Although its name sounds frightening, Sever's disease is a common heel injury that occurs in children. It can be painful, but is only temporary and has no long-term effects. It’s a result of inflammation of the growth plate in the heel, an area at the end of a developing bone where cartilage cells change over time into bone cells. As this occurs, the growth plates expand and unite, which is how bones grow.
Sever's disease rarely occurs in older teens because the back of the heel usually finishes growing by the age of 15, when the growth plate hardens and the growing bones fuse together into mature bone.
The most obvious sign of Sever's disease is pain or tenderness in one or both heels, usually at the back. The pain also might extend to the sides and bottom of the heel, ending near the arch of the foot. The patient may also may experience:
- Swelling and redness in the heel
- Discomfort when the heel is squeezed on both sides
- Walking with a limp or on tiptoes to avoid putting pressure on the heel
Symptoms are usually worse during or after activity and get better with rest.
The immediate goal of treatment is pain relief. Because symptoms generally worsen with activity, the main treatment is rest, which helps to relieve pressure on the heel bone, decreasing swelling and reducing pain.
A specialist may also recommend:
- Foot and leg exercises to stretch and strengthen the leg muscles and tendons
- The application of ice (wrapped in a towel, not applied directly to the skin) to the injured heel for 20 minutes two or three times per day.
- The use of an elastic wrap or compression stocking
- Medicines such as ibuprofen
In very severe cases, the doctor might recommend that the child wear a cast for anywhere from 2 to 12 weeks to immobilise the foot so that it can heal.