Many times children's heel pain is dismissed and assumed it is part of growing pains. This is often not the case, and it should always be evaluated by a pediatric podiatrist in order to make sure that there are no red flags for something more serious going on.
Children's heel pain can be the result of Achilles Tendinitis, a heel fracture, Juvenile Idiopathic Arthritis, or in most cases, a condition called Sever's disease.
Sever’s disease accounts for over 90% of the children’s heel pain cases we see and is the #1 cause of heel pain in kids.
In this episode Dr. Mikkel Jarman discusses children's heel pain and possible causes and treatments.
Dr. Mikkel Jarman:
Hello. I'm Dr. Mikkel Jarman here with Pediatric Foot & Ankle, and today I'd like to discuss the topic of pediatric heel pain and try to educate you, the parent, regarding the many different causes that contribute to your child's pain. To be clear, pediatric heel pain and adult heel pain are NOT the same and are not treated the same. Children do not get plantar fasciitis and children should not be getting steroid injections into the heels as a form of treatment. So be very skeptical if this is ever recommended. Pediatric heel pain is not the diagnosis, it is a symptom of some other underlying condition. Pain in your child's heel that will not go away is a warning sign that deserves attention. Other associated signs and symptoms are seen as your child may start to limp, start walking on their toes or their sides of their feet.
Dr. Mikkel Jarman:
They may have difficulty participating in ground and pound activities or sports. And of course they will have pain in the back or bottoms of their heels. This pain may be found in one or in both of the heels. In clinic, I see two to three new children every day specifically for heel pain and I will say 90% of them are experiencing a condition called Severs. This is a syndrome of calcaneum apophysitis affecting 8 to 14 year olds where the growth plate on their heels has been injured. I would advise every parent to watch my video on Severs to better understand what Severs is, how to diagnose it, and the most effective treatments. The second most common condition is Achilles Tendinitis along the course of the back of the leg, specifically at the insertion into the calcaneus, often referred to as an emphasis opposite.
Dr. Mikkel Jarman:
Also, close to this location is a large bursal sac, a retrocalcaneal bursitis that can be irritated by trauma or a possible underlying bone abnormality or secondary to a high arched foot. In the office we utilize digital x-rays that allow us to see the skeletal bone structure and to identify if there are any fractures, bone cysts, or joint abnormalities. A good clinical exam of the foot, ankle and leg will also help to rule out any infections or masses on the heel that may be causing this discomfort. A good standing and gait evaluation would also help to determine if there was a limb length discrepancy with one leg longer than the other. And this is not as uncommon as one would think. Unfortunately, there are also other conditions such as spondyloarthropathies, which are pediatric arthritities that exist and mimic all of these findings just described and are often found by exclusion and may require a thorough workup from a pediatric rheumatologist. The number of possible causes of pediatric heel pain can be extensive. They're all treated differently, but most can be remedied with a custom orthotic to alter the pressure to the heel and change the gait of your child. I cannot stress how important an accurate diagnosis can be, and how important it for the parent and child to understand the condition and treatment options. If your child is suffering with heel pain and current treatment is not resolving their condition, please call our office today and have your child evaluated. I'm Dr. Mikkel Jarman.