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Merck Manual

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Sever Disease

(Sever's Disease; Epiphysitis of the Calcaneus)


Frank Pessler

, MD, PhD, Hannover, Germany

Last full review/revision Oct 2020| Content last modified Oct 2020
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Sever disease is inflammation of the growth plate of the heel bone (calcaneus) in growing children.

Children's bones grow from soft areas of cartilage near the ends of bones. These areas are called growth plates. When children have finished growing, growth plates become solid bone. After growth plates become solid, bones do not grow in length.

Locating the Heel Bone

The heel bone (calcaneus) is located at the back of the foot.

Locating the Heel Bone

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 Achilles tendon excessively 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 and splints or a cast

Heel pads relieve pain by reducing the pull of the Achilles tendon on the heel. Splints may be worn at night to 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 of Sever disease may last several months.

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