Severs disease treatment

Oh pleeeeeeese. The name apophysitis is a misnomer - many publications have stated that! Just like plantar fasciitis, has been shown to be a degeneration and not an inflammation. I ask again - can you provide us with any evidence of inflammation in Severs? Why is it that no one who treats severs disease sees any swelling?

 

:good:

I completely agree. I will send a personal email later.

 

In all my years and probably close to a few thousand cases of severs, I have never had to resort to any sort of anti-inflammatory medication. Never even had to think about doing it.

 

1. Some do "see" it. Esp. by palpation
2. Those who do not believe in it do not look for it, and tend not to see it.
3. Because there is less surrounding soft tissue, there is less inflammation and edema than as in Osgood-Schlatter, the other most common apophysitis.

I am sure that you would like to discount any evidence I might offer, based on our previous history, but here goes:

Background

Sever disease is a painful inflammation of the calcaneal apophysis. It is classified with the child and adolescent nonarticular osteochondroses. (The other disease in this group is Iselin disease, which is inflammation of the base of the fifth metatarsal.) The etiology of pain in Sever disease is believed to be repetitive trauma to the weaker structure of the apophysis, induced by the pull of the tendo Achilles on its insertion. This results in a clinical picture of heel pain in a growing active child, which worsens with activity.
In 1912, J.W. Sever, MD, first described this condition in the New York Medical Journal. He described it as an inflammation of the calcaneal apophysis resulting in the clinical symptoms of pain at the posterior heel, mild swelling, and difficulty with walking.

Author
Mark A Noffsinger, MD, Clinical Instructor, Department of Orthopedic Surgery, Michigan State College of Human Medicine; Medical Director, Department of Orthopedic Surgery, Bronson Methodist Hospital, Consulting Staff, Kalamazoo Orthopedic Clinic

Mark A Noffsinger is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Association of Orthopaedic Medicine, American College of Physician Executives, American Fracture Association, American Medical Association, American Medical Directors Association, Christian Medical & Dental Society, Indiana State Medical Association, International Society on Thrombosis and Haemostasis, Michigan State Medical Society, Mid-America Orthopaedic Association, and Phi Beta Kappa

Editors: James K DeOrio, MD, Director of Foot and Ankle Fellowship Program, Assistant Professor of Orthopedic Surgery, Orthopedic Surgery, St. Luke's Hospital, Jacksonville, Florida; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Shepard R Hurwitz, MD, Executive Director Designate, American Board of Orthopaedic Surgery; Dinesh Patel, MD, FACS, Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital; Jason H Calhoun, MD, FAAOS, Chairman, J Vernon Luck Distinguished Professor, Department of Orthopedic Surgery, University of Missouri

See: http://www.emedicine.com/orthoped/topic622.htm#section~Introduction
:empathy:

 

" I ask again - can you provide us with any evidence of inflammation in Severs"

OK, since this has been accepted medical terminology and the condition has responded to anti-inflammatory protocol since the term was coined, I'll ask you.................................

Can you prove it is not?

And let's stick with Severs...Plantar Fasciitis is NOT something you should compare this too in order to prove a point. We all realize plantar Fasciitis is an common "all encompassing" term for many different pathologies.

Steve

 

I already have. In a previous message, I quoted a MRI study done in france (Do not have reference handy and we have a thread on it) that found no inflammatory elements in their detailed study. They just showed some "stress fracture" like elements in the metaphysis.

I only used the plantar fasciitis as an eg of wrong terminology that is so widely used its accepted. The use of the term apophysitis is the same.

 

You really have to stop digging a deeper hole for yourself and grasping at straws. That is a review paper, not evidence. They cite no references that it is an actual inflammation.

I will be the first to change my mind when I see EVIDENCE.

 

"itis" or not, I agree with others. I have not had to resort to any anti-inflam modalities or drugs in those with severs.

 

Gary

I have always been fascinated with people who come up with a new product (be it good, bad, or indifferent) and seek to promote it here. As has been observed there have been several such pass through the arena of late.

