How do I know if my child has growing pains? versus other pains?

What the evidence says

Growing pains are very common, but doctors can't test for them directly. There's no blood test or X-ray that shows growing pains. Instead, doctors and parents look for a specific pattern of symptoms.

Classic growing pains usually happen in both legs at the same time, not just one. The ache is usually in the calves, the front of the thighs, or behind the knees. It tends to strike late in the day or wake a child up at night, then completely disappears by morning. Between episodes, the child feels totally fine and moves normally, with no limping.

A useful trick: a child with growing pains usually doesn't mind if you rub or massage the sore spot, and it often helps. If your child pulls away, cries when you touch the area, or won't let you near it, that's more worrying and needs a doctor's look.

Some signs suggest it's NOT growing pains and needs medical attention: pain in only one leg, a swollen or hot joint, a limp, fever, weight loss, pain severe enough to stop play, or pain that's still there in the morning. These can point to things like an infection, arthritis, or a fracture, which need a proper check-up.

If the pattern is classic, most doctors won't order any tests at all. Tests are usually only done if something doesn't fit the usual pattern, just to rule out other causes.