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AI-Generated response:

What is the preferred treatment for calcaneal apophysitis (Sever disease)?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Preferred treatments for calcaneal apophysitis (Sever disease) include rest, shoe corrections, heel lifts, gentle stretching, physical therapy, and NSAIDs.

Corticosteroid injections may be used cautiously due to potential side effects such as skin atrophy or depigmentation.[1-2]

  • Rest and modification of activities to reduce stress on the heel.

  • Use of shoe corrections or orthotic devices to provide better heel support and reduce pain.

  • Application of heel lifts can help alleviate tension on the Achilles tendon.

  • Gentle stretching exercises for the calf muscles to reduce tightness and strain on the heel.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to manage pain and inflammation.

Additional info

The management of calcaneal apophysitis should be tailored to the individual patient's symptoms and activities. Physical therapy, as a non-invasive treatment, often includes exercises that focus on stretching and strengthening the surrounding muscles, which can help alleviate the stress on the heel. Orthotic devices, such as heel raise inlays, can provide significant relief by supporting the arch and reducing the strain on the growth plate of the heel. NSAIDs are effective for pain management but should be used judiciously due to potential side effects like gastrointestinal discomfort or increased risk of bleeding. Corticosteroid injections, while beneficial in some cases, should be administered by an expert due to risks of complications like fat pad atrophy or plantar fascia rupture. It's important to discuss these options with patients and their parents to determine the most appropriate and acceptable treatment plan based on the severity of symptoms and lifestyle impacts.[1-2]

References

Reference 1

1.

Biundo, Joseph J., Canoso, Juan J. (2024). In Goldman-Cecil Medicine (pp. 1742). DOI: 10.1016/B978-0-323-93038-3.00242-2

Management includes NSAIDs (Table 26-4), rest, shoe corrections, heel lift, gentle stretching, and sometimes a splint with slight plantar flexion. Corticosteroid injections by an expert are also beneficial.The treatment should be followed by calf-muscle exercise therapy.Platelet-rich plasma injection is of no benefit.

Reference 2

2.

Wiegerinck JI, Zwiers R, Sierevelt IN, et al. Journal of Pediatric Orthopedics. 2016;36(2):152-7. doi:10.1097/BPO.0000000000000417.

Publish date: March 2, 2016.

Each treatment modality showed significant improvement of all outcome measures during follow-up (P<0.005). No clinical relevant differences were found between the respective treatment modalities at final follow-up. CONCLUSIONS: Treatment with wait and see, a heel raise inlay, or physical therapy each resulted in a clinical relevant and statistical significant reduction of heel pain due to calcaneal apophysitis. No significant difference in heel pain reduction was found between individual treatment regimes. Calcaneal apophysitis is effectively treated by the evaluated regimes. Physicians should deliberate with patients and parents regarding the preferred treatment.

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