Sever’s Disease

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.