knee pains in growing kids


Rohan, a six-year-old boy was brought by his distraught parents for leg pains which used to be worse at nights. This story has been going on for the past 6 months or so. It was distressing to the family to have the child wake up night after night complaining of pains. He was taken to his pediatrician for a check-up. He was evaluated by his pediatrician and was diagnosed to have ‘Growing pains’.

Growing pains in children typically seen between 2 to 12 years of age. It might be the reason why it has been labeled or mislabelled as growing pains. Firstly, it has nothing to do with the growth of the child. The usual story is that of a physically active child who either complains of lower limb pain typically in calves, shin, or behind the knees, typically just before going to bed or wakes up at night due to pains. The pains tend to be seen in both lower limbs in 80-90% of the patients. There might be periods of time when the pain seems to disappear completely for a few days or weeks. The pain typically gets better with some massage or paracetamol use.  There are multiple theories of why growing pains in children happens. It is thought to be related to happen due to muscle/bone fatigue due to lower limb overuse. This might be supported by the fact that the pain tends to be worse on days of increased physical activity.

It might also be related to psychological stressors like marital discord at home, stressors at school, or bullying at school. Some of these children might have a lower pain threshold which would mean that they experience pain even with minimal painful stimulus.  

The condition tends to resolve in most of the children in the teenage years. It is estimated the pain is experienced anywhere between 10% to 20% of children. The treatment is usually symptomatic with massage and hot fomentation like the immersion of the lower limbs in a bucket of warm water. Medications like paracetamol can be useful in a few patients.