Benign nocturnal idiopathic limb pains

This leaflet explains the symptoms of and treatment for nocturnal idiopathic limb pains, what are commonly called ‘growing pains’.

What are benign nocturnal idiopathic leg pains?

‘Benign idiopathic nocturnal limb pains’ are non-harmful pains affecting the legs, and occasionally the arms, that occur in the evening or at night for no known or concerning reason. A common name for them is ‘growing pains’. Pain is usually felt as an ache or throbbing sensation in the muscles and is most commonly felt by the young person in the thigh, calf or shin muscles.

Physically active children tend to experience these types of pains more often and can also develop delayed onset muscle soreness (DOMS) after activity. This is a sign the muscles have worked hard and usually occurs the day after, or a few days after, exercise and will settle with rest. It is not a sign of bone, joint or muscle damage.

Children who experience a sudden increase in growth may feel limb pain because the bones grow first and then the muscles must stretch to catch up. Therefore, the muscles can become tight and be sore when used.

• Most pains settle in time, although this can take months.
• Growing pains are not associated with growth problems.
• Growing pains do not increase the risk of developing arthritis.

In some severe cases, a doctor may need to examine your child’s joints and muscles to check that there is no other underlying reason for the pain.

How to help your child with these pains

• Reassure your child that the pains do not mean serious illness.
• Be understanding that the pains do really exist.
• Keep a diary of when the pains occur and the activities which aggravate them: this can be useful in identifying patterns and may allow you to predict when the pains may happen in future (for example, after your child has taken part in a busy day of activities).
• Make sure your child’s shoes are supportive and well fitting. Trainers or ankle boots can be helpful for children with more flexible feet and ankles. It is important that shoes are fastened securely. Some trainers come with arch supports which may help provide further stability.
• Keep your child active. Gently strengthening the muscles often results in less pain.

How to help ease the pains

• Gently massage to the muscles around the areas of pain.
• Give your child a warm bath before bedtime.
• The pain usually eases with rest and gentle stretches.
• A hot water bottle wrapped in a cover or towel can also help the muscles to relax.

When is it NOT benign nocturnal idiopathic limb pains?

If you notice any of the following symptoms, make an appointment with your child’s doctor (GP) to review them:

• joint swelling
• pains always in one leg rather than in both
• if the child consistently points to a specific bony area or joint
• persistent limping, especially during the day, that doesn’t go away
• waking every night with pain
• missing school because of pain
• fever, loss of appetite or weight loss

This leaflet is only a guide; for specific medical advice, please consult your child’s doctor for further information.

Contact us

Paediatric Rheumatology: 01223 348577