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ANKLE PAIN: EFFECTIVE TREATMENT AND PREVENTION

09/10/2024

Ankle pain is a fairly common condition, often occurring after a fall, sprain, sports injury, etc. However, the symptoms of ache in the ankle area are often quite severe, limiting walking and affecting the ability to move, causing pain and swelling for patients. Here are some suggestions for effective management of ankle pain.

What is ankle pain?

Ankle pain is a condition that causes discomfort and ache in the ankle and ankle joints, occurring due to many different causes. Ankle pain can occur for many reasons. The most common causes include injuries, arthritis, etc. Depending on the cause, you may feel pain anywhere around the ankle. The ankle also causes inflammation, swelling, and makes it difficult to move normally.

Typically, ankle pain improves with rest, ice compress, and pain medication, and usually does not require surgical intervention for treatment. However, serious ankle injuries especially fractures will require surgery, if the condition does not improve after trying medical and physiotherapy treatments.

Who usually has ankle pain?

• Sports participation:
Ankle injury (ankle dislocation) is a common injury in sports, especially in sports that require jumping, the act of rotating the feet such as basketball, tennis, football, rugby and jogging.

• Moving on uneven surfaces:
Walking or running on uneven surfaces or poor training ground conditions may increase the risk of ankle dislocation.

• Previous ankle injury:

Once you've had a dislocated ankle or other type of injury, you have a higher risk of having a dislocated ankle again.

• Poor physical condition:
Poor ankle strength or flexibility can increase the risk of dislocation when participating in sports.

• Wear unsuitable shoes:

Shoes that don't fit or aren't suitable for activity, as well as high heels in general, make the ankle more susceptible to injury.

Causes of ankle pain

Some of the most common injuries that cause ankle pain include:

• Sports injuries
• Ankle sprain
• Tendinitis (peroneal or Achilles tendinitis)
• Bursitis
• Achilles tendon injury (including Achilles tendon tear)
• Ankle fracture (malleolus fracture)

• Tarsal tunnel syndrome (TTS)

Any health condition that affects the joints can cause ankle pain. Some of the most common conditions include:

•Foot and ankle arthritis

• Rheumatoid arthritis
• Ankylosing spondylitis
• Lupus
• Flat feet
• High arched feet (also known as pes cavus)

•Infection that forms or spreads within the ankle (including cellulitis and osteomyelitis)

Common symptoms of ankle pain

• Pain, swelling, bruising that begins after intense exercise

• Pain in the ankle and heel, pain in the calf when standing on the toes
• Redness and swelling, dull pain

• Sudden and sharp pain, swelling, cracked or popping sounds during trauma, difficulty walking, ankle at an unusual angle

Complications

If ankle pain is not treated properly and in a timely manner, or engaging in activities too soon after an ankle dislocation or having multiple ankle dislocations, it can lead to the following complications:

• Chronic ankle pain: Pain can be long lasting and affect the quality of life.

• Chronic ankle instability: The ankle joint can become less stable, easily dislocated again.

• Arthritis in the ankle joint: May develop into arthritis, leading to pain and limited range of motion.

Diagnosis of ankle pain

Physical examination

A physical examination is a fundamental step in the evaluation of ankle pain. The doctor will press on specific areas around the foot and ankle to locate the pain, as well as assess the alignment of the foot…

Blood tests

Blood tests may sometimes be ordered to rule out gout, infection, or arthritis. These tests can help detect elevated levels of uric acid or specific antibodies, aiding in differential diagnosis.

Diagnostic imaging

X-rays are the first imaging measure used to evaluate injuries, fractures, and arthritis in the ankle. In more complex cases or when soft tissue injury is suspected, a doctor may recommend magnetic resonance imaging (MRI) or computed tomography (CT) scans to provide more detailed images.

Differential diagnosis

A differential diagnosis is a group of diagnoses that can explain your symptoms. Through a thorough medical history, physical examination, and imaging review, your doctor can accurately determine diagnosis and help you with a suitable treatment plan.

How to treat ankle pain?

Limit playing sports or engaging in vigorous physical activities that puts extra pressure on your ankle until your doctor assesses your condition and gives you the correct advice. Follow the RICE method as soon as you notice pain or other symptoms:

Rest: Avoid activities that cause injury or ankle pain, limit movement in the injured area, let the bones and joints rest completely.
Ice: Ice compress is very useful to reduce swelling and pain. Apply the ice pack wrapped in a thin towel to the ankle for 15 minutes at a time, several times a day.

Compression: You can bandage your ankles with elastic bandages to help reduce swelling. Note that it should not be too tight because it can interfere with blood circulation, making the pain worse.
Elevation: Elevate your ankle above the level of your heart as often as possible.

If the pain persists for more than a few days or does not improve after you try home treatments, you should visit the nearest medical facility for timely treatment. Common treatments for ankle pain include:

•Anti-inflammatory drugs: Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) — such as naproxen or ibuprofen — help relieve pain and reduce swelling. Your doctor may also prescribe corticosteroids (prescription medications used to treat inflammation).

• Use foot orthoses or change shoes: Foot orthoses are shoe inserts and splints that support your feet and ankles. You may also need to change the type of shoe to suit certain activities.
• Physiotherapy: The physiotherapist guides exercises to increase the strength and flexibility of the ankle.
• Ankle immobilization: You may need to wear a splint, bandage, or cast to keep your ankle immobilized and relieve pressure during recovery.
• Arthrocentesis: The doctor inserts a needle into the ankle to remove excess fluid that causes swelling.

• Ankle surgery: In case rehabilitation is not effective, the doctor may consider surgical treatment. Ankle surgery can usually be performed by minimally invasive arthroscopic surgery, which have the advantage of being less painful and helping patients recover quickly.

Prevention

The best way to prevent pain is to stay safe while participating in physical activity. During sports or other physical activity it is important to remember:

•Wear appropriate protective equipment when participating in sports to protect the ankles.

• Give your body time to rest and recover after intense activity.
• Take time to warm up with ankle stretches before playing sports or training.

• Stretching after physical activity.

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