Growing pains in the knee

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

"Growing pains" typically occur in young children.

Thanks to Dr. Tom Lehman for his help with this page

According to Dr. Tom Lehman, Chief of Pediatric Rheumatology at the New York Hospital, “They wake up from sleep complaining of pain. Parents become aware of the problem when they hear the child crying. Most often growing pains occur in the first few hours after the child has gone to sleep. Typically a child will point to the front or back of the knee, or the muscles just above the knee. The pain will usually disappear with ten or fifteen minutes of gentle massage to the area and be completely gone in the morning. The pain is always in a large joint like the knee or ankle. Sometimes the pains will wake the child up two or three nights in a row, but more often they occur episodically over a period of weeks or months. They may disappear for months or a year only to start up again.”

Dr, Lehman goes on to say, “The key finding for growing pains is that the child is absolutely fine when they wake up in the morning. There is no pain, no limping, or any other abnormality in the morning. Whenever pain is still present when the child wakes up in the morning or occurs while the child is awake, it must not be dismissed as ‘growing pains.’

For a child with typical growing pains a trip to the doctor is not usually necessary. However, if the pains are persistent or unusually severe a medical examination is warranted. A child with growing pains should have absolutely normal blood tests and X-rays. Bone scans, MRIs and other special tests are not indicated for a child with growing pains. However, they may be necessary to exclude other causes of pain in children who have atypical findings.

There are a variety of explanations for growing pains. There is evidence that the body produces more growth hormone at night, and some doctors believe the body is actually growing faster at night leading to the pain. Surprisingly growing pains tend to run in families. If one of your children is having a lot of growing pains ask your parents and your spouse’s parents. It’s likely one of you also had a lot of growing pains.

Growing pains can be disturbing to both parents and children. The first step is to be sure that, “It’s just growing pains.” Most often gentle massage and reassurance are enough to help the child get back to sleep. Children with more severe pain usually will respond to a dose of acetaminophen or ibuprofen just as you would treat them for a headache during the day. If they have been waking up with pain several nights in a row, it may be helpful to give them a dose of medication at bed time. This will decrease the perception of pain and may prevent the child from awakening. After two or three nights without episodes the medication should be stopped. If the pains persist despite medication or return as soon as the medication is stopped, a full medical evaluation should be done.

Growing pains will go away. They may come back when the child goes through another period of rapid growth, but they never stay. While inconvenient they are not of any long term significance. They do not interfere with proper growth or development. If you think your child might have a more serious condition, consult your doctor.”

[If you’re not getting the answers you need you may find more help in Dr. Lehman’s new book, “It’s Not Just Growing Pains.” (available on Amazon).]

Another type of “Growing pains” is a common complaint of adolescents. Usually found in young men and women around the ages of 9 to 14, growing pains are the result of the rapid growth of these adolescents.

Conditions such as Osgood-Schlatter Disease are types of growing pains. These conditions are caused by inflammation around sites where tendons insert. These tendons pull on the growing bone (at the growth plate) and cause inflammation. Osgood-Schlatter disease is a common condition in children often referred to as growing pains of the knees. Osgood-Schlatter disease is the result of rapid growth and pulling of the tendons around the growth plate of the knee at the tibial tubercle in adolescents.

Treatment of Osgood-Schlatter is best accomplished with rest. By avoiding irritating activities, the inflammation usually subsides without other treatment. Occasionally, a knee brace or even a cast is used, but this is rarely necessary.

These types of growing pains are almost always seen in active youths, often while participating in sports. Growing pains are best treated with rest, stretching, and ice packs. If activities are causing significant growing pains, they should be avoided until the symptoms resolve.

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