An afternoon of physical activity is healthy for kids, but they should also know the importance of taking regular breaks to avoid aches and pains. (For Health Beat)

Your child complains of achy legs at night. The pain seems to be either a dull ache or cramping.

Should you be concerned?

“No one really knows the true cause of what is called ‘growing pains,’” said John Kemppainen, MD, section chief of pediatric orthopedics at Corewell Health Helen DeVos Children’s Hospital. “The theory is that as bones grow, they pull on the muscles attached to them. But there is no evidence that the growth of bones causes pain.”

Growing pains can be a misleading term, because the common aches and pains that children experience are not caused by growing.

Possible causes include overexertion, cramping or lack of rest.

From about preschool age to preteen, children may commonly complain of these types of pains, which usually affect the muscles in the legs.

“The vast majority are of no concern,” Dr. Kemppainen said. “As long as it doesn’t stop what kids do, stop their usual activities, there is no reason for parents to worry.”

Dr. Kemppainen recommends over-the-counter children’s pain medication for aches and soreness.

Pain or stiffness usually occurs in the evening or night and disappears by morning. It can occur equally in boys and girls.

“Children don’t always know how to express pain,” Dr. Kemppainen said. “They might say what gets the expected response from mom. But most parents know their child. They know when something really is unusual.”

If a child exhibits a loss of function, such as limping that lasts beyond a day or two or stops playing or participating in a physical activity because of pain—pain that cannot be controlled by over-the-counter medications such as acetaminophen or ibuprofen—then it may be time to see your doctor.

Some items of concern to watch for:

  • Severe pain
  • Fever
  • Swelling that persists beyond 24 hours
  • Discoloration of the painful area
  • Lump in the muscle
  • Limping that lasts more than a day or two

While there are no tests for what parents and caregivers commonly refer to as growing pains, your child’s doctor can conduct a physical exam to check your child for other possible causes.

The doctor will ask your child about their daytime activities. Have they been playing sports? Have they been running and exercising?

An abundance of physical activity during the day can lead to aches and pains during the night. Teaching your child to take breaks during physical activity can help alleviate nighttime soreness.

This kind of pain can be treated by gentle massage, a heating pad on the painful area, a warm bath, or wearing shoe inserts if needed.

Simply resting can help, too.

“If your child is still out there playing during the day, they are OK,” Dr. Kemppainen said. “Children have pain, too, but they may have a lower pain tolerance than adults. Unless it is severe, there is no need to worry.”