“Growing pains” is a term parents use to describe aches and throbs children experience, particularly in their legs. These pains are common in childhood and often cause concern when they affect mobility or sleep. While the name suggests a link to physical growth, true growing pains are a benign, temporary condition of unknown cause, unrelated to growth spurts. Understanding the characteristics of this phenomenon helps determine if hip discomfort fits this diagnosis.
Defining Growing Pains and Typical Locations
Growing pains are defined as a recurrent, non-inflammatory pain syndrome affecting children typically between the ages of 3 and 12 years. The discomfort usually strikes in the late afternoon or evening, sometimes waking a child from sleep. A distinguishing feature is their intermittent nature; they do not happen daily, and the child is pain-free and active during the day.
The pain is confined to the muscles of the lower extremities, specifically the front of the thighs, the calves, and the shins or behind the knees. This muscular discomfort often affects both legs simultaneously (bilateral presentation). Unlike joint pain, growing pains are often relieved by simple measures like massage, stretching, or heat application. Diagnosis is one of exclusion, confirmed only after ruling out other causes of pain.
Why Hip Pain Is Usually Not Growing Pains
Growing pains do not typically occur in joints like the hip. The hip is a major ball-and-socket joint, and pain localized directly within the joint capsule is highly unlikely to be growing pains. True growing pains are musculoskeletal (myofascial), affecting muscles and fascia rather than joint structures.
Pain consistently felt in the hip joint, or pain causing a noticeable limp or difficulty bearing weight, does not fit the pattern of growing pains. Growing pains lack physical signs such as swelling, warmth, or tenderness over the painful area. If the pain interferes with normal daily activities or persists into the morning, it suggests a cause other than simple growing pains.
Alternative Causes of Hip Pain in Children and Adolescents
Since the hip is a complex joint, pain in this area often indicates conditions unique to the developing skeleton.
Transient Synovitis
This is a common benign cause of hip pain in children aged 3 to 8, sometimes called “irritable hip.” It involves temporary inflammation of the hip joint lining, often following a viral illness, and usually resolves within a week or two.
Legg-Calvé-Perthes Disease
In younger school-age children (ages 4 to 8), this condition involves a temporary interruption of the blood supply to the ball of the hip joint. This causes the bone to break down and reform, leading to a limp. Pain may be felt in the knee or thigh rather than the hip itself (referred pain).
Slipped Capital Femoral Epiphysis (SCFE)
For adolescents, especially those who are overweight, SCFE is a serious condition. The growth plate at the top of the thigh bone weakens, causing the ball of the joint to slip off the neck of the bone.
Other potential causes include muscle strains from physical activity or severe conditions like septic arthritis, a bacterial infection within the joint. Recognizing age-specific presentations is important, as the differential diagnosis shifts between early childhood and adolescence.
When to Seek Medical Evaluation
Any hip pain deviating from the classic, benign characteristics of growing pains warrants a medical evaluation to rule out more serious issues. Specific “red flags” indicate the need for prompt medical attention.
These signs include:
- Pain localized to one side of the body (unilateral), which is atypical for growing pains.
- Pain accompanied by a fever, joint swelling, visible redness, or localized tenderness.
- Inability to bear weight, a persistent limp, or pain present in the morning.
- Severe, persistent pain or pain associated with systemic symptoms like a rash, unexplained weight loss, or fatigue.
The physician will conduct a physical exam and may order diagnostic tests, such as X-rays or blood work, to distinguish a simple muscle ache from a potentially serious bone or joint condition.