Child Health
Our peak height velocity guide covers the knee and heel pain that can show up in active teens during the growth spurt, and our guide on when to worry about a child's height covers growth itself. This piece answers a different question that wakes parents up at night: is the leg ache your young child keeps complaining about at bedtime normal, and which signs mean it's something else? It covers what classic growing pains look like, what the research says about the name, the red flags that call for a doctor, and which home remedies have any evidence behind them.
What Growing Pains Looked Like in 185 Preschoolers
When the pain started and where it hurt, from a Danish cohort followed with check-ins every two weeks
Why They're Called "Growing Pains," and Why the Name Misleads
The term traces back to an 1823 book by French physician Marcel Duchamp, written when doctors assumed leg aches in children came from bones growing. The label stuck long before anyone tested it.
When Danish researchers measured preschoolers every six months, children growing fastest were no more likely to have growing pains. The pains also peak in early childhood, years before the fastest growth of puberty.
Researchers have tried for decades to pin down a cause. A 2022 scoping review in Pediatrics examined 145 studies and found that more than 93% defined growing pains without any reference to growth, and that definitions varied so widely that no single feature appeared in more than half of them. Fatigue after active days, a lower pain threshold, a link with restless legs syndrome, and low vitamin D have all been proposed. None has been confirmed, which is why growing pains are still diagnosed by exclusion: a doctor confirms the pattern fits and rules out other causes.
The timing alone argues against the name. As our puberty growth spurt guide explains, the fastest growth after infancy happens in the preteen and teen years, yet most research on growing pains centers on preschool and early school-age children, and the Danish study found prevalence rising gradually with age through that younger window rather than spiking with growth.
What Classic Growing Pains Look Like
Doctors typically use a set of criteria first proposed in 1986 and refined by Australian researcher Angela Evans. A typical episode follows a recognizable arc.
Normal play and activity, no injury, no limp
Usually both legs, in the muscles rather than the joints
Rubbing or holding the legs often eases it
Normal walking and play the next day
In the Danish cohort, a child was classified as having growing pains only when all five criteria were met: pain that comes and goes, with pain-free stretches of days, weeks, or months; unexplained pain in the limbs, away from the joints; pain that typically occurs at the end of the day or at night and isn't there in the morning; no limping or loss of function; and no injury, swelling, redness, local tenderness, or restricted joint movement. Most children had episodes one to three times a week. Most pain was in both legs, but about 20% of qualifying episodes were in one leg only, so the authors suggested one-sided pain alone shouldn't rule out the diagnosis. A 2017 review in Sports Health adds that when a child's history is classic and the physical exam is normal, blood tests and X-rays aren't needed to make the diagnosis.
What researchers still don't know. There is no lab test for growing pains, the cause is unknown, and the 2022 Pediatrics review found little agreement across studies on how to define them. That doesn't make the pain imaginary: it is real, common, and consistent across countries. It does mean the label works only as a description of a harmless pattern, not as an explanation, and it should only be applied once the pattern clearly fits.
Red Flags: When It's Not Growing Pains
The biggest risk with growing pains isn't the pain itself. It's that a more serious problem gets dismissed under the same label. Any of the following falls outside the growing-pains pattern and is a reason to see a pediatrician.
One detail deserves care. Night pain is part of the classic growing-pains pattern, but it isn't reassuring on its own. In a multicenter Pediatrics study of children with unexplained bone or joint complaints, a history of nighttime pain was one of the three strongest predictors of acute lymphoblastic leukemia, alongside subtle blood-count changes. Leukemia is rare, and the vast majority of children with night leg aches have growing pains. The point is that night pain doesn't settle the question; the rest of the picture does. A child who is otherwise well, has pain-free days and normal mornings, and has nothing to see or feel on the leg fits growing pains. A child with night pain plus any red flag above should be seen, and a simple blood count is often one of the first tests a doctor orders.
What Actually Helps
Growing pains go away on their own, so the goal is comfort and good sleep, not a cure. Here is how the common remedies stack up against the evidence.
Those stretching figures come from a 1988 trial of 34 children aged 5 to 14, with 18 in the stretching group and 16 in the control group. Both groups started at about 10 episodes a month. A later review of the growing-pains literature noted it was still the only randomized trial on treatment, and pointed out its limits: small groups, no blinding of the examiners, and no power calculation. It is encouraging rather than conclusive, but stretching is free, low-risk, and easy to fit into a bedtime routine.
Don't confuse growing pains with growth-spurt injuries in active kids. Older children and teens who play sports can develop pain at specific growth-plate sites, such as just below the kneecap (Osgood-Schlatter disease) or at the back of the heel (Sever's disease). Unlike growing pains, this pain is localized, tied to activity, and often tender to the touch. These conditions cluster around the growth spurt and are covered in our peak height velocity guide. If a young athlete has pain in one of these spots, it deserves a check rather than the growing-pains label.
What This Means For You
The practical takeaway: growing pains are real, common, and harmless, affecting roughly a quarter to more than a third of young children, and they don't mean your child is growing faster or will end up taller. The pattern is what matters: an ache in the legs at the end of the day or at night, gone by morning, in a child who is otherwise well and moves normally. Anything outside that pattern, especially pain in one spot, swelling, a limp, daytime pain, or signs of illness, is a reason to see a doctor. For the growth-spurt injuries that older athletes get, see our peak height velocity guide, for vitamin D needs see our vitamin D guide, and if your concern is height itself, see our guide on when to worry about a child's height.
Frequently Asked Questions
Are growing pains a sign my child is growing?
No. Despite the name, research hasn't linked growing pains to growth. A Danish study of 777 preschoolers found no association between growing pains and periods of rapid growth, and a 2022 review found that more than 93% of studies defined growing pains without referring to growth at all. They don't predict a growth spurt or a taller adult height.
What age do growing pains start and stop?
Most research focuses on preschool and early school-age children. An Australian survey found growing pains in about 37% of children aged 4 to 6, and a Danish cohort of children aged 3 to 6 found rates of 24-43% depending on the definition, rising gradually with age. Episodes come and go and eventually stop on their own.
How can I tell growing pains from something serious?
Look at the whole pattern. Growing pains are an ache in the legs late in the day or at night, gone by morning, with no limp, swelling, redness, or tender spot, in a child who is otherwise well. Pain in one specific spot or joint, swelling, a limp, daytime pain, pain after an injury, fever, weight loss, unusual tiredness, or easy bruising are not growing pains and should be checked by a doctor.
Can growing pains happen in just one leg?
Sometimes. In a Danish cohort, about 20% of episodes that met every other criterion affected only one leg, though most affected both. One-sided pain alone isn't a red flag, but pain that always stays in the same single spot, or comes with swelling, tenderness, or a limp, should be examined.
What helps growing pains at night?
Massage, comfort, and reassurance are the first-line approach. A small randomized trial found that a twice-daily leg stretching routine reduced episodes compared with reassurance and leg rubs alone. Children's acetaminophen or ibuprofen, given according to the label, can help on bad nights. Never give children aspirin, and talk to your pediatrician if pain relievers are needed often.
