Ankle pain can result from a variety of underlying causes, including trauma, arthritis, sports-related conditions, infection, systemic disorders, and neoplastic processes. Successful treatment requires a full understanding of ankle anatomy, a proper history, and a thorough physical examination to yield an appropriate differential diagnosis.
A very common injury in sports, as well as the general population, is acute sprains of the lateral ligaments about the ankle. Most commonly, a partial tear or complete rupture of the anterior talo-fibular ligament (or ATFL) occurs. More severe injuries include the calcaneofibular ligament (or CFL). An inversion mechanism can cause a lateral ankle sprain.
Classification of Ankle Sprains:
Grade I: Partial tear of the ligaments Grade II: Partial to complete tear of the ATFL, partial tear of the CFL Grade III: Complete rupture of the ATFL and CFL
Treatments For Ankle Pain & Sprains
Treatment for ankle sprains or low-grade trauma include the R.I.C.E. protocol and gradual weight bearing as tolerated. A provider would typically splint a patient with ankle fractures, request they remain non-weight bearing, and a refer them to an orthopedist for definitive care. Hot, swollen, bright-red ankles may warrant arthrocentesis (collection of joint fluid) to rule out a gouty attack or septic arthritis.
The provider may recommend physical therapy in certain cases once they determine the diagnosis and perform specific treatments. Exercises include ROM, strengthening exercises, and proprioceptive retraining if indicated.
Patients should show full strength and ROM before returning to sports. Functional bracing or taping during their return to athletics may help prevent recurrence.
FAQ About Ankle Sprains
Which ligaments are involved in a lateral ankle sprain and in what sequence do they occur?
A lateral ankle sprain injures the following, in order: anterolateral joint capsule, ATFL, and occasionally the CFL.
What are appropriate initial treatments for acute ankle sprain?
RICE protocol, stirrup brace, early ambulation, and ROM exercises.
What are some possible causes of ankle pain?
Fracture, sprain, tendon injury, tendonitis, arthritis, infection, or neoplasm.
What type of condition is suggested by morning stiffness and ankle pain?
Rheumatoid or inflammatory arthritis.
What conditions likely require a referral to an orthopedist?
Acute fracture, neoplasm, and a chronic condition unresponsive to initial non-surgical treatment.
While icing and resting an ankle are good things to do if you are experiencing ankle pain, it might not be enough in certain cases. If you are suffering from ankle tendonitis, bursitis, a sprain, osteoarthritis, or other pain that is not responding to rest, ice, or medication, a steroid injection may help with ankle or foot pain.
Much like an epidural steroid injection, after the area is numbed, a solution of anesthetic and corticosteroid is injected into the ankle or foot, depending on the area affected. Once administered, the doctor will monitor you for about 15 minutes, then allow you to go home. You should avoid any strenuous activity for at least 48 hours. You may feel immediate pain relief from this procedure. However, it may also take a couple of days to take effect. This is not meant to be a cure for any ankle conditions, so be sure to continue any other recommended treatments.
Risks are minimal, but include bleeding, infection, and nerve damage. Be sure to consult with your provider if you are on blood thinners, are immunosuppressed, have an active infection, or are pregnant.
If over-the-counter medication and regular care are not providing relief to your ankle/foot pain, contact us today and learn more about our pain treatments. We will work with you to create a treatment plan to control or eliminate your pain.
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CUTTING EDGE PAIN MANAGEMENT
We are double board-certified in pain management and specialize in spinal and neuromuscular pain conditions. Beyond providing safe and appropriate medication management options,We are highly-skilled experts in non-surgical interventions, using state-of-the art treatments to relieve pain and improve function.
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