Growing pains

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PatternChoose one

Red flags presentChoose any

Red flags absentChoose any

ExamChoose one

AssessmentChoose one

LabsChoose any

ImagingChoose any

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Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Growing pains
• Intermittent pain in both legs in the evening or overnight, gone by morning, with normal activity during the day
• No fever, limping, pain in only one leg, joint swelling or redness, daytime pain or morning stiffness, weight loss, bony tenderness, or unexplained bruising or pallor
• Normal musculoskeletal exam with full range of motion, normal gait, and no tenderness
• Pattern and exam reassuring for growing pains without red flags
• Reassurance and supportive care reviewed
• Follow up as needed

Growing pains are common and normal in young children, and growth itself is not the cause. Recommended supportive care with tylenol or motrin as needed on painful nights, with an emphasis on massage, a warm bath at bedtime, and rest breaks during active play. Return precautions given including pain during the day, limping, fever, swelling or redness, pain in only one leg, a lump, dark urine after exercise, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Typical pattern (both legs, evening or night, gone by morning)
Red flags present or absent (fever, limp, one-sided, joint swelling, daytime pain or morning stiffness, weight loss, bony tenderness)
Normal exam
Labs, x-ray
Rest breaks, variety of activities
Massage, warm bath, tylenol or motrin

Return precautions in the template

pain during the daylimpingfeverswelling or rednesspain in only one lega lumpdark urine after exercise

Sources

Few formal guidelines cover this topic, so the template also leans on expert opinion.