Severs disease, also known as calcaneal apophysitis, is a common cause of heel pain primarily seen in children. Adults do not typically develop Severs disease. This article explains why and explores common causes of adult heel pain.
Understanding Severs Disease
Severs disease affects the heel bone. It is an inflammatory condition impacting the growth plate at the back of the heel. This cartilaginous area allows new bone to form and lengthen. The condition occurs primarily in children and adolescents, typically between 8 and 14, who are undergoing rapid growth spurts. Repetitive stress from activities like running and jumping can place tension on the Achilles tendon, which attaches near this vulnerable growth plate, leading to inflammation and pain.
Why Severs Disease Does Not Affect Adults
Adults do not develop Severs disease because of the nature of growth plates. These cartilaginous areas, present at the ends of long bones in growing individuals, facilitate bone development. As a person matures, typically by late adolescence or early adulthood, these growth plates undergo fusion. During fusion, cartilage is replaced by solid bone, effectively closing the growth plate. Without an active growth plate in the heel, the specific inflammation and microtrauma characteristic of Severs disease cannot occur. Adult heel pain therefore stems from different underlying causes than those seen in growing children.
Common Causes of Adult Heel Pain
One of the most frequent causes of adult heel pain is plantar fasciitis, an inflammation of the plantar fascia. This thick band of tissue runs along the bottom of the foot, connecting the heel bone to the toes, and helps support the foot’s arch. Plantar fasciitis often causes a stabbing pain near the heel, particularly noticeable with the first steps in the morning or after periods of rest, and can be aggravated by prolonged standing or activity. Factors like overuse, inadequate footwear, or excessive body weight can contribute to its development.
Another common condition is Achilles tendinitis, which involves inflammation of the Achilles tendon, the strong cord connecting the calf muscles to the heel bone. Pain from Achilles tendinitis is typically felt at the back of the heel, often worsening with activity. Overuse, sudden increases in physical activity, or tight calf muscles are common contributors to this type of heel pain.
Heel spurs are bony growths that can form on the underside of the heel bone. While often associated with plantar fasciitis, heel spurs themselves are not always the source of pain. They can develop over time due to chronic strain on the foot’s ligaments and muscles.
Stress fractures are tiny cracks in a bone, frequently occurring in the heel bone due to repetitive force or overuse. This type of fracture can result from activities that place repeated stress on the foot, such as increased training intensity or prolonged impact. Pain from a stress fracture typically worsens with activity and improves with rest.
When to Seek Professional Medical Advice
If you are experiencing persistent heel pain, it is advisable to consult a healthcare professional. Seek medical attention if the pain is severe, worsens over time, or interferes significantly with daily activities. Other concerning signs include swelling, bruising, numbness, or tingling in the affected foot. An accurate diagnosis is important for determining the specific cause of your heel pain. Early intervention can help manage symptoms effectively and prevent potential long-term complications.