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Sever Disease

(Sever's Disease)

By David D. Sherry, MD, Professor of Pediatrics; Director, Clinical Rheumatology, University of Pennsylvania; The Children's Hospital of Philadelphia
Frank Pessler, MD, PhD, Helmholtz Centre for Infection Research; Hannover Medical School, Braunschweig, Germany; Hannover, Germany

Sever disease is inflammation of the heel bone (calcaneus).

The heel bone develops until about age 15. A child (usually aged 9 to 14) who is athletically active may develop Sever disease if the calf muscle and tendon (Achilles) pull on their point of attachment to the immature heel bone.

Pain affects the sides or margins of the heel and is aggravated by standing on tip toes or running. Some children have warmth and swelling. Doctors base the diagnosis on the symptoms. X-rays cannot make the diagnosis of Sever disease but may help identify other causes of heel pain such as bone cysts or stress fractures.

Heel pads relieve pain by reducing the pull of the Achilles tendon on the heel. Splints may be worn at night to passively stretch the calf muscles, helping maintain flexibility. In more severe cases, a cast may be recommended to immobilize the area. This treatment relieves pain and stretches the calf muscles. Symptoms may last several months.