{
  "schema_version": 1,
  "kind": "condition",
  "id": "growing-pains",
  "name": "Growing Pains (Benign Nocturnal Limb Pain of Childhood)",
  "category": "chronic",
  "sources": "NICE Clinical Knowledge Summaries: Growing pains in children 2022 · MSF Essential Drugs 2024 - paracetamol (oral) · No labelled dose - a procedure, not a medicine",
  "review_status": "reviewed",
  "verified_against": "No labelled dose - a procedure, not a medicine · MSF Essential Drugs 2024 - paracetamol (oral)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 824,
      "generic": "Reassurance, leg massage, and local heat",
      "line": 1,
      "is_adjunct": false,
      "form": null,
      "strength_mg": null,
      "adult_dose": "Not applicable (childhood condition)",
      "adult_duration": "Not applicable",
      "dose_source": "No labelled dose - a procedure, not a medicine",
      "rationale": "Growing pains are benign and self-limiting; reassurance, gentle calf/thigh massage, stretching exercises, and warm baths provide effective relief without regular medication",
      "cautions": [
        "MUST rule out red flags: unilateral pain, daytime pain, limping, joint swelling/erythema, localized bone tenderness, fever, or weight loss.",
        "Physical exam must be completely normal; symptoms should resolve by morning leaving child fully active during the day."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Provide reassurance to parents; massage legs gently, apply local warm compress or bath, and perform hamstring/quadriceps stretches before bedtime",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": null,
      "brands": [],
      "condition_id": "growing-pains"
    },
    {
      "id": 825,
      "generic": "Paracetamol",
      "line": 1,
      "is_adjunct": true,
      "form": "oral.liquid",
      "strength_mg": 120.0,
      "adult_dose": "Not applicable (childhood condition)",
      "adult_duration": "Not applicable",
      "dose_source": "MSF Essential Drugs 2024 - paracetamol (oral)",
      "rationale": "Simple analgesic added to reassurance and non-drug comfort measures for nights when limb pain is significant; it does not alter the benign, self-limiting course of growing pains and is not meant for nightly use.",
      "cautions": [
        "Do not administer continuously every night; use only on nights with significant pain.",
        "Ensure correct pediatric liquid strength (120 mg/5 mL or 250 mg/5 mL) to prevent dosing errors.",
        "Re-evaluate child if pain frequency increases or changes character.",
        "500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case."
      ],
      "peds_mgkg_low": 10.0,
      "peds_mgkg_high": 15.0,
      "peds_max_mg": 500.0,
      "peds_basis": "dose",
      "peds_unit": "mg",
      "peds_note": "Child 1 month and over: 15 mg/kg per dose, 3 or 4 times daily (max 60 mg/kg daily).",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": null,
      "peds_doses": [
        {
          "weight_kg": 10,
          "low_mg": 100,
          "high_mg": 150,
          "capped": false
        },
        {
          "weight_kg": 20,
          "low_mg": 200,
          "high_mg": 300,
          "capped": false
        },
        {
          "weight_kg": 30,
          "low_mg": 300,
          "high_mg": 450,
          "capped": false
        },
        {
          "weight_kg": 40,
          "low_mg": 400,
          "high_mg": 500,
          "capped": true
        }
      ],
      "brands": [
        {
          "trade_name": "CETAMOL 120MG/5ML PEDIATRIC SYRUP 120 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MEMPHIS",
          "price_egp": 8.5,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 120.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "PARAGESIC BABY 120MG/5ML 120ML SUSP.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "AMRIYA",
          "price_egp": 36.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 120.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "PARAMOL 120MG/5ML SYRUP 125ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "MISR",
          "price_egp": 36.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 120.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "FEBRIMOL ORAL DROPS 20 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHARCO",
          "price_egp": 4.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": null,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        },
        {
          "trade_name": "THERA-LO 3.2G/100ML ORAL SUSP. 100 ML",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "PHAROPHARMA",
          "price_egp": 5.0,
          "pack_count": null,
          "unit_price": null,
          "strength_mg": 3200.0,
          "exact_strength": false,
          "exact_form": false,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "growing-pains"
    }
  ]
}