Filed under: Foot Disorders
Severs disease is a common problem of the heel in children. There is certainly debate if it should be called Severs Disease or calcaneal apophysitis, but we will use Severs here as it is the most commonly used term. It occurs when there is too much load on the cartilage growing area at the back of the heel bone leading to a condition that is possibly similar to a stress fracture. The classic symptoms are pain at the back the child’s heel, that is also painful to lateral squeezing at the back of the heel. The condition is self limiting as the growing area joins to the rest of the heel bone by the mid-teenage years. However, that is no reason to not treat it as its is painful and does affect quality of life.
The approach to it management to to treat the symptoms with some pain relief (ice, Oscon, anti-inflammatory drugs) and load management. Load management is related to things like heel pads to protect the painful area and a reduction of activity levels. In the child, managing this can be difficult as they like to run around and play, so some negotiation to achieve that is probably going to be needed.
As the condition is self-limited, these control of pain and load management strategies as well as managing expectations may be all that can be done over the long term until the natural history of the growth area is to merge with the rest of the heel bone. Education is the key.
PodChatLive did a real deep dive into Severs disease, interviewing an expert: