If the child has heel pain, then this symptom should alert parents. This may be a sign of inflammatory diseases of the musculoskeletal system, which require immediate treatment. Also, discomfort in the foot area can often occur after trauma. With minor injuries, children may not experience pain in the early days. But the injury can affect the well-being of the child after some time. In the article we will consider the most common causes of pain and methods for treating pathologies.
Natural causes
Often, a child's heels are sore due to increased physical activity on their legs. An exacerbation of such symptoms is most often noted in the fall. During this period, children resume visiting sports after the summer. During long vacations and vacations, the legs wean from regular exercise. And the resumption of training can lead to the appearance of pain. Usually unpleasant sensations pass as the body adapts to the loads.
If the child has heel pain after playing sports, then this may indicate an excessively high physical exertion. In this case, the training intensity must be reduced, pay close attention to the diet. A deficiency in the body of calcium and vitamin D can provoke pain in the calcaneal region. Also, discomfort in the legs after sports is more likely to occur in overweight children and flat feet.
Uncomfortable shoes can also cause pain. In this case, you need to pick up the insole with arch support. This will help reduce the load on the foot when walking and running.
Pathological causes
However, there are cases when the discomfort in the feet does not disappear even after reducing physical activity and choosing comfortable shoes. Parents should be alarmed if their heels hurt for a long time. The cause of this may be various pathologies of the musculoskeletal system. Such diseases can be divided into several groups:
- Pathologies characteristic of childhood. These include osteochondropathy (Schinz disease), apophysitis, pineal gland, inflammation of the Achilles tendon. These diseases are often noted in children aged 7 to 12 years. During this period, the musculoskeletal system of the child continues to form. In this case, children usually lead a very active lifestyle. A large load on the fragile musculoskeletal system can provoke inflammatory diseases.
- Injuries. Often, parents suddenly notice that the child has a heel ache and it hurts to advance. The cause of this can be various damage. The calcaneus is quite fragile, and its trauma is not always accompanied by severe pain. Therefore, discomfort in the foot sometimes sometimes does not occur immediately after a fall or bruise.
- Diseases rarely seen in childhood. These include bursitis and calcaneal spur. These pathologies are more common in adults, but can also occur in children due to infections, metabolic disorders or excessive physical exertion. Plantar warts (tongs), which are rare in young children, also belong to the same group of diseases.
Next, we will consider in detail the symptoms and methods of treatment of the above pathologies.
Osteochondropathy
This pathology is also called Schinz disease. Calcaneus osteochondropathy is most common in girls 7–9 years old, and in boys 10–12 years old. The cause of the pathology is increased physical activity and calcium deficiency in the body.
In this disease, the absorption of nutrients in bone tissue is impaired. Because of this, necrotic changes in the calcaneus occur. This is accompanied by the following symptoms:
- pain in the heel, worse in the daytime when walking;
- swelling of the calcaneal region;
- limp (the child avoids stepping on a sore leg);
- malaise, fever;
- difficulty in flexion and extension of the foot.
In the acute stage of osteochondropathy, the foot needs complete rest. For fixation, use a plaster cast or a special splint with stirrups.
Physiotherapeutic procedures are prescribed:
- ultrasound;
- electrophoresis;
- applications with ozokerite.
In order to stop the pain syndrome, non-steroidal anti-inflammatory drugs are used in the form of ointments and tablets.
Epiphysitis
Often, parents notice that the child's heels hurt after training. This may be a sign of microdamage to the calcaneal cartilage - epiphysitis. This disease most often affects adolescent boys who play sports intensively. Vitamin D deficiency can provoke pathology. It has been established that children living in regions with a cold climate are especially susceptible to this disease. Due to the lack of ultraviolet exposure, the production of vitamin D by the skin is reduced. Therefore, this ailment is also called the disease of the North.
With pineal gland, the heel hurts when running, jumping and fast walking. At rest, the discomfort weakens. The pain is localized in the back and side of the heel, it intensifies when pressed. With severe damage to the cartilage, swelling and redness can occur. In advanced cases, the child can not bend the foot, begins to limp.
A sick child is recommended to wear orthopedic shoes with soft insoles, a pillow under the heel and an arch support. Prescribe a course of treatment with drugs with vitamin D and painkillers. Physiotherapeutic procedures are shown:
- electrophoresis with novocaine and calcium;
- massage;
- baths with therapeutic muds.
Epiphysitis has a favorable prognosis. Signs of this disease completely disappear in adulthood, since cartilage is ossified.
Apophysitis
There are times when pain is not observed at rest. Swelling in the foot area is almost absent. However, the child has a sore heel when walking. The cause of this may be an inflammatory process in the calcaneal cartilage - apophysitis.
This disease most often occurs in children under the age of 14 who are actively involved in sports. The cartilage in the child is quite weak and easily inflamed with increased load on the legs. Most often, this pathology appears in the puberty, when a teenager is growing rapidly.
Apophysitis is accompanied by the following symptoms:
- pain in the back and side of the heel;
- the occurrence of discomfort when walking;
- the disappearance of pain at rest;
- lack of puffiness (there may be only a slight swelling).
In the inflammatory process in the calcaneal cartilage, it is recommended to temporarily stop sports. A small patient is prescribed a course of physiotherapy and massage. Wearing special shoes with soft insoles is recommended. Drug therapy consists of prescribing anti-inflammatory drugs (for example, Ibuprofen) and complexes with vitamin D, ascorbic acid and calcium. The disease practically does not occur in adults, as cartilage undergoes ossification with age.
