Growing Pains: Medicate or Massage?

It is 2:00 AM. The house is quiet, and you are deep in a well-deserved sleep. Suddenly, a cry echoes from your child’s bedroom. You rush in, adrenaline pumping, only to find your little one clutching their shins, tears streaming down their face, complaining that their legs hurt. If you are a parent, this scenario is likely all too familiar. As Dr. Anita Sabeti, I hear this story in my office constantly. We call these episodes “growing pains,” but understanding them—and knowing how to treat them—is often more complex than the name suggests.

When you are standing there in the dark, groggy and worried, you face a common dilemma: Do you reach for the medicine cabinet, or do you start rubbing their legs? Is it better to medicate or massage? In this guide, I want to walk you through the science, the options, and the best methods for growing pains relief so you can help your child get back to sleep with confidence.

What Are Growing Pains, Really?

Before we decide on a treatment, we need to understand what we are treating. Despite the name, there is actually no medical evidence that the physical act of growing bones causes pain. If growth were painful, we would likely see children in pain constantly during their rapid growth spurts in infancy and adolescence. Instead, growing pains—medically known as benign nocturnal limb pains of childhood—usually strike during the preschool and elementary school years.

These aches typically occur in the muscles, not the joints. Your child will usually point to the front of their thighs, the calves, or behind the knees. The pain is almost always in both legs; if it is just one spot on one leg, that is a different conversation we need to have in the clinic.

Who Gets Them?

You are not alone in this. This is one of the most common complaints I see in pediatrics.

Data Point 1: According to prevalence studies, growing pains affect approximately 37% of children between the ages of four and six. While some children grow out of it quickly, others may experience intermittent episodes up until age 19.

Because these pains usually happen in the late afternoon or evening (and famously, in the middle of the night), they can be incredibly disruptive to a family’s sleep schedule. This brings us back to our main question: what is the most effective way to handle them?

The Case for Medication: The Quick Fix

When your child is screaming in pain, your instinct is to stop the hurt immediately. Over-the-counter pain relievers are often the first line of defense for many parents. Medications like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) are generally safe when used correctly and can be very effective for growing pains relief.

When Medication Make Sense

I often recommend medication when the pain is severe enough to prevent the child from falling back asleep. If your child is tossing, turning, and visibly distressed, a dose of ibuprofen can reduce inflammation (if any exists from daily activity) and dull the pain receptors.

• Speed: Medication typically takes 20 to 45 minutes to kick in.
• Duration: The relief can last 4 to 8 hours, usually getting everyone through the rest of the night.
• Ease: It requires less physical effort from the parent at 2:00 AM compared to a 30-minute massage.

However, we must be cautious. We do not want to teach children that every minor discomfort requires a pill. Furthermore, giving medication on an empty stomach (common in the middle of the night) can sometimes upset the tummy, specifically with ibuprofen.

The Case for Massage: The Hands-On Approach

On the other side of the debate is massage. In my practice, I am a huge advocate for touch therapy. Rubbing your child’s legs does more than just address the muscles; it addresses the emotional distress that comes with waking up in pain.

Why Massage Works

Massage works through a mechanism often referred to as the “Gate Control Theory” of pain. Essentially, non-painful input (like rubbing) closes the “gates” to painful input, preventing the pain sensation from traveling to the central nervous system. Plus, the warmth of your hands increases blood flow to the area.

When you massage your child’s legs, you are also releasing oxytocin—the bonding hormone. This calms the child’s nervous system, lowering their heart rate and helping them relax enough to sleep, sometimes even before the physical pain has entirely vanished.

Comparing the Options

To help you visualize the trade-offs between these two methods, I have put together a comparison chart based on what I observe in my clinic.

The Hybrid Approach: Dr. Sabeti’s Protocol

Why choose just one? In my experience, the best growing pains relief comes from a combination of strategies. We shouldn’t view this as “Medication vs. Massage,” but rather as a toolkit.

If your child wakes up crying, try this sequence:

1. Assess the Pain: Ask them to rate it from 1 to 10.
2. Start with Massage and Heat: Use a heating pad (on a low setting) or warm hands to rub the thighs and calves. Gentle stretching—pulling the toes up toward the nose to stretch the calf—can also work wonders.
3. Evaluate: If 10 minutes of comfort measures haven’t reduced the tears, or if the child cannot settle down, then administer the proper dose of medication.

This approach teaches your child coping mechanisms and body awareness before relying on pharmacological intervention.

The Hidden Triggers: It’s Not Just “Growing”

One of the most interesting aspects of growing pains is what triggers them. As I mentioned earlier, it isn’t bone growth. The prevailing theory in the medical community today is that these pains are actually a form of muscle overuse syndrome. This explains why the pain is more common on days when your child has been running, jumping, or playing sports excessively.

Data Point 2: Recent research suggests a correlation between lower pain thresholds in children and Vitamin D levels. A study found that only 6% of children with growing pains had optimal Vitamin D levels, suggesting that supplementation might help reduce the frequency of episodes.

I have created a graph below to illustrate the most common triggers reported by parents in pediatric settings. This helps us understand that “growing pains” are often “activity pains.”

Prevention: Stopping the Pain Before It Starts

While knowing how to treat the pain at 2:00 AM is vital, I always prefer prevention. If we accept the theory that these are overuse injuries, we can take steps during the day to prevent the tears at night.

Hydration is Key

Muscles cramp and ache more easily when they are dehydrated. Ensure your active child is drinking plenty of water throughout the day, especially if they are playing sports. A simple water bottle habit can sometimes reduce the frequency of leg cramps significantly.

Footwear Matters

Look at your child’s shoes. Are they worn out? Do they offer arch support? Children with flat feet (flexible flatfoot) are often more susceptible to leg pain because their mechanics are slightly off, causing their muscles to work harder to stabilize the body. Good, supportive sneakers can act as growing pains relief before the pain even begins.

The Warm Bath Routine

On days when your child has been exceptionally active—perhaps after a soccer tournament or a long day at the park—try a proactive approach. A warm bath with Epsom salts before bed can relax the muscles. The magnesium in the salts may help with muscle recovery, and the heat is naturally soothing.

When Should You Worry?

As a doctor, my biggest job is to rule out the serious stuff. While growing pains are harmless, they can sometimes mimic more serious conditions. It is crucial to know the difference.

You should book an appointment with a pediatrician if you notice:

• Morning Pain: Growing pains vanish by morning. If your child wakes up still in pain or stiff, that is a red flag.
• Swelling or Redness: Growing pains do not look like anything on the outside. If the joints are swollen, red, or warm to the touch, we need to investigate for infection or juvenile arthritis.
• Limping: A child should not be limping during the day due to growing pains.
• Systemic Symptoms: Fevers, unexplained rashes, or weight loss accompanying the leg pain require immediate medical attention.

For more detailed information on distinguishing these symptoms, I recommend reading this article on growing pains from the American Academy of Pediatrics’ official website, HealthyChildren.org.

Final Thoughts for Parents

Navigating your child’s pain is never easy. It pulls at your heartstrings and tests your patience, especially when you are sleep-deprived. But remember, growing pains are a normal, albeit unpleasant, part of childhood for many families. They are a sign that your child is active, playing, and developing.

Whether you choose to medicate, massage, or use a mix of both, the most important thing you provide is your presence. That comfort—knowing that mom or dad is there to make it better—is the most powerful pain reliever of all. So, stock up on the ibuprofen, keep the heating pad nearby, but never underestimate the power of a gentle massage and a hug in the middle of the night.