There are various reasons for heel pain in adults, but in children the most common by far is a problem known as Severs disease. As this is an injury to the growing area in the back of the heel bone, it cannot occur in adults. The most frequent age of onset is around the early teens or maybe a bit before. When we are born the heel bone expands from two parts, one being the major area of the heel bone and the other being the growth area at the back of the heel bone. These two areas of bone are split up by a zone of cartilage material. Severs disease occurs when there is excessive force on that region of cartilage.
The key causes are simply a lot of activity done to rising amounts so that the bone does not get time to adapt to the stress that are placed on the bone. Usually the child is involved with a lot of sports activity, generally on hard surfaces. Limited calf muscles may also be commonly present. The main symptom is soreness around the edges of the heel bone at the back of the heel as well as pain on activity. Increasing the level of sporting activity also should make it worse.
The main approach to the management is a lowering of physical activity to ensure that load on the growing area of bone is decreased. Commonly a soft heel lift is needed to protect the area and reduce the force in the Achilles tendon. Ice after exercise to help with pain can be useful. If this isn't helping, an additional decrease in the amount of physical activity is needed and in the most stubborn cases, a walking brace or cast is utilized to substantially decrease activity levels. If all this does not help, which it occasionally does, then it is just a matter of managing it until the two areas of growing bone combine to form one and it will not be an issue.