Orthopedics - Oleksa A.P. 2006

Limb Pain Syndromes
Calcaneal Apophysitis

Heel pain in children may be caused by apophysitis (Sever's disease), which typically flares up when the child gets out of bed and starts to walk. After walking around for a bit, the pain subsides, only to return after a prolonged period of sitting.

Despite the similarity of these symptoms to those of a heel spur, children generally do not develop spurs. Parents often attribute the pain to a potential injury, although the children deny any trauma.

Unlike a heel spur, calcaneal apophysitis presents with tenderness upon pressure localized to the posterior region of the heel, specifically at the apex of its posterior surface. X-rays typically reveal no pathological Changes in the apophysis, though minor irregularities and a "feathery" appearance are very rarely observed.

Treatment for calcaneal apophysitis is conservative, involving heel offloading with arch Supports or specialized orthopedic footwear, UHF therapy, overnight ozokerite-paraffin Applications, and calf Muscle stretching exercises.

With proper treatment, apophysitis ceases to bother the patient, and once the apophysis fuses with age, the heel pain does not recur.



Last update: 10/08/2026

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