, persistent throughout the day, or accompanied by swelling, redness, limping, fever, or weight loss [1, 2, 3, 4].

Use this comparison table to help differentiate between typical growing pains and other potential causes of leg discomfort [1, 2, 3, 4]:


Symptom	Typical Growing Pains	Potential Red Flag
Location	In the muscles of both legs (thighs, calves, shins) [1, 2, 4]	In or around a single joint (e.g., knee, ankle) or persistently in one spot [1, 2, 4]
Timing	Late afternoon, evening, or nighttime; disappears by morning [1, 2, 4]	Persistent pain throughout the day, including the morning [1, 2, 3, 4]
Associated Signs	No visible signs of injury, such as swelling, redness, or warmth [1, 2, 4]	Swelling, redness, bruising, tenderness to the touch [1, 2, 3, 4]
Mobility	No limping or restricted movement; normal activity level [1, 2, 4]	Limping, favoring one leg, or refusal to walk [1, 2, 3, 4]
Overall Health	Child appears healthy otherwise; no fever or weight loss [1, 2, 4]	Accompanied by fever, rash, weight loss, or fatigue [1, 2, 3, 4]
Effect of Activity	Occurs after a day of increased physical activity [2, 4]	Worse with activity and doesn't get better with rest [1, 2, 4]

Red flags: When to see a doctor

While growing pains are usually benign, seek medical advice if your child's leg pain includes persistent daytime pain, joint involvement, limping, swelling, redness, warmth, fever, rash, weight loss, or if it follows an injury [1, 2, 3, 4].

Management and home care

For typical growing pains, home remedies can provide relief [1, 2, 3, 4]. Gentle massage of the leg muscles, applying warmth with a heating pad or warm bath, and gentle stretching before bed can help [1, 2, 3, 4]. Over-the-counter pain relievers may be used, but consult a healthcare provider first [2, 4].

Conclusion: Navigating growing pains

Recognizing the characteristics of growing pains—nocturnal, bilateral muscle aches without visible signs or daytime limitations—is key to managing them with simple home care [1, 2, 3, 4]. However, being aware of red flags is essential to rule out more serious conditions [1, 2, 3, 4]. When in doubt, consult a healthcare professional [1, 2, 3, 4]. For more information on childhood health, the American Academy of Pediatrics provides resources at healthychildren.org.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your or your child's health.

Frequently Asked Questions

Growing pains commonly affect children between the ages of 3 and 12, often with peaks during early childhood and the pre-teen years [2, 3, 4].

Growing pains most often occur in the late afternoon, evening, or night and rarely affect a child's normal activities during the daytime [1, 2, 4].

Yes, if your child's pain is localized in their joints (like knees or ankles) rather than their muscles, you should consult a doctor as this is not a typical sign of growing pains [1, 2, 4].

Gentle massage of the affected muscles, applying a warm compress or heating pad, and gentle stretching before bed are effective remedies [1, 2, 3, 4].

Growing pains typically affect both legs. Persistent pain exclusively in one limb is a red flag and warrants a doctor's visit [1, 2, 4].

Despite the name, growing pains are not directly caused by growth spurts. The pain is more likely related to muscle strain or fatigue from a child's active daytime play [2, 3, 4].

You should contact a doctor if the pain is persistent, causes a limp, is located in the joints, is accompanied by fever, swelling, or redness, or if the child seems unwell [1, 2, 3, 4].