Kohler Disease

Köhler disease is a bone disorder of the foot in children, and is thought to result from stress-related compression at a critical time during foetal growth. It most often occurs in children between the ages of three and seven, and it affects males five times more often than it does females.

Typically, just one foot is affected. Most children grow out of the disorder, and the affected bones regain their size, density and structure within a year. For some, however, symptoms may last as long as two years.

The exact cause of Köhler disease is unknown, though it doesn’t seem to be hereditary. Some  specialists believe that Köhler disease may be the result of delayed bone formation, leading to structural weakness.

Kohler Disease usually causes pain and swelling in the middle part of the foot, causing the patient to limp as a result. However, symptoms are often mild, and patients may not seek treatment until the pain and swelling have persisted for a while.

Treatment usually involves resting the affected foot, taking pain relievers and trying to avoid putting pressure on the foot. In acute cases, the patient is often fitted with a cast that stops below the knee. The cast is usually worn for 6 to 8 weeks. After the cast is taken off, some patients are prescribed arch support for about 6 months. Also, moderate exercise is often beneficial, and physical therapy may help as well.

Treatment

The immediate goal of treatment is pain relief. Because symptoms generally worsen with activity, the main treatment is rest, which helps to relieve pressure on the heel bone, decreasing swelling and reducing pain.

A specialist may also recommend:

• Foot and leg exercises to stretch and strengthen the leg muscles and tendons
• The application of ice (wrapped in a towel, not applied directly to the skin) to the injured heel for 20 minutes two or three times per day.
• The use of an elastic wrap or compression stocking
• Medicines such as ibuprofen

In very severe cases, the doctor might recommend that the child wear a cast for anywhere from 2 to 12 weeks to immobilise the foot so that it can heal.