What is Sever condition?

Sever 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 condition is at the point where the Achilles tendon attaches to the back of the heel bone.

What causes Sever condition?

Sever 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 condition?

Sever 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 condition also causes tenderness and swelling in the area of the pain.

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

Who gets Sever condition?

Sever 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 condition, such as ankylosing spondylitis and other forms of arthritis. Usually Sever condition is self-limited; that is, it disappears as the child ages.

How do health care professionals diagnose Sever condition?

Sever 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 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 condition? How long does it last?

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

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Medically Reviewed on 8/17/2018
References
Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia: Lippincott Williams & Wilkins, 2003.
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