FOOT AND ANKLE PAIN
The ankle joint is the meeting of the bones of the leg and the foot and is responsible for the up and down motion of the foot. In popular usage, the ankle is often considered to be the ankle joint plus the surrounding anatomic region, including the lower end of the leg and the start of the flat part of the foot. Pain in the ankle can result from inflammation or injury to any of the structures in this region, including the bones, joint space, cartilage, ligaments, tendons, or muscles.
Sign and Symptoms
Sprains
An ankle sprain refers to an injury of one or more ligaments (tough, fibrous tissues that connect bone to bone). Ankle sprains are common injuries that may occur from stepping off a curb, walking on an uneven surface, a fall, or while engaging in a sport, like tennis or basketball, where a rapid change in direction causes the ankle to roll or twist inward.
The most common ankle ligament sprained is the anterior talofibular ligament (ATFL). With a lateral ligament sprain, a person develops throbbing pain on the outside of the ankle. Swelling, bruising, and/or a feeling that the joint may give out, especially if there is a complete tear through the ligament, may also occur.
Medial and high ankle sprains occur much less frequently than lateral ankle sprains. Medial ankle sprains cause throbbing pain on the inside of the ankle and result from the ankle rolling outward.
High ankle sprains cause pain above the ankle, where ligaments connect the two lower leg bones. They result from the foot rotating out with respect to the leg and are most common in people who play impact sports like football.
Tendonitis
Ankle tendonitis occurs when the tendons, the attachments of muscle to bone, become irritated and inflamed.
A common type of ankle tendonitis is peroneal tendonitis, which refers to injury of the peroneal longus or the peroneal brevis tendons. These two tendons run along the outside of the ankle joint. People with peroneal longus or brevis tendonitis often report a history of running on an uneven or slippery surface, or playing in sports that involve rapidly changing directions.
The pain of peroneal longus or brevis tendonitis, often described as a dull ache or a tightening sensation, is located on the outside of ankle, develops over a period of several weeks, and worsens with standing or walking. Swelling may occur with more severe cases of tendonitis. In addition, sometimes people describe a popping sensation felt along the outside of the ankle.
Another type of tendonitis—posterior tibial tendonitis—typically causes gradual ankle pain on the inside part of the joint, along with swelling. If left untreated, posterior tibial tendonitis may lead to significant walking problems. While a twisting injury may cause posterior tendonitis, most people do not actually recall a specific trauma.
The Achilles tendon is the largest tendon in the body, joining your calf and lower leg muscles to your heel bone. Achilles tendonitis causes a burning, tightening pain along the back of the ankle. Mild swelling may also occur, along with morning stiffness in both the heel and calf.
Any activity that places stress on the Achilles tendon can trigger tendonitis, such as playing sports that require sudden starting and stopping or a change in direction. Wearing poor-fitting shoes, inadequate training, or having bone spurs on the heel may also lead to Achilles tendonitis.
Arthritis
Plantar fasciitis
It typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually the worst with the first few steps after awakening, although it can also be triggered by long periods of standing or when you get up after sitting. The pain is usually worse after exercise, not during it.
Bone Break
An ankle bone break (fracture) is common and refers to a break in one or more of the following bones:
Similar to ankle sprains, twisting or rolling the ankle, tripping on a curb, or falls may cause an ankle fracture.
Besides immediate and severely sharp pain, other typical symptoms of an ankle fracture are swelling, bruising, and an inability to put weight on the ankle. If the ankle joint becomes dislocated in addition to a bone break, the ankle may appear deformed.
Bone Bruise
An ankle bone bruise occurs from a less severe injury to the bone than a fracture. Ankle bone bruises may occur on their own or along with an ankle sprain. They are often severely painful and cause swelling, similar to that of a fracture.
Gout
Gout, a type of inflammatory arthritis, develops as a result of uric acid crystal formation within one or more joints. Since gout is an uncommon cause of ankle pain, it will be primarily considered in people who have an underlying diagnosis of gout.
Bone Infection
An infection in the bone (osteomyelitis) may rarely occur in the ankle. Besides a tender ankle joint, other signs of an infected bone include warmth and swelling.
Tarsal Tunnel Syndrome
Tarsal tunnel syndrome refers to compression of the tibial nerve within the “tarsal tunnel” of the ankle (similar to carpal tunnel syndrome, which occurs in the wrist).6 This syndrome may cause an aching or burning pain and numb or tingling sensations on the sole of the foot, toes, and sometimes, the heel, ankle, or calf.
Peroneal Neuropathy
The common peroneal nerve runs down the lower leg and branches into both the deep peroneal nerve and the superficial peroneal nerve. Depending on where the nerve is compressed, a person will experience unique symptoms. For instance, compression on the outside of the knee and upper shin, which can occur from prolonged recumbency during a hospitalization or from an excessive crossing of the legs, may cause a foot drop.
Deep peroneal nerve compression causes lateral ankle pain, along with burning or tingling sensations between the two toes of the foot. This is a rare condition, often resulting from wearing a tight-fitting strap from a shoe.
Tumor
Benign (non-cancerous) tumors of the foot and ankle, such as a synovial cyst, are not necessarily uncommon, but malignant (cancerous) bone tumors, such as a chondrosarcoma, are rare.
Many ankle conditions can be diagnosed with a medical history, physical exam, and X-ray. Other conditions require a bit more of a work-up, including additional imaging tests and/or blood tests.
