Q AMy toddler’s started waking up saying her knees hurt. Are growing pains real? Paediatrician Dr Scott Dunlop says: Growing pains can affect children from preschool age through to early adolescence. Children usually develop muscle pain in the early evening or can be woken with pain during the night. The cause is not known, but there is no underlying damage to joints or muscles. Growing pains are a diagnosis of exclusion, so other important conditions need to be considered first, such as childhood arthritis, infection of bone or joint and abnormal bone growths. Most symptoms recover with simple massage or heat packs, but always see your GP if you are concerned that the pain is severe.