Heel pain is an issue that brings many patients in to see us here at the office of G. Jason Wilks, DPM. In part, this is because our heels absorb a tremendous amount of force throughout the day, but it also is explained by the simple fact there are several conditions that can cause it. In adolescent patients, it can often be attributed to a condition known as Sever’s disease (or calcaneal apophysis). This particular problem can be experienced in either foot, and sometimes both, but thankfully it is a temporary issue that your son or daughter will outgrow.
Sever’s Disease Cause and Symptoms
In spite of the misleading name, the condition is not actually a disease. Further, it is not an injury (even though there is a link to physical activity). Instead, it is an issue that develops from differences in physical maturity between the calcaneus (heel bone) and the Achilles tendon (which connects calf muscles to the back of the heal). More specifically, there is a growth plate located in the back of the heal which can develop more quickly than the Achilles, and this results in excessive tension on the tendon that leads to pain in the heel.
The condition is commonly seen in girls between the ages of 8 and 13 and boys between the ages of 10 and 15, but it can sometimes happen a little earlier or later than those ranges. Physical activity may make pain and other symptoms worse if Sever’s is present. Other factors which can lead to an increase in symptoms include ill-fitting shoes, excessive periods spent standing, and overuse.
Symptoms of calcaneal apophysis include:
- Heel pain, which is the most prominent sign of the condition
- Swelling, redness, and tenderness (which is evident with a gentle squeeze in the back of the heel)
- Limping while walking, or even difficulty walking
- Stiffness or discomfort in the back of the heel
These symptoms can become more severe either during or immediately after physical activity. They will generally improve with rest.
Treating Sever’s Disease
Since Sever’s is caused by variances in natural growth processes, treatment is not concerned with correcting the condition, but rather providing relief for painful symptoms.
Treatment options we may recommend include:
- Reduced levels of physical activity – Activities causing pain need to be limited or perhaps even stopped altogether for a time, depending on the circumstances.
- Medication – In order to further relieve inflammation and pain for a patient, we may recommend or prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), like naproxen or ibuprofen. If you are providing over-the-counter medications for your child, be sure to consult with us for appropriate dosages and specific recommendations (no aspirin!).
- Physical therapy – Various therapeutic modalities and stretching exercises may be quite beneficial in allowing the inflamed tissue to heal correctly.
- Support for affected heels – In some cases, we recommend the use of shoe inserts or custom orthotics to better support the affected heel(s). These devices can help reduce pain and inflammation.
- Immobilization – When rare cases bring severe pain, we may recommend immobilizing the area with the use of a cast.
Given the natural development processes, there really is no way to prevent Sever’s from appearing, but wearing supporting footwear (especially for sports), limiting high-impact activities, and maintaining a healthy body weight are proactive measures your child can take to reduce heel pain. These help by keeping excess pressure off heels affected by calcaneal apophysis.
Child Heel Pain Treatment in Roseburg, OR
Fortunately, your child will simply grow out of this common cause of adolescent heel pain in time and without experiencing any long-term issues. In the meantime, though, Jason Wilks, DPM can provide effective Sever’s disease treatment to relieve your child’s pain. Contact our Roseburg, OR foot doctor office by calling (541) 673-0742 for more information or to schedule an appointment for your son or daughter.