Treatment
of Ankle Pain As there is no uniform cause for ankle pain, the therapy
for ankle pain needs to be individualized according to the underlying pathology.
Here are some common ankle conditons and their usual treatment protocols.
Arthritis
of the Ankle Joint This is another very common condition
and as it has been mentioned in the table above can be due to inflammation (rheumatoid
arthritis, gout, pseudogout, ankylosing spondylitis etc.), degeneration (osteoarthritis)
or septic (various inectious agents). The therapy is directed at the specific
cause and can be found under the various headings elsewhere in this chapter.
Circulatory
Reasons for Ankle Pain In the case of Buerger's disease where
the arteries to the legs contain narrow passsages, the only rational approach
is to identify the arterial lesions by angiograms (X-rays of the arteries after
infection of dye into the arteries) and subsequent bypass surgeries by a vascular
surgeon. The results of this surgery can be very rewarding as the patient
had to stop every 1 or 2 blocks with walks before the surgery and after the surgery
there are suddenly no limitations. With venous insufficiency and varicous veins
the veins can often be obliterated by a series of injections. If this alone does
not lead to the success, surgical removal of the veins with damaged valves can
be done except for the deep veins. However, the process of damage to the valves
of the deep veins is halted by removing the dilated superficial varicose veins.
This condition seems to be constitutional in certain families. A vascular surgeon
can be very helpful in these cases.
Nerve
Entrapment In this condition there is often an area of numbness
associated often with a muscle weakness due to the compression of a nerve that
travels through a tunnel formed by a bony or ligamentous structure. Electromyography
studies, which are usually done by a neurologist or by a physiatrist, will help
to identify, which nerve is compressed. An orthopedic surgeon or a neurosurgeon
can then "decompress" this nerve in a daycare type surgery. If this
is done early enough there will not be any residual weakness in the nerve or the
associated muscles and all of the sensitivity loss usually returns to nomal. |