The thing which confuses me is why you are surprised and almost offended that we are not convinced by your arguments. As somebody trained in the scientific method i'm sure you are aware of the difference between a relevant reference and convincing evidence. Why then, are you surprised that nobody is impressed? Would you be were the roles reversed?

In fact, lets reverse those roles if you would indulge me.

Brian Rothbart makes claims that his insoles are most effective in the treatment of osgood schlatters and other knee pain (as you do for your product). He provides copious glowing testimonials (as you do), a sort of a rational (as you do), and copious references for the science AROUND his product from impressive sounding sources although no specific blinded outcome studies (as you do).

Are YOU convinced by HIS product? Would you maintain an open mind and try his product for knee pain as you ask us to do with your product?

If not, why not?

Regards
Robert
Junior deputy of the Treatment Police mentioned in Gangstapod (youtube it)

 

"They just showed some "stress fracture" like elements in the metaphysis."

I assume you mean apophysis.
So, what you're telling me is that this study showed "stress" fractures in the apophysis but NO INFLAMMATION! Hmmmmmmmm.

OK, I'll have to recheck all I know about the bodies response to injury!!!!!!
Apparently the Frenchmen reading the MRIs for this study do no know what inflammation looks like.

Steve

 

Uncanny! I just emailed Admin about this topic (but also included Dr Kipper and his silicone dynamic orthotics). I wanted to start a new thread on this very observation about the promotion of a theory with a product to sell behind it. I emailed Admin as I am a newbie and was worried about starting a topic that degenerates and gets personal.

 

Oscon has been used in over 20,000 cases of apophyseal injuries, with most resolving in less than 1 month.
I am totally baffled that some of you deny that there is no inflammation present in Severs, the entire rest of the credible medical world acknowledges it.
See http://www.emedicine.com/orthoped/topic622.htm

This is not a literature review as someone has stated erroneously. It is an original article by a renowned physician with extensive peer review by respected experts in their fields.
You also might want to look at:
http://www.emedicine.com/sports/topic89.htm for a similar article on Osgood-Schlatter.

Unlike some posters here I am willing to concur with the current medical acceptance of inflammation's presence in Sever's.

I also am willing to try someone's new product, even if sold for a profit by them (are there any products that are not so classified?) and do not reject them out of hand as long as they "first, do no harm" and have some scientific rational behind them. I will reserve judgement until I have enough personal objective information to make one.

Finally, perhaps some of you need to remember that clinical trials do not create facts, they can only confirm or deny them.

I have studied and employed the principles used in the Oscon product since 1987. But children had to take 5 pills per day then because the right combination was not extant in one dosage form. For whatever reason, the more vociferous of posters here refuse to accept the real truth. They often state "profit" as being a reason not to accept my position.
"Riddle me this" Do any of you provide your services and products for free??
I rather doubt it!

I do not really care if the doubters here accept it or not, and I do not care if they purchase it. I am perfectly satisfied to distribute it to those who are willing to give it a try. If you have not heard of it from your patients yet, you soon will. My business has increased exponentially since Oscon became available, and word of mouth has been the greatest influence.

In closing, here is the previously cited (but not displayed) "French Article" on possible stress fracture in Severs Disease http://cat.inist.fr/?aModele=afficheN&cpsidt=16071158
It is not French, and it does not even remotely imply that there is no inflammation present. Also since it is the only one of 116,000 references on Google that takes the "stress fracture position" on Severs, it is far from being an accepted fact.

I have resisted the temptation to post my 90 pages of reports from the users of Oscon in the field, both consumers and health professionals, as that would be unseemly.

I have also chosen to unsubscribe from this thread, as it has taken enough valuable time from my practice, and I doubt if anything could satisfy the more reactionary dogmatists among the posters. BUT, I could not care less.

'Bye for now
ignelson@aol.com
Cheers! :drinks

 

Well having read all of the above threads on this subject its certainly given me food for thought and opened up a very interesting debate. Having not come across anyone with Sever's disease or treated the condition before, i have found this a most thought provoking article. Many thanks to all of those contributors who have given their own expertise/slant on the therapies they use.