Pediatric Heel Pain

What Is Pediatric Heel Pain?
Heel pain is a common childhood complaint. That doesn’t mean, however, that it should be ignored, or that parents should wait to see if it will “go away.”Heel pain is a symptom, not a disease. In other words, heel pain is a warning sign that a child has a condition that deserves attention.

Heel pain problems in children are often associated with these signs and symptoms:

• Pain in the back or bottom of the heel
• Limping
• Walking on toes
• Difficulty participating in usual activities or sports

The most common cause of pediatric heel pain is a disorder called calcaneal apophysitis (see below),which usually affects 8- to 14-year olds. However, pediatric heel pain may be the sign of many other problems, and can occur at younger or older ages.

What Is the Difference Between Pediatric and Adult Heel Pain?
Pediatric heel pain differs from the most common form of heel pain experienced by adults (plantar fasciitis) in the way pain occurs. Plantar fascia pain is intense when getting out of bed in the morning or after sitting for long periods, and then it subsides after walking around a bit. Pediatric heel pain usually doesn’t improve in this manner. In fact, walking around typically makes the pain worse.

Heel pain is so common in children because of the very nature of their growing feet. In children, the heel bone (the calcaneus) is not yet fully developed until age 14 or older. Until then, new bone is forming at the growth plate (the physis), a weak area located at the back of the heel. Too much stress on the growth plate is the most common cause of pediatric heel pain.

Causes of Pediatric Heel Pain
There are a number of possible causes for a child’s heel pain. Because diagnosis can be challenging, a podiatric foot and ankle surgeon is best qualified to determine the underlying cause of the pain and develop an effective treatment plan.

This information has been prepared by the Consumer Education Committee of the American College of Foot and Ankle Surgeons, a professional society of 5,700 podiatric foot and ankle surgeons. Members of the College are Doctors of Podiatric Medicine who have received additional training through surgical residency programs. The mission of the College is to promote superior care of foot and ankle surgical patients through education, research and the promotion of the highest professional standards.

Copyright © 2004, American College of Foot and Ankle Surgeons, www.acfas.org