Episodes of generalized pain in the lower limbs, referred to as ‘growing pains’ or nocturnal idiopathic pain, are common in preschool and school-aged children.
The pain often wakes the child from sleep and settles with massage or comforting.
The condition is poorly understood. Features to be fulfilled for this diagnosis are often referred to as the ‘Rules of Growing Pains’, which are:
- Age: range 3–12 years
- Pains symmetrical in lower limbs and not limited to joints.
- Pain often follows a day with exercise or other physical activities.
- pains never present at the start of the day after waking up
- physical activities not limited; no limp
- Physical examination normal (including pGALS), with the exception of joint hypermobility in some, and otherwise well.
If the presentation ‘does not fit the rules’, further assessment is necessary.
- Should also focus on reassurance, education, and healthy sleep hygiene.
- Massage during the episode is very effective
- NSAIDS may be useful for frequent episodes.
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