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

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.

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. 1, 2008