Sever’s Disease

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Patient Information

http://www.orthobullets.com/pediatrics/4074/severs-disease

GP Information

Background Information

  • A common cause of heel pain due to overuse of the calcaneal apophysis in a growing child.
  • Classically seen in immature athletes.
  • Patients typically complain of activity related pain at the calcaneal apophysis +/- inflammation.
  • Examination may reveal a tight achilles tendon with pain to direct palpation over the calcaneal apophysis.

Investigation Guidelines

  • Severs disease is a clinical diagnosis. Diagnostics are not required prior to treatment or referral.

Management Recommendations

Initial management is symptomatic:

  • Avoid precipitating activities.
  • Regular Achilles tendon stretching.
  • Apply ice before and after sport.
  • Short course NSAIDs.
  • Heel pad.
  • Formal physiotherapy.

Referral Indications

  • Diagnostic uncertainty.
  • Failure of minimum 3/12 conservative measures.
  • Referral for physiotherapy / orthotics.