Achilles tendon inflammation (tendovaginitis)
The Achilles tendon runs along the back of the leg. This is the strongest bundle of the human body that can withstand heavy loads. However, in childhood, with excessive sports, inflammation of the tendon often occurs. As a result, the ligament thickens and prevents the normal extension of the leg. The disease is more common in adolescence.
With tenosynovitis, the heel hurts in the child and it hurts to step on the foot. Unpleasant sensations can radiate to the foot. The back of the lower leg looks edematous. The calf muscles are tense. In advanced cases, a creak is heard during movements.
Treatment consists in fixing a diseased limb with an orthosis or elastic bandage. For pain relief, oral and local anti-inflammatory drugs are prescribed (Nimesil, Ibuprofen). The application of compresses with solutions of novocaine or analgin is also shown.
After the relief of acute pain, the child is prescribed a course of physiotherapy:
- magnetotherapy;
- laser treatment;
- electrophoresis;
- mud baths and applications;
- ultrasound.
After treatment, it is recommended to reduce the load on the legs. The child is prescribed a course of restorative physiotherapy exercises.
Injuries
If the child has a heel ache and it hurts to step on his leg, then this symptomatology can be a sign of injury:
- fractures
- bone cracks;
- sprains.
Such damage is the result of unsuccessful jumps and falls from a height. It is important to remember that pain with a calcaneus fracture can be quite bearable. Injuries are always accompanied by severe tissue edema. In severe cases, the leg looks deformed. It is urgent to deliver the child to the emergency room and take an x-ray.
In case of calcaneus fracture, a plaster cast is applied to the leg. If the injury is accompanied by the displacement of fragments, then the child must be placed in a hospital. Under anesthesia, the bones are repositioned, and only after that the limb is fixed with gypsum. Fusion splicing can last up to 6 to 7 weeks. During the rehabilitation period, the child is prescribed a course of physiotherapy exercises and physiotherapy.
Other diseases
These pathologies are more common in adults. However, in rare cases, they can be noted in children. Such diseases include:
- heel spur;
- achillobursitis;
- plantar warts (tongs).
Calcaneal spur is also called plantar fasciitis. The disease is accompanied by inflammation and degeneration of the ligament (fascia) of the foot. In advanced cases, pathological outgrowths (osteophytes) appear on the calcaneus, which look like spurs. In the initial stages, the heel hurts the child only in the morning. When osteophytes appear, the pain syndrome becomes constant and is difficult to stop.
This pathology often affects children with flat feet and overweight. At an early stage, heel spur lends itself to conservative therapy. The child is prescribed anti-inflammatory and hormonal ointments, as well as physiotherapy sessions. In advanced cases, the operation is shown.
Achillobursitis most often occurs after an ankle sprain. This disease is accompanied by inflammation of the joint bag located between the Achilles tendon and the calcaneus. There is pain in the heel and limited mobility of the joint. Pathology very quickly becomes chronic. Patients are prescribed a course of antibiotics, painkillers and shock wave therapy. In severe cases, corticosteroids are injected into the joint bag.
Why does the child have sore heels and growths on the foot? The reason for this may be plantar warts (tongues). This type of papilloma is more often observed in adolescence, but the appearance of growths in childhood is not excluded.
The growth of warts is a consequence of infection with the HPV virus and a decrease in immunity. The child has sore heels when walking, as he constantly has to step on the growths. With plantar warts, antiviral drugs and immunomodulators are prescribed to the patient. If the papillomas interfere with normal walking, then removal of growths is indicated.
Diagnostics
We found out that there are many reasons why a child has sore heels. What to do when such a symptom appears? You must consult a pediatric surgeon or orthopedist. Calcaneal pain can have a different origin. Only a specialist can identify their etiology.
To clarify the diagnosis, the following examinations are prescribed:
- calcaneus radiography;
- MRI of the foot and ankle joint;
- clinical blood and urine tests (to detect inflammation);
- study of synovial fluid (in the diagnosis of bursitis).
If you suspect plantar warts, you need to consult a dermatologist and take a blood test for papillomavirus.
First aid
How to provide assistance if the child has a heel ache? Only a doctor can deal with the treatment of diseases of the musculoskeletal system. The choice of the necessary method of therapy will completely depend on the type of pathology.
However, at the pre-medical stage, you can try to stop the discomfort. If the child has a heel ache, then it is necessary to interrupt sports activities and exclude stress on the legs. Before visiting a doctor, you can apply a cold compress to the affected area. If the pain arose as a result of an unsuccessful jump or a fall from a height, then it is necessary to apply a splint on the damaged limb.
It is not advisable to give your child pain medication before visiting a doctor. This can blur the clinical picture of the disease, and it will be difficult for a specialist to make the correct diagnosis.
Prevention
How to prevent calcaneus and Achilles tendon pathology? To prevent such diseases, it is necessary to adhere to the following recommendations:
- Child exercise should be moderate. Exhausting workouts with increased load on the legs are contraindicated in childhood.
- The diet of children should regularly include foods rich in calcium and vitamin D. These substances are necessary for the proper formation and strengthening of bone tissue.
- It is important to ensure that the child wears comfortable shoes with soft insoles and arch support.
- If pain occurs after falls and bruises of the calcaneus, it is necessary to consult a traumatologist in a timely manner.
- It is very important to pay attention to the weight of the child. Extra pounds create an increased load on the cartilage tissue.
- It is necessary to monitor the condition of the skin on the heels. If there are growths on the epidermis, you should immediately visit a dermatologist.
Following these steps will help reduce the risk of heel pain and lameness.