My 3-year old daughter is always complaining of pains in her legs during the night, could these be growing pains?

During childhood, the human body goes through an amazing series of changes. When babies are born their heads, hands, and feet are proportionally much larger in relation to their bodies than at any other time in life. It's one of the things that make babies distinct and adorable. Throughout the growing up process, the human body changes proportions many, many times. Sometimes long, gangly arms and legs seem to shoot out over night! During these spurts of growth, children often complain of nighttime leg pain, hence the common label growing pains.

Most often, growing pains will feel like a sharp throbbing pain. The pain can occasionally even be strong enough to wake the child up from sleep. About 25 to -40% of children between the ages of 3 to 5 and again between the ages of 8 and 12 experience growing pains (Healthy Children, AAP, June 2010).

When children are plagued by episodes of recurrent, brief leg pain, it is a good idea for them to be checked once by a physician. If the physical examination is normal, with no redness, tenderness, swelling, or limitation of movement, and if the pain is not provoked by moving or associated with any abnormal gait, then this situation is what we often call growing pains. These pains typically occur at night with no resultant daytime disability. The actual source of the pain has never been proven, but long experience has taught us that they are benign and self-limited.

If the physical examination is not normal or the pain is associated with other symptoms, your doctor will be able to discuss in more detail other potential diagnoses such as chronic trauma, infection, restless leg syndrome, and childhood arthritis.

In children with benign growing pains, the muscles or tendons are still a little too tight for the growing long bones. Muscle spasms lasting from 1 to 15 minutes cause the pain. Many of these children are unable to touch their toes with their fingertips without bending their knees.

During a pain episode, stretching the foot and toes upward will often resolve the muscle spasm. Gentle massage and moist heat over the painful spot can also help.

In most cases the pain can be prevented with simple, daily stretching exercises. These exercises must be continued even after the pain subsides in order to keep the muscles and tendons relaxed and able to accommodate the next growth spurt.

Some physicians recommend giving a glass of tonic water before bed. I have never seen any studies evaluating this suggestion, but it might help and wouldn't hurt. Plenty of fluids should make cramping less likely.

Although these painful occurrences of growing up are nothing to be worried about, like all of life's growing pains, they can be quite bothersome when in the middle of an episode. It is precisely the reshaping of ourselves that causes physical and emotional growing pains -- in both situations, the pain results in our becoming more mature people.