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Children's Heel Pain - Sever's DiseaseHeel pain can also occur in children, most commonly between ages 8 and 15, as they become increasingly active in sports activity in and out of school. This physical activity, particularly jumping, inflames the growth centers of the heels; also known as the apopyhsis. The more active the child, the more likely the condition will occur. Your doctor may also describe the condition as Sever's Disease or calcaneal apophysitis. Where does the pain occur?The child may complain of pain in the heel area occurring with walking and/or on direct pressure to the calcaneal apophysis. Side-to-side pressure on the heel will also produce discomfort. Can females have Sever's Disease?The condition is associated with increased activity levels and strenuous sports activities. Therefore both males and females within this age group are equally susceptible. What causes the pain?There are several theories as to the cause of this condition. These range from a tight Achilles tendon, to micro stress fractures of the calcaneal apopyhsis. The prevailing theory suggests that the condition occurs when the child's growth plate is at its weakest. Combined with increased athletic activity, improper shoe gear and trauma the heel becomes inflamed and painful. Will my child grow out of this condition?Often the condition is self limiting; meaning as the growth plate fuses to the rest of the heel bone, the pain will subside. However in some cases the child will have so much discomfort that they will be unable to walk comfortably if left untreated. Therefore, heel pain in children should always by evaluated by a physician. What is the treatment?Treatment is primarily directed towards reducing the amount of stress to the heel. Often a heel lift, is placed in the shoe to reduce the pull of the Achilles tendon on the apophysis. Gel or cushioned heel cups may also be helpful in reducing micro trauma to the heel. Orthotic control may also be indicated when a pathologic condition exists in the foot that may be contributing to the increased heel stress. Occasionally, it becomes necessary for adequate healing, to rest the area completely. This can be accomplished either by complete elimination of all strenuous activities, or by using a walking cast or crutches. Often simply reducing activity levels is adequate. Your physician will discuss the best treatment plan with you and your child. How long does the treatment last?The treatment may last as little as 2-4 weeks or as long as 1-2 years. Since the condition does not occur beyond the age of approximately 14-15 years, protection is only necessary until then. What else could cause heel pain in children?Several other conditions should also be considered when evaluating a child with heel pain. These include, but are not limited to; Juvenile rheumatoid arthritis, calcaneal fracture, bone infection, bone tumor and plantar fasciitis.
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