Will this painful ankle ever go away ?

Dear Mirror Doctor, I am a 30-year-old lady working in one of the financial institutions.  For the past three  years I have been experiencing severe  pain in my right ankle.  
I have been to several hospitals but end up being put on different painkillers. The pain is severe especially at night and it is always constant.

The last time I went to the hospital I was asked to go for physiotherapy sessions.

Please will this pain ever go away?

Worried woman

Dear  Worried woman, The ankle joint is where the bones of the leg and the foot meet. It is responsible for the up and down motion of the foot.

Pain in the ankle can result from inflammation or injury to any of the structures in this region such as the bones, the joint space, cartilage, ligaments, tendons, or muscles.    

Ankle pain can be associated with other symptoms including swelling, numbness or tingling sensation, instability of the joint, burning pain, inability to bear weight on the affected ankle, joint stiffness and  joint weakness.

Common causes of ankle pain include sprains or injuries particularly when it is one sided as in your case. Rheumatoid arthritis, gout, osteoarthritis, and other types of arthritis also cause ankle pain.

In addition, inflammation of structures along the joint such as Achilles tendonitis is a potential cause of pain. You fell short mentioning your working diagnosis so I will talk about some causes of ankle pain.

Ankle sprain - This occurs when there has been significant injury to the ligaments that surround and connect the bones of the leg to the foot. The injury typically occurs when one accidentally twists the ankle inappropriately.

During physical activity, the ankle may twist inward as a result of sudden or unexpected movement. This causes tears to the ligaments surrounding the ankle resulting in swelling or bruising and discomfort when weight bears on the affected area.

Tendons, cartilage, and blood vessels may also result from a  sprain injury. Anyone, at any age, can develop an ankle sprain.

Participating in sports, walking on uneven surfaces, or even wearing inappropriate footwear are all common causes of sprains.

Symptoms of ankle sprain includes; swelling, tenderness, bruising, ankle pain, skin discolouration and stiffness. Unstable ankle results if the ligaments are completely torn even after healing.

Sprains are diagnosed after a physical examination has been done to determine which ligaments have been torn.

Imaging tests, such as X-rays, may be ordered to rule out a bone fracture. Magnetic Resonance Imaging (MRI) may be done if there is suspicion of bone chipping, severe ligament injury or damage to the surface of the joint.

Treatment is important to promote recovery and prevent further discomfort. Useful tips and items that help to care for the sprain as one recovers is very necessary.

It is important not to put weight on the injured area while you are recovering from an ankle sprain. Crutches may be prescribed during this stage.

Mild sprains could be managed with elastic bandages to wrap the ankle and use a brace to support the ankle. Keeping the foot elevated when resting or sleeping helps to reduce the swelling.

Pain killers may be prescribed to reduce the inflammation and the pain.

Even though mild sprains, heal within two weeks, it takes several months for a more severe sprain to heal depending on how much attention is paid to it.

Surgery is rare, but may be performed in cases where damage to ligaments is severe. Although pain and swelling may eventually stop, the injured ankle will not be as stable as the unaffected ankle.

At this stage physiotherapy is recommended to promote complete healing and strengthen the joint.

 Physiotherapy  helps especially if it is timed correctly so as not to burden the already stressed joint.

Avoiding high heels and paying attention to slopes and flat surfaces are helpful in promoting healing.

I will continue next week on other causes of ankle pain.

astom2@yahoo.com
A member of Paediatric Society of Ghana.