Nighttime Foot Pain in Children—What Does “Growing Pains” Really Mean?
Nighttime Foot Pain in Children—What Does “Growing Pains” Really Mean?
Author: Dr. Ákos Morvai | February 13, 2026
Many parents are familiar with the situation where, at the end of the day, a child who has been completely active and cheerful wakes up crying in the evening or at night, complaining of pain in their leg. Nothing during the day indicated a problem, yet the complaint arises by evening. In such cases, the term “growing pains” is often used .
Although this term is widely used, it is not entirely accurate from a medical standpoint. That is why it is important to understand what this condition entails, why foot pain occurs in children, when it can be considered harmless, and when it is advisable to see a doctor again.
What is growing pain in childhood?
Growing pains are a common, benign childhood condition that occurs most frequently in preschool and early elementary school-aged children. It is characterized by recurring, intermittent leg pain that primarily affects the lower limbs.
Based on current medical knowledge, it is not caused by bone growth, nor is it associated with periods of rapid growth. The name is therefore misleading, but the term continues to be used in the literature to describe the phenomenon.
This is one of the most common reasons why parents request a consultation with a pediatric orthopedist for recurring nighttime foot pain.
Dr. Ákos Morvai
Chief Pediatric and Neuro-Orthopedic Physician
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Characteristic symptoms of foot pain in children
The symptoms of growing pains are so characteristic that in many cases, the possibility of this diagnosis arises simply based on the pattern of the symptoms.
The pain most often occurs in the lower leg, is usually bilateral, occurs in the evening or at night, resolves completely by morning, and does not cause a limp or persistent limitation of movement.
During the day, the child has no symptoms; he or she is active, runs, jumps, and plays sports, and the pain does not affect his or her daily activities in any way. The symptoms return periodically and may then disappear for weeks or even months. This fluctuating pattern is a very important distinguishing feature.
What causes nighttime leg pain in children?
The exact cause is unknown, but research has clearly shown that it is not caused by inflammation, bone or joint disease, or a developmental disorder.
A more likely explanation is that muscles become fatigued during the day, and by evening, the nervous system’s perception of pain becomes more sensitive. Some children may have a lower pain threshold, which explains why they are the ones who report these symptoms.
This is why the pain typically occurs in the evening and at night, rather than during physical activity.
How is growing pains diagnosed?
Growth pain is what is known as a diagnosis of exclusion. This means that the child’s physical examination is completely normal, the pattern of symptoms is characteristic, and there are no symptoms that would raise suspicion of another condition.
In typical cases, there is no need for blood tests, X-ray examinations, or other imaging tests. The diagnosis can be made based on the nature of the symptoms and the absence of any abnormal medical reports.
When Should Foot Pain in Children Not Be Considered Harmless?
Although growing pains are benign, a follow-up medical examination is necessary if certain symptoms appear.
Warning signs include pain that persists even during the day, pain that always occurs at the same spot and is tender to the touch, joint swelling or redness, the child beginning to limp, or if the symptoms are accompanied by a fever, weight loss, or general malaise.
These no longer fit the typical picture of growing pains.
What can a parent do if their child complains of foot pain?
The most important thing is to reassure the child and relieve the pain. Since this condition is harmless and resolves on its own, the goal of treatment is to improve the child’s comfort.
In many cases, gently massaging the painful area, stretching the muscles, applying a warm compress, and making the child feel safe can help. Occasionally, if necessary, an age-appropriate dose of pain reliever may also be given.
Growth pain is therefore one of the most common causes of nighttime foot pain in children. It is benign, does not cause permanent damage, does not affect the child’s development, and gradually subsides over the years.
The most important thing for parents is to recognize the characteristic symptoms and to know when a follow-up medical examination is warranted. If you are unsure, ask for a consultation in pediatric orthopedics from the specialists at BMM!
References:
Adolf, S., Braun, S., & Meurer, A. “Growth Pains.” Orthopäde 48, 461–468 (2019). https://doi.org/10.1007/s00132-019-03745-2
Lehman PJ, Carl RL. Growing Pains. Sports Health. Mar-Apr 2017;9(2):132-138. doi: 10.1177/1941738117692533. Epub 2017 Feb 8. PMID: 28177851; PMCID: PMC5349398.
O’Keeffe M, Kamper SJ, Montgomery L, Williams A, Martiniuk A, Lucas B, Dario AB, Rathleff MS, Hestbaek L, Williams CM. Defining Growing Pains: A Scoping Review. Pediatrics. Aug 1, 2022;150(2):e2021052578. doi: 10.1542/peds.2021-052578. PMID: 35864176.
Smith M, Pacey V, Davies LM, Coventry J, Ilhan E, Williams CM. Assessments, diagnostic criteria, and outcome measures for growing pains and persistent pain in children with restless leg syndrome: a scoping review. BMJ Open. Dec 3, 2025;15(12):e101989. doi: 10.1136/bmjopen-2025-101989. PMID: 41338633; PMCID: PMC12684109.
Hestbæk L, Lücking A, Jensen ST. Growing pains in Danish preschool children: a descriptive study. Sci Rep. Feb 17, 2024;14(1):3956. doi: 10.1038/s41598-024-54570-3. PMID: 38368453; PMCID: PMC10874442.