Are They Just “Growing Pains”? When to Bring Your Child to a Chiropractor

Growing pains are not really a diagnosis. It is a description parents reach for when a child’s legs hurt at night and nothing obvious explains it, and most of the time that instinct is sound. The difficulty is that several other conditions sit comfortably behind those two words, and a few of them need attention sooner rather than later.

It is also worth saying at the outset that growing pains have little to do with growing. Children grow fastest during infancy and again through adolescence, whereas these aches usually turn up between three and twelve. Bone lengthening is not itself painful. The name stuck because it was reassuring, not because it was accurate.

What follows is the pattern that suggests nothing is wrong, the findings that justify a call to your pediatrician, and where a chiropractor may reasonably fit in.

What Is Probably Causing the Pain

No single explanation has been established. Muscle fatigue is the most widely accepted theory and fits what I tend to see in practice. A child who has spent the day running, climbing, and stopping abruptly has asked a great deal of muscles that are still developing coordination, and those muscles often complain once everything else quietens down at night.

Lower pain thresholds in some children may play a part. So may small variations in how a child stands and loads their feet. None of this is well settled, and any practitioner who tells you they know precisely why your daughter’s calves ache is overstating the case.

The Pattern That Suggests Nothing Is Wrong

Typical growing pains have a recognizable shape, and when parents describe all of the following, I am considerably less concerned:

• Both legs are affected, usually the calves, shins, or the area behind the knees.
• The pain occurs in the evening or at night and seldom during the day.
• It has resolved by morning, and the child does not mention it at breakfast.
• There is no limp, and running and climbing look normal the following day.
• Nothing is visible or palpable. No swelling, redness, warmth, or tenderness

That last point holds more significance than parents expect. Growing pains are a deep, diffuse pain in the muscle. A child who pulls away when you press a specific spot is describing something else.

Findings That Warrant Medical Assessment

Each of the following points away from growing pains, and several require a pediatrician rather than a chiropractor.

Pain confined to one leg, particularly the same one repeatedly. Growing pains move around and affect both sides. Pain that returns consistently to one knee, hip, or shin suggests something localized.

A limp, or reluctance to bear weight. Children generally want to keep playing. When one stops, that is worth taking seriously.

Swelling, redness or warmth over a joint. Any of these alongside pain may indicate septic arthritis or an inflammatory condition, and both need same-day assessment.

Fever, weight loss, unusual bruising or persistent fatigue. Leg pain in a child who is otherwise unwell is a different clinical picture. Juvenile idiopathic arthritis, infection and, rarely, malignancy can present this way. These are uncommon, but they are the reason the question gets asked.

Stiffness that is worst on waking. Growing pains have gone by morning. Pain and stiffness that peak first thing point more towards inflammation.

If any of these apply, please contact your pediatrician before booking with us. I would considerably rather your child was assessed properly than seen by myself first.

Mechanical Causes That Get Missed

Once serious pathology has been excluded, there is a substantial group of children whose leg pain has a straightforward mechanical explanation.

Two conditions in particular are frequently mistaken for growing pains. Sever’s disease, an irritation of the growth plate at the heel, is common in active children between roughly eight and fourteen and produces heel pain that worsens with running. Osgood-Schlatter disease affects the growth plate below the kneecap and typically appears in adolescents during a growth spurt. Both are self-limiting, both respond to load management, and neither is really a “disease” despite the name. They fall under the same sports injury care we provide for older athletes, adjusted for a growing skeleton.

Beyond those two, the findings tend to be less dramatic. A pelvis sitting slightly rotated will load one side harder with every step a child takes. Feet that roll inward change the alignment all the way up through the knee and hip. Sometimes one hip simply does not move through its full range. Imaging shows nothing, because there is no damage to see.

What parents describe is a child who aches after a busy day and cannot settle at bedtime. They also mention tripping, usually with some embarrassment, as though it were a personality trait. Shoe wear is worth checking too. One edge going first is a reasonable clue that weight is not being distributed evenly.

