Will Severs Disease Always Need Surgery?

posted on 20 May 2015 19:20 by marcy3dillard5
Overview

Also known as calcaneal apophysitis, Severs? disease is a condition that primarily affects children between the ages of 7 and 15. The condition is typified by pain in the heel which can affect movement, and as a foot condition, comes under the care of podiatrists. Podiatrists are specially trained professionals who specialise in any and all ailments of the foot and ankle. Podiatrists dealing with Severs? disease are typically podopaediatricians, individuals who have received training in the delivery of childhood care.

Causes

Your child may have pain along the edges of one or both heels during exercise. The pain usually goes away with rest, but may be worse in the morning. Your child's heel may also be slightly swollen and warm. The heel pain may be worse when your child climbs steps or stands on tiptoe. It may cause your child to limp.

Symptoms

The typical patient is a child between 10 and 13 years of age, complaining of pain in one or both heels with running and walking. The pain is localized to the point of the heel where the tendo-achilles inserts into the calcaneus (heel bone), and is tender to deep pressure at that site. Walking on his toes relieves the pain.

Diagnosis

Sever?s disease is diagnosed based on a doctor?s physical examination of the lower leg, ankle, and foot. If the diagnosis is in question, the doctor may order x-rays or an MRI to determine if there are other injuries that may be causing the heel pain.

Non Surgical Treatment

Stretching programs. Strengthening exercises. Exercise and training modification. Orthotic therapy. In rare cases, where fragmentation of the apophysis exists and pain fails to subside with traditional treatments then immobilization of the foot and ankle with a short leg pneumatic walker(walking cast) is indicated.

Surgical Treatment

The surgeon may select one or more of the following options to treat calcaneal apophysitis. Reduce activity. The child needs to reduce or stop any activity that causes pain. Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel. Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation. Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue. Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile. Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.