Foot Pain in Children (Sever’s Disease)

Let's face it. Most adults have uttered those infamous words, "Oh my aching feet". Whether temporary or permanent, we've all suffered from some type of foot pain. Years of stress, wearing the wrong shoes and overall poor foot care can lead to adult foot pain.

However, there is a lesser know group of foot pain sufferers - children.

Although it is fairly common, many of us don't associate foot pain with kids. One of the top causes of children's foot pain has a rather ominous name to it: Sever's Disease.

Sever's Disease (aka:calcaneal apophysitis) is an extremely painful type of heel pain. It occurs when there is inflammation in the growth plates of the heel where the Achilles tendon attaches. Primarily affecting children during their adolescent growth spurt, this can be an extremely painful and debilitating form of foot pain. Children with Sever's experience pain and/or tenderness in one or both heels that can result in difficulty walking. Many children report extreme discomfort in the feet when first waking. The good news is that Sever's is not permanent and while very painful, it has no long-term effects.

Diagnosis of Sever's is a combination of things. You must take your child to the doctor, preferably a Podiatrist. The doctor will make a diagnosis based on the symptoms reported by your child, performing a physical examination and by doing a squeeze test. The squeeze test is exactly as it sounds. The doctor will squeeze the heel to check the pain level. Yes, it will hurt but it is a necessity when making a diagnosis. They may also take x-rays to rule out other potential causes of foot pain such as fractures.

The goal of treatment is pain relief. This can achieved by the following:

Rest - Sufferers are advised to take a break from physical activities to allow inflammation and pressure in the heel to resolve.

Ice - Elevation and ice applied indirectly to the affected heel for 20 minutes 2-3 times daily may be helpful to decrease swelling and provide pain relief.

Medications - Over-the-counter meds such as Tylenol or Motrin can aid in reducing pain and swelling. A physician may prescribe Mobic (Meloxicam) for more severe cases. NEVER give a child Aspirin!

Physical Therapy - Exercises that stretch the Achilles tendon and ligaments in the foot have been found to be very effective in relieving Sever's pain.

Orthotics - Heel cups or lifts can raise the heel reducing strain on the Achilles tendon. Heel pads are a great way to cushion the heel from further stress. Arch supports are a beneficial way to hold the heel in place minimizing future damage.

Recurrence of Sever's is a possibility up until the time a child's foot growth is complete and the growth plate has fused to the heel bone. This usually occurs by age 15.

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