It is half past ten, the bedroom light went out long ago – and then your child calls for you. Their legs hurt, somewhere between knee and calf, and they cannot point to the exact spot. You sit on the edge of the bed, stroke their leg, talk quietly, and eventually they fall asleep again. In the morning the same child heads off to school as if nothing had happened. Many families know this pattern from the preschool and early school years, and most of the time the explanation is the same: so-called growing pains. Growing pains in a child are harmless, but they cost you hours of sleep and leave you wondering whether something more is going on. Below you will find the typical picture, the signs that belong in the paediatrician's office, and what actually helps during a painful night.
The short answer: typical growing pains are aching or cramping pains on both sides, in the calves, thighs or behind the knees. They turn up late in the evening or at night and are gone by morning. During the day your child walks normally, has no fever and no swelling. What helps is unspectacular: warmth, a gentle massage, raised legs, quiet and your presence. Anything one-sided, or paired with swelling, redness, fever or limping, should be seen promptly by your paediatrician.
- Typical: both legs, late evening or at night, gone by morning – during the day your child is free of symptoms and walks normally.
- Common roughly between three and ten years of age. The name is misleading: a link with actual growth in height has not been demonstrated.
- Get it checked promptly: pain on one side only, swelling, redness, local warmth, fever, limping, guarding the leg during the day, night waking over weeks, weight loss.
- At home: warmth, gentle massage, raised legs, enough to drink and no intense sport right before bedtime.
- Pain relief only after speaking to your paediatrician – never from the medicine cabinet on your own initiative.
Growing pains in a child: the typical picture
The pattern is remarkably similar from child to child. The pain sits in the calves, the thighs or behind the knees, less often in the feet. It aches, pulls or cramps, and it cannot be pinpointed: ask “where exactly?” and a small hand sweeps over half the leg. Both legs are usually involved – either at the same time or alternating from one night to the next.
Timing is the second clue. The pain shows up late in the evening, often between bedtime and midnight, or it wakes the child one to two hours after falling asleep. An episode usually lasts 15 to 30 minutes, sometimes an hour. By the next morning nothing is left of it: your child gets up, pulls on their socks and heads off to playgroup or school.
The course is just as characteristic. There are phases with two or three painful nights a week, followed by weeks of calm. Bad nights often come after particularly active days – a forest day at nursery, the first football practice, three hours on a scooter. The age window runs roughly from three to ten years, with a peak around starting kindergarten and school. If your child wakes up often at night in general, it is worth separating painful nights from other reasons for waking – it makes the conversation at the practice much easier.
Why the name “growing pains” is misleading
The term dates back to the 19th century and has stuck because it sounds so plausible: the child is growing, growth pulls, so it hurts. The trouble is that the picture does not match the observations. Growth in height is fastest in the first year of life and later in puberty – precisely the phases in which these night-time leg pains barely feature. Conversely, it is four- to eight-year-olds who complain, even though they are growing fairly steadily.
The specialist literature therefore assumes that a direct link with actual growth in height has not been demonstrated. Other explanations are discussed: muscular overload after active days, a lower pain threshold in the evening, a tendency that runs in families, and overlaps with other harmless pain patterns such as tummy ache with no findings. Research points in these directions, but none of the hypotheses is proven. That is worth knowing when somebody promises you a simple cause – some specialists prefer to speak of benign night-time leg pains.
For your everyday life this changes little – but it takes the pressure off. You do not have to wait until “the growing is finished”. You can do something tonight that makes the episode shorter and more bearable, without calculating any growth window.
When it is not growing pains: drawing the line
Growing pains are a diagnosis of exclusion. In other words: they are likely when everything else looks normal – and they are the wrong explanation as soon as one detail does not fit. The table below helps you sort things calmly, both at night and the next day. It does not replace an examination, but it shows when a call to the paediatric practice is due.
| What you observe | Points to growing pains | Needs a prompt paediatric appointment |
|---|---|---|
| Side | Both legs, or alternating from night to night | Always the same leg, pain on one side only |
| Location | Calves, thighs, behind the knees, diffuse over half the leg | One joint, pinpointed with a finger, bone tender to pressure |
| Timing | Late evening or night, gone by morning | Also during the day, worst in the morning, every night for weeks |
| How the leg looks | Unremarkable, both sides equally warm | Swelling, redness, local warmth, unexplained bruising |
| Movement during the day | Walks, runs and climbs normally | Limping, guarding the leg, refusing to put weight on it |
| General condition | Lively, eating normally, no fever | Fever, unusual tiredness, night sweats, weight loss |
| Course | Phases of a few weeks, then breaks | Steady worsening with no breaks, night waking over weeks |
If one of the descriptions on the right fits your child, do not wait several more nights – book an appointment promptly. With fever alongside leg pain, with a child who suddenly refuses to put weight on a leg, or with a swollen, warm joint on one side, call the same day. It helps to bring a short note: date, which leg, time, duration, whether there was a fever. Two weeks of notes say more at the practice than any memory from three in the morning.
Myths fact-checked
“Growth itself hurts.” There is no evidence for this. Bones grow at the growth plates, and that process does not come with pain. The name describes an observation – growing children complain about their legs – not a demonstrated cause.
