Sever’s Disease – Everything You Need To Know – Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the condition of Sever’s disease.

Sever’s disease is a common cause of heel pain in children between the ages of 9 and 12 years. The pain is due to calcaneal apophysitis occurring due to repetitive and continuous traction on the calcaneus from the Achilles tendon. Sever’s disease is similar to Osgood Schlatter disease of the tibial tubercle. It is important to remember that the apophysis is not the epiphysis. The apophysis is not part of a joint and has muscle or tendon attachments. This traction apophysitis may lead to stress fractures, pain, and tenderness over the heel. Patients are usually young athletes presenting with heel pain that increases with activities.
Examination: there could be swelling, tenderness, warmth and/or redness on the back of the heel where the Achilles tendon inserts.
Plain lateral X-rays may show sclerosis or fragmentation of the calcaneal tuberosity. Sclerosis is not specific for this condition.
Fragmentation of the calcaneal tuberosity, on the other hand, is more common in patients with Sever’s disease relative to the general population.
Remember that Sever’s disease is a clinical diagnosis. X-rays may show other causes of pain such as tumors, fractures, infections or cysts. MRI is not commonly used but can help rule out calcaneal stress fractures or osteomyelitis.
Sever’s disease is a self-limiting condition that usually resolves with time.
Treatment:
•NSAID
•Achilles tendon stretching exercises
•Activity modifications
•In severe condition, a short leg walking cast can be used.

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