Heel pain in children and adolescents : differentials

Heel pain is a relatively common complaint among young children and adolescents, often causing concern for both parents and healthcare providers. However, it's important to note that the majority of causes of heel pain in this age group are benign and self-limiting.

The most prevalent cause of heel pain in children and adolescents is Calcaneal Apophysitis, commonly known as Sever's Disease. This condition is primarily an inflammation of the growth plate in the heel. It occurs due to the traction of the Achilles tendon on the calcaneal apophysis, an area of the heel bone that is not yet fully ossified in children and young adolescents. This traction, especially during periods of rapid growth, results in inflammation and pain [Joseph and Labib, 2013].

Typically, affected individuals are between the ages of 8 and 12 years. They present with symptoms of posterior heel pain that is closely associated with physical activity or a recent growth spurt. This pain generally improves with rest and is exacerbated by activities that place strain on the heel [Davison et al, 2016; Tu, 2018].

Management of Calcaneal Apophysitis is predominantly conservative. It involves simple measures such as reassurance, rest, and avoidance of activities that worsen the symptoms....