“Children with growing pains end up especially tall.” No link is known between these complaints and later adult height. Painful nights tell you nothing about how tall your child will be.
“The child is exaggerating to stay up longer.” The pain is real, even when the leg looks perfectly normal. Children who want attention in the evening go about it differently: they ask for water, for a story, for the door left ajar. A child who cries, pulls their legs up and is hard to comfort is in pain.
“Magnesium or calcium help.” There is no convincing evidence for supplements against growing pains. In children, supplements belong in everyday life only after talking to the paediatrician anyway.
“It is the mattress.” An unsuitable sleeping surface does not cause growing pains. It can, however, affect how well your child settles again after an episode – much as with a child who sleeps restlessly in general.
What you can do step by step during a painful night
The clearer the sequence, the shorter the night. This order works even when you are half asleep.
- Stay calm and keep the light low. A small bedside lamp or a night light is enough. The ceiling light will wake your child more than you need right now.
- Take a quick look and feel. Both legs? Does the skin look normal, is it as warm as on the other side? Is a joint swollen? Does their forehead feel hot? Thirty seconds are enough to rule out the important things.
- Apply warmth. A hot water bottle in a fabric cover for 10 to 15 minutes on the calf or thigh – never directly on the skin, and never left in the bed once your child falls asleep again.
- Massage gently. Five to ten minutes with a flat hand from ankle to knee and from knee to hip, with a little body lotion. Keep the pressure light enough that your child describes it as pleasant.
- Raise the legs. A flat pillow or a rolled-up towel under the lower legs.
- Offer a drink. A few sips of water, especially after a hot day or a lot of activity.
- Be close and negotiate nothing. A hand on the leg, a quiet voice, no discussion about falling asleep again. Most children are off again after 20 to 30 minutes.
- Write two lines in the morning. Date, leg, duration, anything unusual the day before. After two weeks you will see a pattern – and you will have something concrete if a check-up does become necessary.
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Pain relief, sport and the evening before
Painkillers are not the standard answer to growing pains. Do not give your child any medicine on your own initiative, not even the drops left in the cupboard from the last fever. Whether something makes sense, and at what dose, is for your paediatrician to decide – based on weight and on the situation. Sleeping medication and melatonin have no place here at all.
With sport it is about measure, not prohibition. Movement matters for children and belongs in every day. What does help: no intense exertion right before bedtime. Leave around 90 minutes between the end of training and bed, with supper, a shower and the bedtime routine in between. After a very active day – the pool, a hike, a tournament – you can build a short round of warmth and massage into the evening routine as a precaution, rather than waiting for the first complaint.
The bedroom is part of the evening too. A room temperature of around 18 °C, a darkened room and a consistent sequence make settling easier again; the details are in our article on the room temperature in a child's bedroom. For school children it is also worth looking at how much sleep six- to ten-year-olds need: a chronically late bedtime makes every painful night harder.
Warmth, massage and closeness: what really helps at home
Warmth is the most effective tool you have without a prescription. A hot water bottle in a knitted cover or a cherry stone cushion relaxes the muscles and shifts the attention. Three things matter: do not fill it with boiling water, always keep a cover between bottle and skin, and take it away after 10 to 15 minutes. A hot water bottle does not belong in the bed of a sleeping child.
A warm bath in the evening works in a similar way but takes more time. Ten minutes at a comfortable water temperature, then straight into pyjamas and into bed – that way it becomes a ritual rather than a wake-up call. The gentle massage is the second building block: calm, broad strokes feel better than pressing on single spots, and many children like being allowed to say where and how firmly.
The third building block is underrated: your own calm. Children read from you how threatening the situation is. A sentence such as “I know this, it will pass, I am staying here” does more than any explanation. If your child usually startles awake with a night terror instead, you will notice the difference quickly: with growing pains your child is awake, responsive and can be comforted.
Frequently asked questions about growing pains in children
At what age do growing pains start in children?
Most often in the preschool and early school years, roughly between three and ten years of age, with a peak around starting kindergarten and school. A few older children report them too. In a toddler under two who cries because of leg pain, the cause should always be investigated by a paediatrician.
How long does a painful night last?
An episode usually lasts 15 to 30 minutes, sometimes up to an hour. The child then sleeps on and is free of symptoms in the morning. Phases with two or three painful nights a week can last a few weeks and then disappear on their own.
Can I give my child a painkiller for growing pains?
Only after speaking to your paediatrician. In children the dose depends on body weight, and leftovers from the last cold are not a good basis for it. Warmth, massage and your presence are the first step, not the tablet.
Do magnesium or calcium help against growing pains?
Convincing evidence is lacking. In children, supplements should only be used after speaking to a paediatrician. A balanced diet and enough to drink across the day are more useful than preparations taken on a hunch.
When should we see a paediatrician about night-time leg pain?
When the pain always affects the same leg, when a joint is swollen, red or warm, and with fever, limping, guarding the leg during the day, night waking over weeks or weight loss. These signs argue against harmless growing pains and should be checked promptly.
Can growing pains affect the arms as well?
The legs are affected far more often, above all the calves, thighs and the area behind the knees. Some children report arm pain in addition. If arm pain occurs on its own, on one side only or together with swelling, it is better to have it checked.
This article is for general information only and does not replace paediatric advice. If symptoms persist, please contact your paediatrician.
