Growing pains are typically non-articular, inter-mittent bilateral aches or pains in the legs that occur in the evening or at night in children aged 3-12 years. They are not associated with limping or limited mobility and do not involve the joints (all of which are recognised signs of pathology); no signs of local trauma or infection are seen.1 Physical examination and laboratory and x ray investigations are normal. The diagnosis of growing pains is one of exclusion. Reported prevalence ranges from 2.6% to 49.4%, which reflects the diverse criteria used to identify cases and the differing populations sampled.

What causes growing pains? The short answer is that we still do not know. Although the term has been used for more than 180 years it has proved to be a misnomer—growth spurts do not play a part in this condition.2 Many aetiologies have been proposed but …