Heel pain in children may be commonly known as Sever’s disease or Calcaneal Apophysitis. Way back in 1912, James Warren Sever an orthopedic doctor was the first person to describe the condition. Doctor Severs decided to name the condition after his last name. So keep in mind Sever’s disease is not a sinister disease, rather just the name commonly used to describe heel pain in children.
What is Children’s heel pain? (Sever’s disease)
Children may develop Calcaneal Apophysitis which is caused by irritation to the heel growth plate. The irritation may be due to an increased level in sporting activities, an increase in body weight or starting a new activity. Also the irritations can arise due to the foot muscles that connect to the bottom of the heel and Achilles tendon (the big fibrous cord on the back of your heel) as they pull against the heel when walking.
Growth spurts in both girls and boys start between the ages 8-14 years old. Usually by the age of 15, the growth plate has fused, hardened and your child symptoms will cease.
Pain in the morning
Redness at the heels
With these symptoms of heel pain it may prevent your child from wanting to play sport, be active or even move. Children may also toe walk so they can try to reduce pressure on their heels.
Here at better health podiatry we can
assist with diagnosis of your child’s heel pain.
We may request imaging if we suspect a fracture or other more serious condition. Imaging such as an xray is usually not required since there is no difference between children with and without heel Calcaneal apophysitis on imaging.
Luckily Calcaneal apophysitis easies over time without treatment. Our podiatrists can assist with further offloading strategies for your child to be continually active during sporting activities if symptoms do persist.
If your child is experiencing heel pain one easy management option that they can start off with is massaging the back of the leg with moisturiser for 10 minutes. Also using a wheat heat pack before and after activities may assist to sooth pain.
If you child experiencing heel pain come in for an assessment and we will get to the root of the cause. For further information call (02) 9518 0722
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Gastro Oesophageal Reflux disease (GORD) or ‘reflux’ is a very common condition which can be experienced at any age. Babies can suffer silent reflux right from birth, and many adults experience reflux up into later life. Just like all health conditions, reflux is caused by a combination of factors.
What is reflux?
Reflux or heartburn is the backwash of acid and the contents of the stomach up the oesophagus. This causes inflammation and a burning pain in the middle of the chest up to the back of the throat. Sometimes it can even cause a cough, or regurgitation of food up into the mouth. In babies, silent reflux can present as constant dribbling, coughing, wheezing and a runny nose. It can seem as if they have asthma. The condition can be aggravated by both mechanical and external factors.
First of all, let’s clear up the acid confusion. Reflux feels like burning, yes. This is because our stomach produces hydrochloric acid (as well as enzymes) to digest your food. Even though reflux feels like burning as if there’s too much acid, quite often it is not the case.
The pH of hydrochloric acid secreted into our stomach is as low as two. For comparison, water is neutral around the pH of seven. Have you noticed your mouth or throat become slightly burnt after you’ve thrown up a lot? This is how powerful your stomach acid is. It will cause burning on tissues it shouldn’t be in contact with.
How does it happen?
Understanding more about the power of stomach acid helps explain how reflux happens. If production and secretion of our acid levels are low, then we find that reflux will occur. Low stomach acid levels means digestion of our food doesn’t happen properly in the stomach. This slows the speed at which the food leaves the stomach to move through the gastrointestinal system. The food in your stomach begins to ferment, and washes back up the oesophagus causing that burning feeling. Even though it feels like the acid is high, the cause is usually low levels. It’s a bit confusing to get your head around.
Another common cause of reflux is a bacteria called Helicobacter pylori. It secretes an enzyme that converts to ammonia in the stomach. This buffers the acid levels of the gut to become more neutral so they can survive. Then, you understand how the lack of acid begins the development of the condition.
What else apart from the acid?
We must also consider the first line of defence, your lower oesophageal sphincter (LOS). Your LOS is responsible for contracting and keeping the stomach contents down in the stomach where they belong. This sphincter can become lazy and relaxed in response to a different variety of triggers. Alcohol, caffeine, tobacco, stress, fatty foods and oils, garlic, menthol, tomato, just to name a few. If you consume foods you have an intolerance to, this can also aggravate this sphincter. Common food intolerance triggers are dairy and wheat, but an IgG test is the best way to identify yours.
You may not always feel the burning from the acid, and that is why reflux can be quite a sinister condition. You may be consuming too much of a trigger that is causing the tone of it to slacken. A cough only present in the morning can be caused by reflux. You can also have silent reflux which doesn’t feel like anything at all!
The danger of having constant reflux lies in the damage that the acid can cause to the oesophageal lining. The stomach has cells that secrete a protective mucus to protect it from becoming damaged by the stomach acid. The oesophagus does not have the same cells, so the mucosa is a lot more susceptible to damage and inflammation. Silent or not, chronic reflux will cause changes in these cells, which can lead to cancer in later life.
How do I fix it?
The quick solution is to stop the pain of the backwashing acid by using medications that either buffer the acid so the pH becomes closer to neutral (= less burning and pain) or by reducing the production of acid and enzymes by our body ( = less secreted into the stomach that can then back wash). While these temporarily address the burning and pain of reflux, they are short term and will not prevent reoccurrence.
Buffering the acid, or reducing the production of acid and enzymes only leads to reduced absorption of nutrients from your meals. This puts you at a high risk to develop nutritional deficiencies over time from using these medications. They can also contain aluminium as an ingredient which isn’t something you want to be ingesting.
Seeing a naturopath can help you to identify what is triggering your reflux, as well as address the functionality of your gastrointestinal system so that you can live comfortably and reflux free. There are ways we can improve the functionality of your LOS, and herbal medicines we can prescribe for symptomatic relief with no side effects to relieve pain in the meant time. Call the clinic to book an appointment
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