What is Sever's condition?

Picture of the metatarsal (foot) and calcaneus (heel) bones, the plantar fascia ligament, and the Achilles tendon of the lower leg and foot
Picture of the metatarsal (foot) and calcaneus (heel) bones, the plantar fascia ligament, and the Achilles tendon of the lower leg and foot

Sever's condition is an inflammation of the growth plate of the bone at the back of the heel (apophysitis of the calcaneus). The inflammation of Sever's condition is at the point where the Achilles tendon attaches to the back of the heel bone.

What causes Sever's condition?

Sever's condition is caused by sprain injury where the Achilles tendon attaches to the calcaneus bone at the back of the heel.

What are signs and symptoms of Sever's condition?

  • Sever's condition causes pain at the back of the heel.
  • The pain is increased with plantar flexion of the ankle (pushing down with the foot as if stepping on the gas), particularly against resistance.
  • Sever's condition also causes tenderness and swelling in the area of the pain.
Heel Spurs

Sever's Condition Symptom

Heel Pain

Pain in the heel can result from a number of factors. Abnormalities of the skin, nerves, bones, blood vessels, and soft tissues of the heel can all result in pain. Because of walking and daily movement, we are always at risk for injury or trauma to the heel area. Common causes of pain in the heel include blisters and corns. Plantar fasciitis, inflammation of the "bowstring-like" tissue in the sole of the foot stretching from the heel to the front of the foot, is one condition commonly associated with heel pain. Sometimes diseases that affect other areas of the body, like peripheral vascular disease or arthritis, can also result in pain in the foot or heel. Sever's disease is a cause of heel pain in children that results from injury to the growth plate of the heel bone. Treatments for heel pain depend on the particular cause.

Who gets Sever's condition?

  • Sever's condition occurs in adolescent or older children, particularly active boys.
  • It can be very painful.
  • It is one of those conditions commonly referred to as "growing pains."
  • Patients are evaluated for signs of conditions that can mimic Sever's condition, such as ankylosing spondylitis and other forms of arthritis.
  • Usually, Sever's condition is self-limited; that is, it disappears as the child ages.

How do health care professionals diagnose Sever's condition?

Sever's condition is diagnosed by detecting the characteristic symptoms and signs above in the older children, particularly boys between 8 and 15 years of age. Sometimes X-ray testing can be helpful as it can occasionally demonstrate irregularity of the calcaneus bone at the point where the Achilles tendon attaches.

What is the treatment for Sever's condition?

When the condition flares, it is treated

  • with activity limitation,
  • medication to reduce inflammation (such as ibuprofen [Advil] or naproxen [Aleve]),
  • shoe inserts,
  • heel lifts,
  • cold packs, and
  • sometimes casting when it becomes especially severe.

What is the prognosis of Sever's condition? How long does it last?

Sever's condition is generally a self-limited problem that usually improves within a year.

QUESTION

The term arthritis refers to stiffness in the joints. See Answer

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Medically Reviewed on 1/29/2020
References
Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.
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