Which characteristic defines growing pains in children?

Growing pains in children are characterized by normal physical examination findings and bilateral lower extremity pain, typically occurring in the evening or at night. The pain is often described as a deep, aching sensation and is usually located in the legs, particularly in the thighs, calves, or behind the knees.

The fact that the physical examination is normal is crucial because it indicates that there are no underlying pathological conditions causing the pain. Additionally, the bilateral nature of the pain differentiates growing pains from other conditions, such as arthritis, which would typically present with localized or unilateral symptoms, swelling, or warmth in the joints.

This characteristic helps reassure both parents and healthcare providers that the pain is part of normal development and does not indicate any serious health issues.