Sever’s Disease Or Severs Heel

Sever’s disease is frequently the source of heel pain in children between 9 and 14 years of age. This painful affliction is caused by inflammation of the growth plate found in the heel of the foot, which refers to the area on the developing bone where cartilage cells eventually become bone cells with time. During the growth stage the plates grow larger and eventually knit together, which is they process by which bones grow. It also the reason that Sever’s disease is found exclusively in children.

While this is a common childhood condition it is most often found in those who are physically active during adolescent growth spurts. It is rarely found in kids older than 15 years of age simply become the back of the heel has generally finished growing and is fully formed by this age.

The primary symptom of Sever’s disease is pain and/or tenderness at the back of one or both heels. Unfortunately, it’s not unusual for the pain to travel through the sides and bottom of the heel all the way to the arch of the foot. Heel pain may also be accompanied by swelling and redness of the skin in the afflicted area, discomfort during weight bearing activities, stiffness in the feet upon waking, heel pain when the area is squeezed on both sides, and an alteration in walking patterns, such as the development of a limp or walking forward on the toes to avoid putting pressure on the heels.

Most children will experience increased discomfort during, or immediately following, physical activity. Diagnosis of Sever’s disease is generally made in the doctor’s office using the ‘squeeze test’ (applying pressure to the heel to look for tender areas and pain) and by ascertaining whether the child is able to stand on tiptoes without experiencing pain. While x-rays may be performed this is generally done to rule out fractures or breaks in the heel bone as Sever’s disease is not observable on an X-ray.

Because there is no cure for this type of growing pain relief of symptoms is the primary goal in treating this condition, and because physical activity aggravates the pain a reduction in activity levels is usually the first step taken. By decreasing physical activities less pressure is placed on the heel bone, which reduces swelling and inflammation and minimizes the level of heel pain that the child is experiencing. Orthotic devices may also be used if the child tends to pronate or has other lower limb issues.

While swimming or biking may be approved by the child’s doctor its best to minimize any type of pressure on the feet and heels, especially in the beginning stages of the recovery process. While rest is the primary treatment option foot and leg exercises may be prescribed to strength muscles and tendons of the legs and feet. Elevation of the feet and cold therapy may be recommended and compression in the form of stockings or tensor bandages may also help.

It’s important to note that while acetaminophen or ibuprofen may be used to treat discomfort aspirin must be avoided at all costs as it has been linked to the development of Reye’s syndrome in children. Once treatment is begun symptoms should begin to improve within 2 weeks though in some difficult cases it can take up to 2 months before significant improvements are seen.

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