Common
Causes Of Ankle PainThere are a variety of causes for ankle pain as indicated
in the table below. Trauma is a common cause of ankle pain and spans from a strain
(also called "sprain") injury to the more serious injury of a fracture
of one or more of the bones. There can be a nerve entrapment such as in tarsal
tunnel syndrome. Osteoporosis is a problem of bone nutrition and can be from hormone
deficiency in postmenopausal women or might be from chronic malnutrition as in
chronic alcoholics. Arthritis with inflammatory changes can lead to degenerative changes
in the ankle joint with chronic synovitis, which causes a more dull ankle pain.
A feeling of heaviness with diffuse pain around the ankles and in the feet and
lower legs is associated with varicose veins and venous circulation problems. When
the arteries are affected from severe hardening in endstage Buerger's disease
or from severe uncontrolled diabetes, there will be other associated problems
such as chronic infections, sores that do not heal and that can rapidly develop
into deep ulcerations. Due to the lack of circulation this is an acute emergency
that requires tests ordered by a cardiovascular surgeon and possibly by-pass surgery
as otherwise amputation might be needed. Other reasons for chronic ankle pain
can be from contusion injuries or nerve compression injuries in the ankle, foot
or lower leg area. A complex regional pain syndrome (CRPS) can cause a chronic
and more severe, deep pain. Finally, more rarely cancer from other tumors can
metastasize into the ankle region or start as a bone tumor in the bone of the
ankle.
| Common causes of ankle
pain | | Anatomical
structure: | Comments: |
| Tibiotalar joint (proper ankle
joint) | Sprain or fracture with tripping,
falling, sports or industrial injury; arthritis also common in this joint |
| subtalar joint (between talus and
calcaneus bones) | often traumatic with fall
onto feet, sometimes involves talar or calcaneal fracture as well; arthritis also
common in this joint | | nerve
injury or entrapment | sensory branch of superficial
peroneal nerve, direct injury or entrapment from ganglion, lipoma |
| osteoporosis | produces
bone pain, often microfractures or ankle fracture |
| swelling around ankle | synovitis
from arthritis, ankle sprain, occult fracture; may be secondary to edema from
congestive heart failure or circulation problems (diabetes) |
| skin veins around ankle standing
out | varicose veins with congestion and secondary
swelling of tissues | | Buerger's
disease | end stage hardening of arteries
in legs due to chronic smoking, pain due to lack of oxygen in tissue |
| complex regional pain syndrome
(CRPS I or II) | CRPS I : fracture, immobilization
in cast can start this pain syndrome; CRPS II: direct nerve damage from nerve
contusion causes this | | cancer
of bone (tibia, fibula, talar bone) | pain
originates from nerve endings inside the bone |
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to Top of Table |
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Disclaimer: This
outline is only a teaching aid to patients and should stimulate you to ask the
right questions when seeing your doctor. However, the responsibility of treatment
stays in the hands of your doctor and you. References:
1.The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station,
N.J., 1999. Chapter 49. 2. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders
3. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004
ed., Copyright © 2004 Mosby, Inc. 4. Rakel: Conn's Current Therapy 2004,
56th ed., Copyright © 2004 Elsevier Last Modified:
Feb. 5, 2012 | |
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