Sever's Disease: A Complete Guide to Understanding, Preventing, and Treating It

Many children between the ages of 5 and 14, especially those who play sports, may complain of heel pain. This condition could be Sever's disease, an inflammation that affects the growth plate of the heel. Although temporary, it can cause significant discomfort and affect a child's mobility. In this guide, we'll explore what Sever's disease is, how to recognize it, the best treatments, and how to prevent it.

What is Sever's Disease?

Sever's disease is a nonspecific term for osteochondrosis of the calcaneal cartilage-ossification nodes, or more commonly, heel osteochondrosis in children. In children still undergoing growth spurts, inflammation occurs at the back of the heel. Because the heel bone is not yet fully mature, the Achilles tendon places excessive strain on it. Pain develops with local swelling, and in extreme cases, walking may become too painful for the patient.

These are the main causes of Sever's disease. Excessive pressure on the heel can promote inflammation, likely through intense activities and sports such as football, basketball, and running, among others. Poorly fitting shoes, or those lacking adequate cushioning or support, can also contribute to the problem. Another risk factor is obesity, as excess weight increases pressure on the foot.

The main symptoms therefore include heel pain, mostly resulting from physical activities with difficulty walking.

Risk Factors for Sever's Disease

Those with flat feet or high arches tend to distribute weight unevenly across their feet, which increases pressure on the heel area. Children who participate in sports that require repetitive heel impacts, such as running and jumping, may also be among the most prone to developing the problem. Family history also plays a role, as a family history of orthopedic problems increases the risk of developing Sever's disease.

The impossibility of completely eliminating the risk of heel spurs comes down to a series of measures. Primarily, avoiding excessive pressure on the heel cancels out the effect of body weight, so it's very important to prevent it. Furthermore, anti-inflammatory footwear with adequate cushioning and support reduces the risk.

Diagnosis of Sever's Disease

Sever's disease is diagnosed primarily through a clinical examination. The doctor examines the foot and checks for pain when pressing on the heel area. To rule out other conditions, such as fractures or bone infections, an X-ray may be ordered. In rare cases, an ultrasound or MRI may be useful to confirm inflammation and evaluate any complications.

Treatment of Sever's Disease

Although only temporary, the essential aspect of a treatment regimen for Sever's disease includes plenty of rest. Other very important measures to take are avoiding any activity that would cause more pain and applying ice to the underlying area to reduce inflammation and swelling. If the pain is excessive, your doctor may prescribe medications to reduce pain and inflammation, such as ibuprofen or acetaminophen.

Physical therapy may help strengthen the foot and calf muscles, normalizing posture and relieving stress on the Achilles tendon. Orthotics may also be helpful; furthermore, pain relief may be achieved by restoring normal foot biomechanics with the use of heel cups. Sometimes, a support may be needed to help stabilize the foot for a short time during the acute period to remove all stress from the inflamed area.

Complications of Sever's Disease

If Sever's disease is not treated properly, complications can arise. Persistent pain can alter the gait pattern, placing excessive stress on other parts of the foot and leg. In some cases, overloading can lead to stress fractures or Achilles tendinitis . Bursitis, the inflammation of the bursa near the heel, can also develop if the problem is not properly addressed.

In children with a genetic predisposition, chronic inflammation may contribute to abnormal bone growth, affecting posture and mobility. Fortunately, in most cases, Sever's disease tends to resolve spontaneously with growth, as the heel bone fully develops and the inflammation subsides.

SmartHallux: The Role of Physicians in Treating Sever's Disease

If heel pain is severe and does not improve with rest, it is a good idea to consult a doctor to find out the specific treatment that will help avoid complications. 

Dr. Luigi Manzi is one of the world's most qualified specialists in foot and ankle pathologies and treatments. Thanks to his experience and the support of the SmartHallux team , patients can receive an accurate diagnosis and personalized treatment to best address Sever's disease. If your child suffers from heel pain and persistent discomfort, making an appointment with a specialist is the first step toward recovery. Book your specialist video consultation with Dr. Luigi Manzi now.