Ankle conditions

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What causes ankle pain?

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Arthritis

Although ankle pain caused by arthritis is not as common as the degenerative changes in other joints, it can still be significantly painful. Ankle arthritis is the most common in patients with rheumatoid arthritis or a previous ankle injury.

Sprains

A sprain in the ankle causes pain and swelling to the surrounding ligaments. In addition, patients may feel as though the joint may give way.

Tendonitis

Tendonitis occurs when the tendons become irritated and inflamed

Posterior Tibial Tendonitis

Posterior tibial tendonitis causes ankle pain in the joint and can lead to significant walking difficulty.

Achilles Tendonitis

This is the most common type of tendonitis causing pain over the back of the heel.

Fractures

Different types of ankle fractures must be treated differently. While some ankle fractures can be treated like sprains, others may require surgery.

Gout

Gout is a rare cause of ankle pain.

Cartilage Damage

Ankle cartilage is susceptible to injuries if the ankle sprains, fractures, or is neglected after some injury.

When do you need to consult your doctor about your ankle pain?

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Patients are advised to seek medical attention if unsure of the cause of symptoms, such as the following:

Inability to walk comfortably on the affected side
Injury causing deformity around the joint
Ankle pain occurring at night or while resting
Ankle pain persisting beyond a few days
Inability to bend the ankle
Swelling of the joint in the calf region
Signs of infection, including fever, redness and warmth
Other unusual symptoms

Treatment options

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Patients receive treatment appropriate for the cause of the problem. Therefore, it is important to seek medical advice and understand the diagnosis and the severity of symptoms before beginning any treatment programme.

Rest

This is usually the first treatment for ankle pain relief because it allows the inflammation to subside. Crutches may be helpful for severe symptoms.

Footwear Modifications, Orthotics and Braces

The choice of treatment depends on the patient's condition.

Ice and Heat Application

Ice packs and heat pads are among the most commonly used treatments for inflammation. Ice packs are mostly used for acute injuries to help minimise swelling while heat pads are used for chronic conditions to help relax and loosen tissues, and to stimulate blood flow to the area.

Stretching

A good routine of stretching the muscles and tendons surrounding the joint can help with some ankle pain.

Physiotherapy

Physiotherapy is an important aspect of treatment for almost all orthopaedic conditions. Physiotherapists use different modalities to increase strength, regain mobility, and help return patients to their pre-injury level of activity.

Anti-Inflammatory Medication

Nonsteroidal anti-inflammatory medications, commonly known as NSAIDs, are some of the most frequently prescribed medications, especially for patients with ankle pain caused by problems such as arthritis, bursitis, and tendonitis.

Steriod Injections

Triamcinolone is a powerful medication that treats inflammation, a common problem in patients with ankle pain.

Surgery

Surgery is rarely used as part of the acute treatment of an ankle sprain. Patients who undergo surgery usually have recurrent ankle injuries and persistent ankle pain, stemming from torn ligaments that did not properly heal.

Patients who have chronic, recurring ankle sprains usually have loose ligaments. The most commonly performed surgery to 'tighten' these ligaments is called a Brostrom repair. During surgery, the ligaments on the outside of the ankle are tightened, preventing ankle instability.

An unstable ankle joint can be detected via a physical examination where the doctor will compare the 'good' ankle with the injured ankle to assess its 'looseness'. An X-ray of the ankle can also be taken to ascertain its strength.