Duration

The symptoms usually occur in children between five and ten years of age. A pain attack usually lasts about ten to fifteen minutes, but can sometimes last an hour. The pain usually occurs in the evening or at night.

The following morning the children have no more complaints. The pain attacks usually occur over a period of two weeks. After half a year there is often another period of pain. Some children experience periods of growth pain two to three times a year. After growth is complete, growth pain definitely does not occur again.

Causes

The cause of the growth pain is still unclear. Some theories suggest that it could be a problem in pain processing, resulting in a lowered pain threshold. This lowered pain threshold could therefore cause pain even under light load.

Another theory says that the pain is caused by the stretching of tendons and ligaments, which do not have enough time to grow during growth spurts. The bones would grow by about 0.2 mm per day, which would cause constant stretching pain due to tendons and ligaments on the periosteum. Since the growth of children can be roughly divided into three growth phases, children grow particularly fast in these phases, after which the pain can be particularly intense at certain stages.

The legs grow especially in large spurts, after which pain in the legs occurs most frequently. Since the pain is concentrated at night and in the evening, it is assumed that growth hormones are released during these periods, which leads to accelerated growth. In addition, bad posture, over-mobility, excessive stress on the joints, and a lack of blood circulation can also play a role.

Growth pain in different localizations

If knee pain occurs due to growth, it usually occurs at night, so the children may be awakened by the pain. The pain occurs mainly at the front of the knee. Sometimes the pain radiates into the upper or lower leg.

Growth pains are particularly common in children who are active in sports. However, the pain never occurs during physical exertion, but always at rest.Accompanying complaints such as redness or swelling are completely absent in growth pains. If the pain persists over a longer period of time, possible alternative causes should be clarified by a doctor.

Among these alternatives rank with the knee the Sindling Larsen Johannsson illness or disease Osgood Schlatter. Sindling-Larsen-Johansson’s disease is a knee-cap disease that usually occurs in boys between the ages of ten and sixteen. Due to circulatory problems, pain occurs in the lower part of the patella.

Osgood-Schlatter’s disease is also a disease of the patella, which also manifests itself primarily in boys between the ages of ten and sixteen. The disease causes irritation of the patellar tendon. Another differential diagnosis, which is often misinterpreted at the beginning as growth pain, is osteochondrosis dissecans.

In osteochondrosis dissecans, which occurs mainly in the knee, small bone fragments die off. These bone fragments become detached from the rest of the bone and can then cause pain and entrapment in the joint. These joint fragments are also called joint mice.

In contrast to growth pain, swelling of the knee and suddenly occurring joint blockages are common. As with the other diseases, young patients are also affected. It is suspected that the growth pain is caused by uneven growth.

Sometimes the bones, sometimes the ligaments and sometimes the muscles grow fastest. As a result, the load axis in the joints changes again and again, and the most heavily stressed structures have to get used to their new load during the growth spurt. In principle, growth pains can occur anywhere in the body, but the legs and hips are most frequently affected.

Perthes disease Excluding growth pain from Perthes disease. It is a hip disease in children and adolescents. For reasons that are not yet known exactly – circulatory disorders and an imbalance of hormones are suspected – the bone at the femoral head dies.

This can result in serious consequential damage. Therefore hip pain in adolescents should not be dismissed as growth pain alone. Rather, serious diseases such as Perthes disease should be ruled out with a simple X-ray or MRI.

As with many other hip diseases, Perthes disease can first manifest itself as knee or back pain. These different structures form a functional unit, i.e. they are together in action with every movement. Problems can therefore spread from one joint to the other areas.

You can find additional information at: Morbus PerthesGrowth pain in children can also manifest itself in the form of abdominal pain – or cramps. Similar to the bony skeleton, the internal organs also undergo a longer growth process. Children often complain of pressing, pulling abdominal pains that occur from time to time at intervals of several weeks and then cease completely.

These complaints can occur as the organs grow. In the form of growth spurts, tensions and cramps in the upper and lower abdomen often occur, which cannot be localized to a single spot, but rather migrate. In the area of the thorax, complaints often arise during the growth phase in the form of reduced mobility or breathing, as well as muscular tension.

