There is all sorts of false information about this common problem. I fix growing pains all the time, so if you wanna know what they are and how to treat them just read on.

Growing pains, the popular definition . . .

Your 12-year-old daughter wakes you in the middle of the night complaining of aching pain in her legs.

Have you been there?

Growing pains are relatively common in children of ages three to 12. Typically they are located in the muscles and sometimes the joints of the legs, less commonly in the arms. They typically appear late in the day or night, often waking the child and may vary from mild to severe. Growing pains are not associated with other serious disease and usually resolve by late childhood.

Medical mystery . . .

What I am about to say is true for many common pains.

‘Just because we have a name for it does not mean we know what it is.’

It is the most common pains (some suggest that growing pains occur in 40 per cent of children) that are so often the greatest enigma to the medical world. This is true of growing pains. It has been hypothesised that they are due to bone growth, but they don’t necessarily only occur during growth spurts. They have been thought to be due to inflammation, but there is no inflammation associated. They are often described as neuralgic but there is no nerve dysfunction.

So doctors diagnose growing pains via a ‘diagnosis of exclusion’. This means, they examine and test for all the nasty possible causes of pain like illnesses, sporting injuries, cancers and more, and when they find nothing they say: ‘Well, your child has growing pains. Don’t worry they will pass. Good luck with your sleepless nights.’

Most parents are satisfied with the doctor’s ‘diagnosis’ which is not really a diagnosis at all. In reality the doctor has said ‘Your child has growing pains and we don’t know what that it is, but it won’t kill them.’

Great.

What are growing pains?

Now I am not smarter than your GP. In fact she knows a lot more than me. But I know more about a specific area of health and that is in the area of chronic musculoskeletal pain. Myofascial pain to be more precise. In my 20 years of treating hundreds of cases of growing pains, I cannot recollect a case that I have not resolved or improved with careful manipulation of the muscles and tendons. So as far as I am concerned, growing pains are not a mystery.

The problem with growing pains is that they are just about always ‘myofascial pain’. This is a problem because this type of pain is very poorly understood and very poorly recognised by the medical profession in general. It is no wonder they have no explanation for growing pains when it is a type of pain not widely understood by the medical profession.

Myofascial pain is a type of pain that is caused by muscle and tendon and creates a deep aching sensation, usually at rest. It can relieved by heat and movement and massage.

Well gee.

Myofascial pain is eased by movement, massage or heat and is most noticeable when you lie still. Like … at night.

Makes sense.

What is the actual cause of the pain?

Muscles all over the body have built-in mechanisms by which they can cause aching and pain. When a muscle is strained or overloaded it has the potential to protect itself and the joints it serves by developing restrictions, commonly described as knots. Once these knots are established they will stay present in the muscle 24/7 but only cause pain at certain times.

In particular they will cause pain when the muscle cools down, when the muscle is still for a long period of time or when the muscle  is placed under full stretch. In other words when Jimmy is running around the schoolyard his muscles are warm and symptom free. The knots are present but, as I said, if the muscle is warm and moving – no pain.

Why do the knots or restrictions form?

This is a theory but I have found it to be consistently true.

Muscles typically develop the knots I am describing as a built-in response to joint injury or joint instability. It is the body’s way of trying to communicate that there is a structural or joint injury or instability.

In the case of growing pains the portions of muscle affected typically are portions of muscle that overlie epiphyseal plates.

What?

The epiphyseal plate is the growth plate in a bone.

As a child grows, their bones do not grow uniformly but all the growth occurs at either end at one line in the bone. You can see in the diagram here what looks like breaks in the tibia and fibula. You are not looking at breaks but lines of cartilage where all the bone growth is occurring. When the child becomes an adult and stops growing these portions of bone will solidify and you will not see these lines very clearly at all.

My son broke his wrist twice as an adolescent and guess where the break occurred. Yep. On the growth plate.

Same wrist.

Both times.

Anyway.

What I suspect is happening is that little Jimmy is a fit young fella and getting more and more active. Running, jumping and climbing. He is loading muscles that are anchored to a bone that is growing; that is unstable and ‘moving’ underneath it. Imagine if you were that muscle. You would probably activate those knots that can cause aching pain because you are suspicious that there is a joint injury or joint instability underneath you. This is part of your job. Now you and I know that what the muscle is perceiving is an instability due to a perfectly normal growing bone, but nonetheless in a decent percentage of children the skeletal muscle develops knots and creates aching pain at rest.

Does my child need treatment?

Now there are many degrees of intensity in growing pains. Everything from mild discomfort to strong pain through long hours of the night.

First line of defence is massage and the faithful old heat pack (Check out ‘What heat is good heat?’ to learn more.) This will ease the pain, however your heat pack will only hold heat for 15 or 20 minutes. If this is enough time to get Jimmy back to sleep then great.

If the symptoms are too frequent or too intense see your Myotherapist. They will be able to assess exactly which muscles are referring the pain, and some skilful manipulation over a few treatments will not only ease the pain but actually fix it! This will give long lasting and usually permanent results.

Finally an apology to all of you reading this who, as a child, or parent, put up with numerous sleepless nights only to read here that that pain could have been fixed!

Sorry.

 

Look after those little ones,

Tim