Condition-Chronic Ankle Pain

Cary B.
Chapman, M.D., PLLC

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Chronic Ankle Pain

Chronic ankle pain often develops after an injury such as a sprained ankle. However, several other conditions may also cause chronic ankle pain. The most common cause for a persistently painful ankle is incomplete healing after an ankle sprain. When you sprain your ankle, the connecting tissue (ligament) between the bones is stretched or torn. Without thorough and complete rehabilitation, the ligament or surrounding muscles may remain weak, resulting in pain and instability. As a result, you may experience additional ankle injuries. Other causes of chronic ankle pain include, development of scar tissue in the ankle after a sprain takes up space in the joint, inflammation of the joint lining (synovium), bone spurs, fracture, tendon injury, nerve entrapment, or arthritis

• Symptoms
The most common symptom is pain, usually on the outer side of the ankle. The pain may be so intense that you have difficulty walking or participating in sports. In some cases, the pain is a constant, dull ache. Other symptoms include difficulty walking on uneven ground or in high heels, feeling of giving way (instability), sensation of clicking or locking of the ankle joint, as well as, swelling, stiffness, and repeated ankle sprains.

• Diagnosis
The first step in identifying the cause of chronic ankle pain is taking a history of the condition and performing an appropriate physical examination. X-rays of your ankle joint are usually ordered. You may also need to get x-rays of the other ankle so the doctor can compare the injured and non-injured ankles. A shot of local anesthetic may also help pinpoint the source of the symptoms. In some cases, additional tests such as a bone scan, computed tomography (CT) scan, or magnetic resonance image (MRI) may be needed.

• Treatment
Treatment will depend on the final diagnosis and should be personalized to your individual needs. Both conservative (non-operative) and surgical treatment methods may be used. Conservative treatments include:

Anti-inflammatory medications such as aspirin or ibuprofen to reduce swelling
Physical therapy, including tilt-board exercises, directed at strengthening the muscles, restoring range of motion, and increasing your perception of joint position
An ankle brace or other support
An injection of a steroid medication
In the case of a fracture, immobilization to allow the bone to heal

If your condition requires it, or if conservative treatment doesn't bring relief, surgery may be recommended. Many surgical procedures can be done on an outpatient basis. Most procedures can be performed arthroscopically; other require open surgery. Rehabilitation may take 6 to 12 weeks to ensure proper healing.

Dr. Chapman is proficient in arthroscopic and open techniques to treat chronic ankle pain.