ANKLE PAIN

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Ankle sprain swelli...

Ankle sprain

Sprained ankle

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Ankle pain
Pain

Call your health care provider if

Go to the hospital or call 911 if:

• You have severe pain when NOT bearing weight.
• You suspect a broken bone (the joint appears deformed and you cannot put any weight on the leg).
• There is an audible popping sound and immediate difficulty using the joint.

Call your doctor if:

• Swelling does not go down within 2-3 days.
• You have symptoms of infection -- the area becomes red, more painful, or warm, or you have a fever over 100°F.
• The pain does not go away after several weeks.

What to expect at your health care provider's office

Your doctor will perform a physical examination, including a detailed examination of the ankles, and ask questions such as:

• Does the pain shift from joint to joint?
• Is the pain the same in both ankles?
• Did the pain begin suddenly and severely?
• Did the pain begin slowly and mildly and then get worse?
• Did the pain resolve spontaneously in less than 6 weeks?
• Does the ankle feel warm to the touch?
• Does the ankle hurt when you are not bearing weight on it?

Diagnostic tests that may be performed include the following:

• X-ray of the ankle and possibly the foot
• Aspiration of synovial fluid (fluid from the joint space) and synovial fluid analysis

Prevention

• Lose weight if you are overweight. Extra pounds put strain on your ankles.
• Warm-up before exercising. Stretch the muscles and tendons that anchor the ankle.
• Avoid sports and activities for which you are not properly conditioned.
• Make sure that shoes fit you properly. Avoid high-heeled shoes.
• If you are prone to ankle pain or twisting your ankle during certain activities, use ankle support braces. These include air-casts, ACE bandages, or lace-up ankle supports.

References

Chorley JN. Ankle sprain discharge instructions from the emergency department. Pediatr Emerg Care. 2005; 21(8): 498-501.

Van Rijn RM, van Os AG, Bernsen R, Luijsterburg PA, Koes BW, Bierma_Zeinstra SM. What is the clinical course of acute ankle sprains? A systematic literature review. Am J Med. 2008;121:324-331.e6.

Osborne MD. Chronic ankle instability. In: Frontera WR, Silver JK, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 77.

Ivins D. Acute ankle sprain: an update. Am Fam Physician. 2006;74:1714-1720.

Reviewer Info: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Dept of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., 02/03/2009