I get a lot of questions about "growing pains," so I thought I would set the record straight. Growing pains have nothing to do with active growth of bones! Who knew?!

Growing pains are actually muscle spasms or aches that typically occur often at night and for no apparent rhyme or reason. Some kids who have had a particularly active day may experience these pains at night but not with every active day. Some kids never have them and others have them frequently, which make a genetic predisposition a likely factor.

The reason I get so many questions about these nocturnal aches is that every parent worries and wonders at the back of his mind if perhaps these growing pains are actually a sign of something more sinister. To tell the difference between run-of-the-mill growing pains and something more serious is actually pretty easy. Serious bone issues will present with pain in a very discrete area. When you ask your child where it hurts, if she has a serious bone condition she won't move her hand over the whole forearm or shin but instead will consistently point to a specific place with just one or two fingers. Also if the pain is located at the elbow or knee joint as opposed to the longer boney areas it is a worry sign that there could be something different going on.

Just this week, I had a girl in the office who had been having some pains in her arm and leg off and on for the last few weeks. Her aches didn't wake her up at night but were there when she woke up in the morning and she seemed stiff and achey for an hour or so before she could move around easily. What brought her to the office was that her left elbow had gotten stiff and it hurt whenever she stretched it out straight. When I asked her where it hurt, she pointed directly at the elbow and knee on the left side. The elbow seemed a bit swollen, too. This was no case of growing pains! This girl had a form of childhood arthritis called Juvenile Idiopathic Arthritis. I did some lab work and X-rays to confirm my suspicion and sent her to a rheumatologist for further management.

That was a pretty easy one to figure out but does point out the red flags that differentiate routine growing pains from a serious problem.

The bottom line: If the pain is in a very specific area, even if it looks fine and improves during the day, it is worth a trip to the doctor. If the pain is hard to pinpoint and moving around from arm to leg and back again, go to the movies and see "Bolt" instead!