A pediatric assessment is largely observational. I watch a child walk, squat and turn, then check pelvic symmetry, hip and knee range of motion, and how the foot loads. It is quite common for leg pain to originate at the pelvis or the foot rather than the leg itself. Our page on chiropractic care for children in St. Paul describes the process in more detail.

Infants and Toddlers

Babies come in for something quite different. Usually a parent has noticed that their newborn will only turn her head one way, or that feeding goes fine on the left and badly on the right. Persistent arching is the other common reason. Birth is a mechanically demanding event, and some infants come through it with less movement available in the neck and upper back than they should have. The principle is the same one behind restricted neck movement in adults, though almost nothing about the handling is comparable.

The techniques used bear no resemblance to adult treatment. There is no twisting and no rapid thrust. It amounts to sustained, light fingertip contact, and most infants sleep through it.

The research base for infant care is limited, and I want to be frank about that. Reported adverse events are rare, though the studies are small. Where feeding and unsettled behavior are the main concern, our page on gentle infant care and colic covers what is and is not reasonable to expect.

The Question Most Parents Want to Ask

Whether it is safe.

Please ask it directly. The force used with a child is a fraction of that used with an adult and is scaled to their size and tissue flexibility. A five-year-old’s spine is considerably more mobile than yours, so far less input is required to restore movement. Aggressive cervical manipulation is not part of pediatric care in this office.

A first visit should involve a full history covering birth, milestones, and any falls, a physical examination, and a conversation with you about the findings before anything is treated. Where a child needs a pediatrician or an orthopedic opinion instead, that is what you should be told.

How We Approach Pediatric Visits

Most of a first appointment is spent talking to you rather than examining your child. Birth, milestones, any falls, what sport they play, how they sleep, and above all what you have been noticing at home. Parents pick up on patterns that no single examination is going to reveal, and that history usually points us in the right direction before anyone has been touched.

After that, I watch your child move. Walking across the room, squatting down, turning to look behind them. A surprising amount is visible in those few minutes.

Where gentle, scaled treatment is indicated, we go ahead and explain what we are doing as we go. Plenty of children do not need it, and you should be told that plainly when it applies. Where care is warranted, it should be a short course, generally a handful of visits before we reassess. Children respond more quickly than adults do. If anyone proposes an open-ended schedule for a child who is otherwise healthy, ask them why.

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Frequently Asked Questions

1. How young can a child be seen?

There is no lower age limit, and infants are seen in their first weeks, most often for a head-turning preference or one-sided feeding difficulty. What changes with age is the amount of force involved, which for a newborn means light fingertip pressure and nothing more.

2. Can growing pains ever indicate something serious?

The classic presentation, meaning both legs, evening only, gone by morning, no limp and nothing to see, is not concerning. Pain localized to one spot, morning stiffness, a limp, visible swelling, or leg pain occurring alongside fever, bruising, or weight loss should be assessed by a pediatrician. Serious causes are uncommon. They are also the reason the pattern is worth knowing.

3. My daughter plays one sport year-round. Does that matter?

Single-sport specialization during the growing years is the situation I watch most closely, since repetitive one-sided loading tends to produce asymmetries that persist. It is also associated with a higher rate of overuse injury generally. That does not mean weekly appointments. A periodic check across a season falls closer to preventive care than to treatment, and every few months is usually sufficient.

4. How many visits will my child need?

Usually fewer than an adult with a comparable complaint, because children tend to respond quickly. A few visits across several weeks is typical, and at that point we review and often finish. The exception is children in demanding sport, where an occasional review through the season can be worth doing.

5. Should I tell my pediatrician?

Yes, please do. I am happy to send notes across, and there are plenty of presentations where I will ask you to see them before I do anything at all. Any practitioner who discourages you from involving your child’s doctor is not one to leave your child with.