The question of whether hip discomfort can be dismissed as “growing pains” is common among parents and caregivers. The term “growing pains” is frequently used to describe any unexplained childhood ache, but it is a specific medical concept. While the general experience of aches and pains is a normal part of development, pain felt specifically in the hip region is structurally different from what professionals recognize as true growing pains and warrants closer attention. Understanding the characteristics of true growing pains helps to properly differentiate them from other, potentially more serious, causes of hip discomfort.
The True Nature and Management of Growing Pains
True growing pains are medically termed Benign Nocturnal Limb Pains of Childhood, reflecting their non-serious nature and characteristic timing. These pains typically affect children between the ages of three and twelve and are not actually caused by bone growth, despite the common name. The discomfort is generally described as an ache or throbbing sensation that occurs deep in the muscles of the lower extremities.
The pain is characteristically felt in the soft tissues of the legs, most commonly in the front of the thighs, the calves, or behind the knees. A defining feature is that the pain is often bilateral, meaning it affects both legs, and is intermittent, not occurring every day. The symptoms almost exclusively appear in the late afternoon, evening, or at night, sometimes waking a child from sleep.
A crucial diagnostic sign is that the pain is completely gone by the morning, and the child is able to participate in all normal activities without a limp or noticeable discomfort during the day. The cause remains unknown, though it is often linked to muscle fatigue or overuse following a day of high physical activity.
Management for these benign pains focuses on simple comfort measures applied when the pain strikes. Gentle massage or stretching of the affected muscles can often provide immediate relief. Applying a heating pad or a warm compress to the area can also help the muscles relax.
If comfort measures are insufficient, over-the-counter pain relievers, such as ibuprofen or acetaminophen, may be administered. The pain is self-resolving and does not require rest or cessation of normal physical activity.
The Structural Difference of Hip Pain
True growing pains, by definition, do not occur in the hip joint itself. A fundamental distinction in pediatric musculoskeletal health is whether the pain originates from an articular (joint-related) or non-articular (muscle/soft tissue) structure. Benign Nocturnal Limb Pains of Childhood are classified as non-articular, affecting the muscles rather than the joints.
The hip is a major ball-and-socket joint, and pain localized to this area often indicates a problem within the joint capsule, involving the bone, growth plates, or surrounding cartilage. Any pain centered on a joint, particularly one as weight-bearing as the hip, requires a thorough medical evaluation. This is because pain originating from a joint is far more likely to represent a structural or inflammatory issue than the benign muscle aches of growing pains.
Common Alternative Explanations for Hip Pain
Since true growing pains do not originate in the hip, any persistent or significant hip discomfort in a child or adolescent should be investigated to rule out specific conditions. Many alternative causes of hip pain are related to the unique anatomy of the growing skeleton, including the presence of growth plates. The relative likelihood of a specific diagnosis varies significantly with the child’s age.
Transient Synovitis
One of the most common causes of hip pain in younger children, typically between the ages of three and eight, is transient synovitis, also known as irritable hip. This is a temporary inflammation of the lining of the hip joint, often occurring after a viral infection like a cold. Symptoms usually involve a sudden limp and hip, thigh, or knee pain, which can be constant throughout the day, unlike growing pains.
Muscle Strains and Apophysitis
In highly active children and adolescents, muscle strains and apophysitis are frequent causes of hip pain. Apophysitis is an inflammation where a muscle or tendon attaches to a growth center on the bone. This occurs because the bone often grows faster than the surrounding soft tissues, causing the muscles to pull excessively on these attachment points.
Legg-Calvé-Perthes Disease (LCPD)
Two more serious structural conditions that must be considered are LCPD and Slipped Capital Femoral Epiphysis (SCFE). LCPD typically affects children between the ages of four and ten. It occurs when the blood supply to the top of the thigh bone (femoral head) is temporarily disrupted, causing the bone to break down. This results in a limp and chronic hip or knee pain.
Slipped Capital Femoral Epiphysis (SCFE)
SCFE is generally seen in early adolescence, often in children between ten and sixteen years old, and is more common in those who are overweight. This condition involves the growth plate slipping, causing the top of the femur to displace from the neck of the bone. SCFE is a serious condition that usually presents with a limp and pain in the groin, thigh, or knee, and requires immediate medical attention and often surgery.
Warning Signs That Require Medical Attention
If a child is experiencing hip pain, certain “red flag” symptoms indicate the pain is unlikely to be benign and requires urgent medical consultation to rule out a serious underlying condition. Pain that is localized only to one side of the body, rather than both, is a key differentiator from true growing pains.
Any inability to bear weight, a new or persistent limp, or refusal to walk are all signs that the hip joint or bone structure may be compromised. Pain that is present in the morning or that persists throughout the day, not just at night, is a significant warning sign. Other systemic symptoms, such as an unexplained fever, joint swelling, redness over the hip, or general malaise and weight loss, also necessitate prompt medical evaluation.