CHILDREN’S HEALTH: SORE HEELS
Symptom: Pain and tenderness
Home care: Pad the heels of the child’s shoes and temporarily restrict activities such as running and jumping.
Precautions
- Inability to move the foot up and down may indicate a torn Achilles tendon and needs medical attention.
- Have the child see a doctor if home treatment does not promptly relieve the pain of Sever’s disease.
- Pain may recur following a new injury. Repeat the treatment.
Painful heels are a common complaint before and during adolescence. Almost 90 percent of the time the pain is due to injury of the bony growth plate near the back of the heel bone (calcaneus). The injury is called Sever’s disease and may be due to a direct blow caused by the heels pounding the ground, or to the calf muscles pulling on the Achilles tendon and the back of the heel bone.
Signs and symptoms
In Sever’s disease, one or both heels hurt when walking and are tender to the touch on both sides and the bottom of the heel bone (about one to two centimeters away from the back of the heel). The heels are not swollen or red; the skin over the heels shows no abnormality. The diagnosis is based on the presence of pain and tenderness at the heel and the absence of other symptoms. Note that other problems that cause pain at the heel also cause other symptoms. For example, infection of the heel bone (osteomyelitis) produces severe pain that intensifies over time, redness and swelling of the infected heel, and a low-grade fever. Blisters, plantar warts, and wounds of the heel can also cause sore heels.
Home care
To relieve pain from Sever’s disease, pad the heels of all of your child’s shoes with a heel pad and temporarily restrict activities that involve running and jumping. Even if a child has pain in only one heel, be sure to pad the heels of both shoes.
Precautions
• If your child can’t move the affected foot up and down (by rising on tiptoes), he or she may have a torn Achilles tendon. Do not attempt home care. The child should see a doctor.
• With the proper home treatment Sever’s disease should subside in four to six weeks; however, pain should cease as soon as the heels of the shoes are padded, and if the pain isn’t promptly eased you should take your child to the doctor. • Pain may recur following a new injury. Don’t worry; just repeat the treatment.
Medical treatment
After a careful examination to rule out other causes of pain, your doctor will follow the same steps as you do in home treatment. If Sever’s disease is severe, the doctor will immobilize the ankles. X rays are seldom required.
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