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Sever's Disease in young child

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  #1  
Old 9th August 2008, 04:16 AM
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Default Sever's Disease in young child

My son started showing signs of Sever's Disease as a two-year-old. That is when his left heel first became painful to touch. Since he was taking gymnastics classes, it was first diagnosed as a sports related injury. The pain never improved and by the time my son was four, you couldn't touch the back of his left heel without causing him to scream from pain. At this point, we were referred to a specialist and Sever's was diagnosed. My son is now seven and still is in daily pain. My son has not been pain free for even one day since this started. His heel always has the bump from inflammation on the back. His heel always hurts to be touched. We've had to explain to his teachers and care givers that if he screams suddenly and loudly, it is probably because he hit his heel on something. We stopped the gymnastics and he now only plays baseball in the spring for 3 months. He is in no other sports.

He is scheduled to have an MRI on his foot soon. Both my regular pediatrician and the specialist said it is unusual for a child to suffer from Sever's at such a young age. Are there any resources you can direct me to for more information about treatment options? Do you know of any studies that looked at the Sever's in very young children? My son's doctors are great and we have followed their advice for restricting activity, performing stretching exercises, etc. but I want to educate myself about additional treatment options if they exist. Thank you!
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  #2  
Old 9th August 2008, 05:10 AM
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Default Re: Sever's Disease in young child

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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Due to the stated age at onset, my first thought is to question the diagnosis, and therefore I am reluctant to delineate specific treatments for Sever's. But there is certainly adequate information on such treatment options on the Internet which can be easily found with any search engine. Certainly, if your son does indeed have unremitting Sever's pain, it would be inappropriate for him to be playing baseball or engaging any sport or activity requiring running and/or jumping.
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  #3  
Old 20th August 2008, 05:07 PM
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Default Re: Sever's Disease in young child

I appreciate your prompt response and I've thought about this situation for several days before replying. I know you cannot give me advice concerning treatment. I was asking to be directed to other sources of information not readily found when doing a basic search on the Internet concerning Sever's in very young children. I've spent hours doing general web page searching, using some great medical databases available with my public library card, etc. but I haven't been able to locate any studies done that look specifically at Sever's in young children. Do you know of any? We have tried all the traditional treatments that are described on the web and by our doctors. Are any doctors in the world trying to find new ones? Are any studies being done?

My husband and I decided that we wouldn't restrict our son from all sports because he is in pain all year round and it is not practical to keep an active, otherwise healthy seven-year-old from running occassionally. We would have to strap him in a wheelchair with restraints to keep him from running and jumping everyday. We don't want to do that. We also don't want inactivity to cause any weight problems so common in children today. According to our pediatrician, our son is at an ideal weight for his height and size.

Playing baseball doesn't cause the pain to increase. He has played two years of t-ball and this year he played coach pitch -- definitely not as stressful to his body as major league baseball. He stands in the outfield most of the time and often needs reminded to keep his glove on and stop picking grass. He is in the same amount of pain in the middle of a winter in Ohio when he doesn't get nearly as much daily exercise. To prevent him from being active as a method to reduce the pain, would cause him social problems at school. He would be the odd kid in the class who couldn't go out to recess or participate in gym.

All of his symptoms point to Sever's. Maybe that diagnosis is wrong. But if not, my son has many more years of pain ahead of him. The information I read on the Internet make it sound like something that is easily treated in a few weeks or months and is not a major concern/problem. For my son, it is serious, and I am trying to find out if any doctors and/or researchers are looking for new treatments.

If you can post the titles and pertinent information of any recent articles or research reports on Sever's, I can try to request them through my local libraries if they are not available to the public online. Thanks so much!
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  #4  
Old 20th August 2008, 05:54 PM
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DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.

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I would still tend to question the diagnosis due both to the age at onset and the seeming complete lack of beneficial effect after many years of standard treatment. I doubt that medical literature is going to tell you anything that has not already been said and tried over the years. I woud advise that if top notch specialized care for children's foot problems is not available in your locale, you find out where it might be obtained and take your child there for another opinion.
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  #5  
Old 21st August 2008, 04:45 AM
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Default Re: Sever's Disease in young child

I too doubt it Sever's disease at two years of age.

There is lot in Sever's disease at Podiatry Arena
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  #6  
Old 26th August 2008, 04:40 AM
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Default Re: Sever's Disease in young child

Thank you for the link to the podiatry arena! Although I need a medical dictionary to comprehend all that I read, I did understand enough to know we haven't tried everything yet. What are NSAIDS? What is the "dumbed-down" explanation of a recalcitrant case?

