What is the treatment of Severs disease?

Pain in the heel of kids is not very common, however when it does happen, the most common cause is a disorder known as Severs disease. It is not a real “disease”, but it's the term which has unfortunately stuck. It is actually appropriately known as calcaneal apophysitis. It is a disorder with the growing region at the rear of the heel bone. As it is a condition, of the growing bone, the problem is self-limiting and definately will no longer be a problem when the growth of that bone has completed. It is more common around the age groups of 10-12 years.

The typical characteristic of Severs disease is soreness on exercise and soreness on compressing the sides of the rear area of the heel bone. In the beginning the pain is not that bad and does not affect activity much, but later it becomes more severe and impacts exercise participation and may also result in limping. The actual reason for it is not clear, but it is obviously an excessive use type problem as it is more common in kids who participate in more sport and more frequent in children who have a higher body weight. Those with tighter calf muscles might be at a increased risk for the development of this problem.

Generally, treating Severs disease is load management. The child is urged to remain active, but simply reduce exercise levels to a level which can be tolerated and not too uncomfortable. A shock absorbing heel raise in the shoe may be helpful to cushion it. Ice after exercise can also be useful to help the inflammation. If the calf muscles are tight, then a stretches needs to be started. At times foot supports can be helpful when the arch of the foot is flat. On rare occasions a splint can be utilized, and all activities ceased until it gets better. By the mid-teens the growth area that this occurs at combines with the rest of the heel bone, and this stops being a problem at those age groups.