What treatment options are effective for calcaneal apophysitis?

• A. Only surgical intervention
• B. Rest, heel cups, NSAIDs, and stretching
• C. Physical therapy and cortisone injections
• D. None, it requires observation only

Answer: (B)

Calcaneal apophysitis, commonly known as Sever's disease, is a condition that affects growing children and adolescents, resulting from inflammation of the growth plate in the heel. The treatment options that are effective for this condition primarily focus on relieving pain and reducing inflammation, rather than surgical intervention.

Rest is crucial in the management of calcaneal apophysitis, as it allows the inflamed area to heal. Heel cups can provide cushioning and support, helping to alleviate stress on the heel during activities. Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in reducing pain and inflammation, making them a common choice for treatment. Stretching exercises, particularly for the Achilles tendon and calf muscles, can help alleviate tension in the area, further reducing discomfort.

In contrast, surgical intervention is typically not indicated for calcaneal apophysitis as the condition is self-limiting and generally resolves with conservative treatment. Physical therapy can be beneficial, but it is not as universally effective as the combination of rest, heel cups, NSAIDs, and stretching. Cortisone injections are generally not recommended for children due to potential side effects and the risks associated with injecting steroids into a growth plate. Observation alone is also not sufficient, as active