In some of the posts, doctors mentioned putting patients with severe cases in casts for a few weeks. I'll ask our doctor about that option. It did depress me a little, though, reading the posts. One post suggested the condition can become chronic if not treated aggressively enough in the beginning. Maybe that is what happened in my son's case. Between the ages of 2 and 4 we could have "missed the boat" by not selecting his shoes more carefully, not using heel lifts in his shoes or not icing his heel twice a day for 20 minutes, etc. During that time, we were told by his general pediatrician to just limit his activity (take him out of tumbling classes at the YMCA) and give him over-the-counter pain relief when he was really hurting. My husband and I had never heard of Sever's and didn't understand why his heel hurt all the time. We assumed he strained it in gymnastics.

If it is truly not Sever's, then I know to keep asking questions and looking for the right specialist until an accurate diagnosis is made.

Tomorrow my son is being fitted for a rigid heel cup/protector. He is suppose to wear it inside his shoe. It was being made to also correct pronating (sp?) on that foot when he walks. Next week he gets his MRI. Hopefully he will soon be pain free. I really appreciate the responses and am so glad I found this forum!!!
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  #7  
Old 3rd September 2008, 03:18 PM
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Default Re: Sever's Disease in young child

If your son has unremitting night pain, which settles with junior aspirin, I would be considering osteoid osteoma as a potential diagnosis
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  #8  
Old 6th February 2009, 10:20 AM
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Default Re: Sever's Disease in young child

Hi Doc,

My son is 10 and is what I would consider - VERY active. Soccer every day at school in school shoes and plays during the season. (if it helps, we live in quite a dry country so the ground would tend to be quite hard)

He plays soccer and has started complaining about a sore heel. He showed me the plantar side of his foot and traced around the whole plantar aspect of the heel. He said it was a bit sore when I squeezed at the sides and into the foot.

He said it is worse after playing soccer.

My podiatrist will be seeing him next week but he mentioned Sever's disease.

I hope I given you enough info but what do you think?
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Old 6th February 2009, 02:24 PM
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Default Re: Sever's Disease in young child

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
************************************************** *********
What I think is that owing to his age, his activity, and the fact that pain is produced by lateral squeezing, I assume of the back of the heel, Sever's (calcaneal apophysitis) is a relevant thought. Sever's is a self-limiting condition involving inflammation of the posterior growth center (apophysis) of the heel and is very common in active children. With or without treatment, it resolves when the apophysis closes in the mid to later teens. Treatment may be merely rest and avoidance of the triggers of the condition, but may also require such as orthotics, heel pads and even casting. It is premature to consider any of the above, as he has not been adequately diagnoses. But if it is Server's, you might be prepared for recurrences and probably his need to avoid running and jumping well beyond any initial relief brought on by treatment. Good luck!
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  #10  
Old 13th February 2009, 01:42 PM
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Default Re: Sever's Disease in young child

Hi Doc,

Been to podiatrist and he has diagnosed Sever's.
Thanks for your ideas.
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  #11  
Old 1st April 2009, 06:32 PM
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Default Re: Sever's Disease in young child

It has been a long journey since I last posted about my son's heel pain in August '08. You were right to suspect Sever's disease was not the cause of his pain since he was so young at onset of symptoms. After two MRIs, two ultrasounds, and a genetics consultation, my son has been diagnosed with Neurofibromatosis (NF). His pain is from tumors growing on his nerves. The doctors told us there are too many tumors in his left foot to count them all. Most are very small but the larger ones are causing him significant pain.

We have tried one experimental procedure that wasn't effective so now we are trying another which leads me to ask...

Does anyone have experience with Radio Frequency Ablation? I've read it has been used to treat pain caused by arthritis. If you have used this treatment, was it beneficial?

Thank you!
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  #12  
Old 1st April 2009, 09:06 PM
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Default Re: Sever's Disease in young child

Quote:
Originally Posted by Unregistered View Post
It has been a long journey since I last posted about my son's heel pain in August '08. You were right to suspect Sever's disease was not the cause of his pain since he was so young at onset of symptoms. After two MRIs, two ultrasounds, and a genetics consultation, my son has been diagnosed with Neurofibromatosis (NF). His pain is from tumors growing on his nerves. The doctors told us there are too many tumors in his left foot to count them all. Most are very small but the larger ones are causing him significant pain.

We have tried one experimental procedure that wasn't effective so now we are trying another which leads me to ask...

Does anyone have experience with Radio Frequency Ablation? I've read it has been used to treat pain caused by arthritis. If you have used this treatment, was it beneficial?

Thank you!
Although symptoms may present in the feet, neurofibromatosis is not a foot condition, and I don't think you'll obtain much health in this forum. I would advise checking with the Children's Tumor Foundation. They have a web site at http://www.ctf.org/
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  #13  
Old 23rd July 2010, 01:18 PM
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Default Re: Sever's Disease in young child

I really do not think the bumps on the heel is really a big problem. When I was eleven, I had Sever's and I have had bumps on my heel ever since.
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  #14  
Old 23rd July 2010, 02:58 PM
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Default Re: Sever's Disease in young child

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.

************************************************** *********
It is probably the case that the bumps on your heel have and had nothing to do with Sever's, as that is not generally a finding associated with that condition or its aftermath.
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