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No response to treatment for Sever's disease

Discussion in 'Ask your questions here' started by Unregistered, Sep 8, 2010.

  1. Unregistered

    Unregistered Guest


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    My 13 year old son was diagnosed with Sever's Disease 4 years ago. He had few symptoms until last fall. Though he has it in both heels, he only has symptoms in the left. He is a soccer player. Last year he had 2 bouts with it, and in the spring the orthopedist put him in a boot for 3 weeks, followed by PT. He recovered in approximately 6 weeks with reduced pain immediately upon wearing the boot.

    He again had a flare up 6 weeks ago. We saw a different orthopedic doctor who prescribed PT. We are seeing the same therapist we saw last year. It is now almost 6 weeks later and my son is in constant pain, unable to bear weight on his left heel at all, no soccer, no playing with friends because of the pain. We've tried the boot and he was unable to tolerate it touching his heel. He's been on crutches for almost 2 weeks now. The therapist is also concerned with the lack of progress so we returned to the dr. Her response was to refer my son to a pain specialist as she considers his pain level not to "match" the condition. X-rays done 4 weeks ago showed significant inflammation. The therapist said there is still inflammation yet the dr. says not. I asked if an MRI might show something that the x-rays didn't and was told there is nothing an MRI would show. The dr. said he can wear the boot or not, he can use crutches or not, it's up to us. I feel a loss of confidence in this dr. because she essentially told us there is nothing she can do for our son.

    He has been taking 2 Aleve daily, icing 3x/day, active ROM exercises of his ankle, as well as calf and hamstring stretches at home. PT 2x/week is limited to these exercises as well as electrical stimulation, massage, and icing due to his pain.

    We are at a loss as to how to help our son. He is beginning to suffer mentally, as he is a naturally active boy. Should we see a podiatrist rather than the ortho/sports med dr.? He wears Superfeet inserts due to pronation as well as Tuli's gel heel cups for the Sever's in his regular shoes and soccer cleats. Might accupuncture help reduce pain?

    Any suggestions or help would be greatly appreciated.
     
  2. FootDoc

    FootDoc New Member

    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, OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
    ***************************************************
    The potential for Severe's disease ends when the calcaneal apophysis closes. As your son is now 17 years old, and the average age for skeletal maturity in males is 16-18 years (although some can be earlier or later), there is probably not much time before the condition becomes self-limiting, assuming that the diagnosis has been correctly made. As I'm sure most treatment approaches for Sever's disease have been exhausted, if I were you, if it has not already been done with certainty, I would have the diagnosis independently re-evaluated with an eye to finding other possible causes of the pain. In my opinion, x-rays and MRI's do not reflect an accurate measure for the diagnosis and assessment of Severe's disease.
     
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