As the bony thorax increases in size and stability over the years, the muscular constitution must also be further developed. Most adolescents describe growth pain in the thoracic region in the form of stabbing and pulling under the costal arch, accompanied by a restriction in mobility when breathing. During growth, the nerves in the spaces between the ribs often become trapped.

This causes mainly movement- and breathing-dependent pain and is in most cases perceived as very unpleasant. Back pain can have various causes. One is a simple and harmless growth pain, which is caused by the uneven growth of bones, ligaments and muscles along the spine.

More common, however, is back pain due to poor posture, caused for example by growth pain in the legs. If back pain occurs in children and adolescents under 18 years of age, a detailed clarification of the symptoms should always be carried out. With the help of a physical examination of the back as well as X-rays and MRI, serious diseases can be ruled out.Also recommended: Urachen from back pain Scheuermann’s disease Scheuermann’s disease is a disease of the spine.

The spine consists of many individual vertebrae that grow together with the body during the first 16 to 20 years of life. In addition, the vertebral bones initially consist partly of cartilage and partly of bone. In Scheuermann’s disease, the cartilaginous parts of the vertebral bodies are so weakened that in the course of growth (usually during puberty), strong and painful malpositions in the back occur.

Scheuermann’s disease is usually diagnosed by X-ray. Therapy consists of physiotherapy and sports as well as the provision of a back orthosis. In rare cases surgery is necessary.

Scheuermann’s disease
Late effects of Scheuermann’s disease

During puberty, hormonal changes trigger major growth spurts. This not only affects the arms, legs, shoulders and back. Especially between the ages of twelve and fifteen years penis and testicles grow most strongly.

Often the two halves of the testicles do not grow evenly, so that one side of the testicles is larger and heavier than the other. This can lead to growth pain in the testicles. Children in the growth phases between the ages of 4 and 16 are particularly affected.

Growth pain in the foot occurs mainly in the evening or at night and during physical rest. After extensive exercise during the day, the ankle joint or sometimes the individual toe joints often hurt. Often the pain also changes and is not always located at the same place on the foot.

The children complain of a feeling of pressure and cannot step on the foot properly. During the day, those affected are usually free of complaints. The pain is usually caused by an overload of the not yet fully developed muscle and ligament apparatus of the foot.

Köhler’s disease I Köhler’s disease I is a disease of the foot. Due to small vascular occlusions, the bone tissue of the scaphoid bone, a bone of the tarsal, dies off. Similar to growth pains in the foot, the symptoms initially occur very unspecifically and are not necessarily dependent on stress.

Therefore, the actual problem, i.e. the dying off of the bone, is often only noticed when consequential damage such as arthrosis has already started to affect the tarsal bones. The typical age for Morbus Köhler I is between three and eight years. Mostly boys are affected.

Köhler’s disease II Just like Köhler’s disease I, type II causes tissue loss (necrosis) to bones in the foot. In Köhler II disease, however, the metatarsal bones are affected. This is also caused by tiny occlusions in vessels, which result in the bones not being adequately supplied with blood and nutrients.

In type II, too, the symptoms, such as pain, are initially unspecific and only become really noticeable when the disease has already progressed. In contrast to type I, young girls are particularly affected by Köhler’s disease II. Growth pain in the heel area occurs very frequently.

In most cases they are not noticed until the evening when the body is at rest and can be very intense. Heel pain caused by growth processes never occurs during acute stress, but always as a result of it in phases of recovery. Many children refuse to walk completely because they can no longer walk without feeling a sharp pain.

In most cases, an inflammatory change in the growth joint at the heel (apophysitis calcanei, see below) is responsible. Apophysitis calcanei is a disorder in the ossification of the growth joint of the heel bone. Usually, the growth plate closes at the age of 12 – 13 years.

The pull of the Achilles tendon on the calcaneus plays a special role in the development of pain. The tendon and ligament apparatus is significantly more sensitive and unstable in adolescents than in adults. In the case of overloading due to increased physical activity or overweight, a great deal of strain is placed on the growth plate. Children complain of swelling at rest accompanied by pressure pain in the upper part of the Achilles tendon insertion. You can find additional information under: Apophysitis calcanei