If you and your child are losing sleep over growing pains, you may wonder why they happen and how to help your child. Legs and knees are most often the areas that ache, though growing pains can affect arms too.

Bradley Weinberger, MD, says growing pains are one of the most common concerns he hears about as a pediatrician. They’re often the primary reason why parents schedule an office visit for their children, he says.

Typically, parents voice these concerns during well child appointments, although occasionally parents will schedule office visits separately.

The odd thing is, what we call growing pains aren’t actually related to growth. But they do affect kids as they’re growing — generally affecting preschoolers and school-aged children.

Myths and facts about growing pains

People used to believe that growing pains flared up when a child’s bones grew at a faster rate than his tendons. That theory has been disproven, but doctors don’t know what does cause them.

Growing pains don’t occur during periods of more rapid growth and they don’t always occur at locations of growth. They may be related to fatigue, postural differences, changes in physical activity and psychological stress — but we don’t know for sure.

Here’s what we do know:

• They are equally common among boys and girls.
• They may run in families.
• They aren’t a sign of something more serious.
• They’re painful, but they’re temporary; they’re usually gone by the teen years.

How to know if your child has growing pains

Lab studies and X-rays won’t help your doctor diagnose growing pains, although imaging can help rule out other, more serious conditions.

“It’s a clinical diagnosis that comes after an office visit and discussion with the child and parent,” Dr. Weinberger explains.

The intensity and frequency of growing pains varies. They can range from feeling like a minor ache to an intense muscle cramp. But there are common factors you can expect to see:

• They occur at night or in the evening hours.
• Your child will probably feel pain in both legs or arms (though it’s possible to have pain in one arm or leg).
• Pain almost always includes the legs. If there’s pain in the arms, it typically is in addition to pain in the legs.
• They’re often intense enough to wake your child up.

“They usually occur in the legs and last anywhere from five to 20 minutes,” Dr. Weinberger says. “There could be multiple nights between episodes or they could happen several nights in a row.”

When to rule out growing pains

There is no “typical” case of growing pains. But there are some symptoms you won’t observe with this diagnosis, Dr. Weinberger says. Another condition is likely at work if:

• The pain is persistent and continues to worsen
• Your child’s pain persists in the daytime
• The pain is clearly located around a joint or joint inflammation is evident like redness, swelling or stiffness
• The pain keeps your child from being active

If you notice any of these signs, you should follow up with your pediatrician so he or she can evaluate your child’s condition.

How can you help soothe your child’s growing pains?

1. Think carefully before giving pain relievers.

When your child wakes up in pain, it’s tempting to reach for a children’s pain reliever. But Dr. Weinberger cautions that, in most cases, pain medications won’t take effect quickly enough to help when growing pains strike.

He notes, however, that ibuprofen and other over-the-counter pain medications may help if your child often has episodes several nights in succession. In that case, your doctor may recommend giving a dose of pain reliever before bed after the first episode.

You may notice that your child is grumpier or more fatigued than usual. Or sometimes the pain may strike after your child has a particularly active day.

Your doctor may suggest medication before bed when you see signs of an impending episode — especially if your child experiences severe growing pains.

2. Try giving a soothing massage.

When growing pains hit out of the blue, however, comforting your child is often the best treatment.

Dr. Weinberger suggests soothing your child by gently massaging or rubbing the arms or legs. This often helps ease the pain, and it is calming and can help minimize the sleep disruption for you both.

What can you expect the day after an episode?

If your child has a painful night, you may notice some grumpiness in the morning due to lost sleep. However, there’s no need to hold your child back from his or her normal activities.

“Some parents may see more episodes of growing pains when their child is really active,” Dr. Weinberger says. But he doesn’t recommend restricting activities to prevent growing pains. You can’t head them off by limiting your child’s activities — and you want your child to stay active for good health, he says.