From the Guidelines
Treatment for Sever's disease primarily involves rest, ice, and pain management. The child should reduce or modify activities that cause heel pain, particularly high-impact sports or running. Ice should be applied to the painful heel for 15-20 minutes, 2-3 times daily to reduce inflammation. Over-the-counter pain medications like ibuprofen (10mg/kg every 6-8 hours, not exceeding 40mg/kg daily) or acetaminophen (15mg/kg every 4-6 hours, not exceeding 75mg/kg daily) can help manage pain and inflammation. Heel cups, heel lifts, or arch supports in shoes provide cushioning and reduce tension on the Achilles tendon. Gentle stretching exercises for the calf muscles and Achilles tendon should be performed 2-3 times daily, holding each stretch for 15-30 seconds. Physical therapy may be recommended for persistent cases. Most children recover completely with conservative treatment within 2-8 weeks, as Sever's disease is a self-limiting condition caused by inflammation of the growth plate in the heel that occurs during periods of rapid growth when the Achilles tendon pulls on the growth plate. None of the provided studies 1 directly address the treatment of Sever's disease, so the above recommendations are based on general medical knowledge and not on the specific evidence provided.
From the Research
Treatment Options for Sever's Disease
The treatment for Sever's disease is primarily conservative, aiming to alleviate pain and promote healing. Some of the methods used to treat Sever's disease include:
- Ice application to reduce pain and inflammation 2, 3
- Activity restriction to avoid exacerbating the condition 2, 4, 3
- Stretching exercises to improve flexibility and reduce tension on the heel 2, 3
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation 2, 3
- Immobilization to allow the heel to rest and recover 2
- Heel cups or orthoses to provide support and cushioning for the heel 2, 4, 5
- Physical therapy, including exercises and modalities to promote healing and improve function 4, 5, 6
- Education for parents and coaches on the symptoms and prevention of Sever's disease to facilitate early diagnosis and intervention 4
Conservative Treatment Effectiveness
Conservative treatment has been shown to be effective in alleviating symptoms associated with Sever's disease 5. A systematic review of conservative treatment options found that methods such as insoles, therapeutic exercises, Kinesio taping, and foot orthoses can be effective in managing Sever's disease symptoms 5. Additionally, the use of ketoprofen gel as an adjunct to physical therapy has been reported to be beneficial in reducing pain and inflammation in a child with Sever's disease 6.
Treatment Goals
The primary goal of treatment for Sever's disease is to alleviate pain and promote healing. Treatment should be individualized based on the severity of symptoms and the patient's response to conservative management. In most cases, conservative treatment is sufficient to manage Sever's disease, and the condition typically resolves within a few weeks to months with appropriate treatment 2, 3.