Growing pains may not be a "growing" concern in the medical sense, but they certainly take root in the minds of parents and school nurses alike. These common and recurring aches, which occur in up to 10% of healthy children, according to the American Academy of Pediatrics (AAP), typically affect the legs of children between the ages of 3 and 14 and can be frustrating and confusing to manage, as they often appear without warning and defy straightforward explanation.
Understanding Growing Pains
The term "growing pains" itself can be a bit misleading. Despite the name, current understanding suggests that these aches are not directly caused by the rapid bone growth that characterizes childhood and adolescence. Even during peak growth spurts, the growth rate is generally not enough to induce pain. Instead, growing pains are likely a result of a combination of factors, including the vigorous physical activity essential to healthy childhood development. While painful, growing pains are usually harmless but can result in daytime fatigue, leading to decreased physical activity and potential school absences. Most growing pains resolve on their own by the time a student reaches puberty.
Identifying Growing Pains
For most young students, growing pains manifest as muscle aches rather than joint pain. These aches are most often felt in the legs, specifically in the front of the thighs, the back of the calves, or behind the knees, and frequently affect both legs simultaneously. The timing of when students say the pain most often occurs can be a telltale sign, as growing pains commonly occur in the late afternoon or evening or may even wake a child from sleep. Students might describe the sensation as deep, crampy, or "tight."
Beyond Growing Pains
School nurses are used to hearing complaints of musculoskeletal pain, and studies show that growing pains are the most common cause. But, careful assessment is necessary, and even if a parent insists "it's just growing pains," further evaluation is necessary if the pain is persistent, localized to one leg or a specific spot, or worsens over time. Any signs of joint involvement, such as swelling, redness, warmth, or tenderness, are also cause for concern, and systemic symptoms like fever, rash, unexplained weight loss, loss of appetite, or a noticeable limp are not typical of growing pains and definitely warrant further medical evaluation.
Supportive Care for Growing Pains
Since growing pains tend to occur mostly at night, pain management interventions like OTC pain relievers and cold/hot therapy are likely unnecessary during the school day (although they can be used at the school nurse's discretion, per school and district policies). Educating parents and students about growing pains can be reassuring and beneficial. Research suggests that daily stretching can help prevent most instances of growing pains. Additionally, gentle massage can alleviate discomfort. Maintaining a healthy diet with adequate calcium and vitamin D levels can also serve as a preventive measure.
By combining vigilance with empathy, school nurses ensure that no complaint is dismissed without careful consideration while also empowering students to navigate their growing bodies with confidence. In this way, school nurses embody the heart of holistic care, proving that even the smallest aches deserve a thoughtful and compassionate response. Who knew that "growing up" could be such a pain in the... legs?
