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Tag: children

How should Severs disease be treated?

Pain in the rearfoot of kids is not common, however when it does happen, the most frequent reason is a condition called Severs disease. It is not really a “disease”, however it is the term which has regrettably widely used. It is actually properly known as calcaneal apophysitis. It is a issue with the growing area at the rear of the heel bone. As it is a problem, of the growing bone, the condition is self-limiting and will no longer be a concern once the growth of that bone has completed. It is more common around the age groups of 10-12 years.


The common characteristic of Severs disease are usually discomfort on activity and discomfort on squeezing the sides of the back part of the heel. At first the discomfort is relatively minor and will not impact activity much, but later it will become more severe and impacts activities levels and may also lead to limping. The precise reason for it is not clear, but it is obviously an overuse type problem because it is more common in those who play more sport and more frequent in children who have a higher BMI. Kids with tight calf muscles might be at a increased possibility for the development of Severs disease.

Commonly, the management of Severs disease is load management. The child is encouraged to keep active, but just reduce exercise levels to a level that can be tolerated and not too painful. A cushioning heel pad in the footwear may be useful to cushion it. Ice following activity may also be useful to help the pain. If the leg muscles are tight, then a stretches needs to be started. Sometimes foot orthotics can help when the arch of the foot is overpronated. On rare occasions a splint can be used, and all sport stopped until it gets better. By the mid-teens the growing plate that this occurs at combines with the rest of the heel bone, so this ceases to be an issue at those ages.

Why do children get growing pains?

Lots of pain in children get called “growing pains” but merely because there is pain in a growing child does not necessarily mean it's a real growing pain. It is possible to dismiss pain in a growing child as this. A genuine growing pain only happens at night and never during the day. The discomfort is also in the upper calf muscle and behind the knee. If the discomfort happens during the day and in another place than the rear of the leg and knee, then it's not really a true growing pain and is probably due to something different which should be looked into. Generally, it only happens in younger children and awakens the kid during the night. There is no history of trauma or any kind of damage to the location that the pain happens in.

Growing pains are usually somewhat benign and self-limiting, in that they do come right after time. However, they can be stressful to the child and parents at the time and, more importantly, there are several very serious and rare conditions that can have signs comparable to growing pains, therefore each case must be given serious attention and looked into to eliminate the other possible reasons. The consequences of missing these rare causes of similar symptoms can be significant.

The standard treatment for growing pains is simply reassurance of the child. They must be comforted and helped to return to sleep. Soothing massage or rubbing of the leg will often help. In some cases medication may be used to help the pain and relieve the returning to sleep. Stretching out just before going to bed and if the pain happens can also be helpful. Of most importance is education in regards to the nature of growing pains and that it will pass as well as an assessment of those potential uncommon and serious causes of the discomfort.