Medical History
As you review your ankle pain with your doctor, try to be as detailed as possible. In fact, it is a good idea to think through these details prior to your appointment. Some thoughts to consider include:
Where your pain is located (e.g., lateral versus medial ankle)
What your pain feels like (e.g., aching versus sharp) and how intense it is (e.g., mild versus severe)
How long your pain has been going on for: Did it occur right after a trauma, or did it come on gradually?
Whether you are experiencing other symptoms besides ankle pain, such as fever, fatigue, or numbness
Physical Examination
To start, he will check your ankle for swelling, bruising, or deformity. Next, he will perform special ankle-related tests, such as the following:
Ottawa Ankle Rules
The Ottawa ankle rules are used by emergency room and primary care doctors to help rule out an ankle fracture in the event of an ankle injury.To summarize, these tests entail your doctor pressing on the medial and lateral malleolus (the round bones that jut out on both the inside and outside of the foot). If tenderness is felt there, or if you cannot bear weight right after the ankle injury and for four steps in the emergency room or doctor’s office, then an X-ray is needed to evaluate for a fracture.
Talar Tilt Test
During this test, your doctor will hold the heel of your painful ankle in his hand and then gently invert (turn inside) and evert (turn outside) your ankle.10 He will compare the laxity of your ankle joint movement to the uninjured ankle. An increased laxity or pain with ankle inversion suggests a potential lateral ankle ligament sprain, while increased laxity or pain with ankle eversion suggests a potential medial ankle ligament sprain.
Squeeze Test
During this test, your doctor will compress your lower leg bones at the mid-calf level. The test is positive and suggestive of a high ankle sprain if pain is felt above the ankle joint.
Imaging
An X-ray is often utilized to access ankle pain, mostly to differentiate between an ankle sprain or a fracture.10 An X-ray can also reveal signs of gout or osteoarthritis.
Sometimes, other imaging tests, like a computed tomography (CT) scan or magnetic resonance imaging (MRI), are utilized as well. This is especially the case when it comes to more complex diagnoses like a high ankle sprain, a bone tumor or infection, or a suspected fracture not visualized on the initial X-ray.
To diagnose a nerve problem, like peroneal neuropathy, a doctor who specializes in nerve disorders (a neurologist) may perform a nerve conduction study and electromyography (EMG) test.
Treatment
Most ankle injuries heal with at-home treatments. More severe injuries may require surgery. Treatment depends on what’s causing ankle pain. Common treatments for ankle pain include:
Braces and splints: An ankle brace may relieve pain and stabilize your ankle. Some braces are better for certain activities. Ask your provider to recommend one that works best for your lifestyle.
Joint aspiration: During this procedure, your provider inserts a needle into the joint and removes excess fluid. Joint aspirations relieve pain and swelling.
Medications: Several types of medication can reduce inflammation and relieve ankle pain. Drugs to treat arthritis and gout can significantly reduce pain and swelling.
Orthotic inserts: Orthotics are inserts that fit into your shoes. You can buy them from the store, or your provider can custom-make them for your feet. Orthotics support and stabilize the foot while ensuring proper alignment.
Physical therapy (PT): A customized PT program will help you improve flexibility and strengthen muscles that support your ankle. Your physical therapist will create a PT plan with exercises and stretches designed just for you. Be sure to do your prescribed exercises and stretches regularly.
Steroid injections: Your provider uses a needle to inject anti-inflammatory medication directly into your joint. Cortisone shots reduce inflammation and pain.
Surgery: A wide range of ankle surgery procedures can repair torn ligaments or tendons. Some options relieve arthritis pain or correct flatfeet. Ankle joint replacement surgery can relieve pain and restore functionality.
Precautions that Prevent from Foot and Ankle Pain
Rest: If you’ve had an injury such as a sprain, you should stay off your feet for a while. Talk to your provider about how long you should rest. Crutches or a walking boot can help you get around without putting weight on your ankle.
Ice: To reduce swelling, apply ice or a cold compress to the area for 15 to 20 minutes every few hours.
Compression: Ask your provider about wrapping an elastic bandage around your ankle to reduce inflammation. Be careful not to wrap it too tight.
Elevation: Resting with your ankle elevated above your heart reduces swelling. You can also try to sleep with your foot elevated at night.
Over-the-counter pain medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce swelling. Talk to your provider before taking any medication.
Supportive footwear: Make sure your shoes provide adequate support for your feet and ankles. Avoid flip-flops, sandals and shoes that are too loose. It’s especially important to wear proper footwear when playing sports. Activities such as basketball and volleyball can lead to ankle injuries, especially without the right footwear.
Maintain a healthy weight: Carrying extra weight puts excess pressure on your joints, including your ankles.
Strengthen other muscles: By keeping other muscles strong, you’ll support your ankles and reduce your risk of injury.
Stop if you feel pain: Don’t ignore pain. If a movement or activity is uncomfortable, take a break. See your provider if the pain doesn’t get better. Continuing to exercise through pain can make injuries worse.
Warm up properly: Stretch before exercising. Muscles and soft tissues (like ligaments and tendons) are less likely to be damaged when they’re warm.
Advino CuraLaser is best foot and ankle pain relief device and also cures other pains as well. Visit our YouTube channel for a better understanding on how to get the best results with our pain relief laser device. Please contact our customer care for more help.
References:
https://www.webmd.com/pain-management/ankle-pain-directory
https://www.mayoclinic.org/symptoms/ankle-pain/in-depth/sym-20050796
https://www.medicinenet.com/ankle_pain/symptoms.htm
https://www.verywellhealth.com/ankle-pain-causes-2549409
https://my.clevelandclinic.org/health/symptoms/15295-ankle-pain/care-and-treatment
