Many of us remember waking up suddenly as children with leg pain—sometimes specifically around the hip joint—just before starting school. Our mothers would rush to our beds, comfort us, hug us, and gently reassure us that the pain meant we were growing. Often, she would happily share the news with the father the next morning, relieved that there was nothing to worry about.
However, a child’s complaint of leg pain or joint pain is not always a sign of normal growth pains. For this reason, NadorMagazine spoke exclusively with Dr. Mohammed Abed, Consultant Pediatric Orthopedic Surgeon, who explained an important question many mothers face: When does leg pain indicate a medical condition rather than natural growth pain? He clarified the differences between normal and abnormal joint pain in children as follows.
What Are Normal Growth Pains in Children?
Growth-related pain in bones and muscles is common and affects approximately 25–40% of children worldwide. These pains may cause children to wake up crying at night or stop playing due to discomfort.
Growth pains usually appear during two main age periods:
Between 3–5 years old
Between 8–12 years old
Although these pains are considered normal, there is no strong scientific evidence proving that bone growth itself causes pain. The more realistic explanation is muscle fatigue and strain caused by running, jumping, and physical activity during the day.
Symptoms of Normal Growth-Related Joint and Bone Pain
Growth pain is typically felt in the muscles rather than the joints. Parents should learn to distinguish between joint inflammation and normal growth pain.
Pain usually occurs in the front of the thighs, calf muscles, or behind the knees
Pain intensifies in the late afternoon or evening
It may sometimes wake the child from sleep
Pain severity varies from child to child
It is not usually present every day
During a medical examination, a doctor typically finds:
No pain when moving the child’s legs
Pain relief when the legs are gently massaged or pressed
In contrast, if the pain is caused by joint inflammation, the pain worsens during examination, and the child may cry when the doctor moves or touches the legs.
Tips to Reduce Growth Pain in Children
Gently massage the painful area using soothing oil or cream
Apply warm compresses indirectly (use a cloth to avoid direct heat)
Give child-safe pain relievers only as prescribed by a doctor
Never give aspirin to children under 12 years of age
When Is Joint Pain in Children Concerning?
Parents should be concerned if:
The pain is continuous and does not come and go
Pain occurs mainly in the morning
The child has difficulty getting out of bed or preparing for school
Signs of concerning joint inflammation include:
Redness or swelling around the joint
Increased warmth in the affected area
Fever
Muscle weakness in the leg
Difficulty walking or abnormal gait
If joint pain is accompanied by skin rash, loss of appetite, or persists for several days, the child should be seen by a doctor immediately. Some joint pain may signal autoimmune diseases such as juvenile rheumatoid arthritis or infections affecting the bones, which require prompt treatment to avoid serious complications.
The Link Between Leg Pain and Recovery from Influenza
Some children experience leg pain after recovering from influenza, especially around age four. This often occurs after taking antibiotics or fever-reducing medications without medical supervision.
Symptoms may include:
Pain in the calf muscles
Limping or inability to walk
Walking on tiptoes after recovery
This condition is often caused by viral muscle inflammation associated with Influenza A or B or other seasonal viruses. Treatment typically includes:
Child-appropriate pain relievers and anti-inflammatory medication under medical supervision
Rest and bed confinement
Plenty of warm fluids
Improvement usually occurs within three days.
Important Conditions to Differentiate
Parents must distinguish between post-influenza muscle pain and more serious conditions such as:
Guillain-Barré Syndrome
Begins with leg muscle pain
Progresses into ascending paralysis
May affect breathing muscles
Can be life-threatening if not treated promptly
Rhabdomyolysis (Muscle Breakdown)
Severe muscle pain
Dark-colored urine
Risk of acute kidney failure
Both conditions require immediate medical attention.
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