From the Research
Sever's disease, also known as calcaneal apophysitis, is a common cause of heel pain in children and adolescents, characterized by inflammation of the growth plate in the heel bone due to repetitive stress and tension from the Achilles tendon, as reported in a recent study 1.
Definition and Causes
Sever's disease typically affects physically active children between the ages of 8 and 14, particularly during growth spurts when bones grow faster than muscles and tendons, creating increased tension at attachment points. The condition is often associated with high-impact sports such as soccer, track, cross-country, gymnastics, tennis, and ballet, as noted in a study published in 2019 2.
Symptoms and Diagnosis
The primary symptom of Sever's disease is heel pain, which can be unilateral or bilateral. Diagnosis mainly relies on a thorough clinical investigation and physical examination, with a positive squeeze test usually sufficient to establish diagnosis, as stated in a 2021 study 3. Radiographic imaging can help exclude other differential diagnoses.
Treatment and Management
Treatment of Sever's disease is mostly conservative and includes:
- Rest from painful activities
- Ice application for 15-20 minutes several times daily
- Over-the-counter pain medications like ibuprofen (5-10 mg/kg every 6-8 hours) or acetaminophen (10-15 mg/kg every 4-6 hours)
- Heel cushions or cups in shoes
- Gentle stretching exercises for the calf muscles and Achilles tendon Physical therapy may be recommended in more persistent cases, as suggested in a 2024 study 1.
Prognosis and Outcome
Most children recover completely within 2-8 weeks with proper management, and the condition resolves entirely once the growth plate closes during adolescence, as reported in a study published in 2019 2. While Sever disease can be painful and temporarily limit activity, it doesn't cause long-term foot problems or growth disturbances if appropriately managed.