Your child wakes up in the middle of the night, complaining his legs are sore. You can't feel any swelling or heat in the limbs. Your first thought is that they’re growing pains. Chances are you don’t know exactly what constitutes a growing pain or even if such a phenomenon exists. Old wives tale or urban legend? Does it actually hurt to grow?

No one knows what causes these pains, which usually disappear by morning. According to experts at the Mayo clinic, there is no evidence to support the idea that bones "hurt" as they grow. More likely, your child has simply been over-exercising. Young athletes are prone to aches and pains just like the rest of us. Trying to tell them that their discomfort is the result of playing too hard, however, is likely to fall on deaf ears.

According to Dr. Barbara Homeier, Health Media Fellow at the Nemours Foundation for Children's Health Media (www.kidshealth.org) growing pains are a normal occurrence in about 25 to 40 per cent of children.

"They generally strike during two periods: in early childhood, among three-to-five-year-olds, and later on, in eight-to-12-year-olds. They always concentrate in the muscles, rather than the joints. Most children report pains in the front of their thighs, in the calves, or behind the knees. Whereas joints affected by more serious diseases are swollen, red, tender, or warm, the joints of children experiencing growing pains appear normal.”

Growing pains often strike in late afternoon or early evening before bed, she says. There are occasions when pain can wake a slumbering child. The intensity of the pain varies from child to child, and most kids don't experience pain every day.

"One symptom that doctors find most helpful in making a diagnosis of growing pains is how the child responds to touch while in pain. Children who have pain for a serious medical disease don't like to be handled because movement tends to increase the pain. But children with growing pains respond differently—they feel better when they're held, massaged, and cuddled. Other conditions should be ruled out before a diagnosis of growing pains is made," she adds.

A thorough history and physical examination by your child's doctor is usually all that’s necessary. In rare instances, blood and X-ray studies may be required before a final diagnosis of growing pains is made.

Growing Up is Hard to Do:

Dr. Homeier recommends the following methods of relief:

• Massage the area
• Practice stretching
• Place a heating pad on the affected area
• Give an analgesic as recommended by your doctor (Never give aspirin to a child under 12 due to its association with Reye syndrome, a rare but potentially fatal disease.)

Be alert for the following symptoms, which suggest a problem other than growing pains:

• Persistent pain, pain in the morning, or swelling or redness in one particular area or joint
• Pain associated with a particular injury
• Fever
• Limping
• Unusual rashes
• Loss of appetite
• Weakness
• Fatigue
• Uncharacteristic behavior