Lateral Ankle Pain
Recurring or persistent
(chronic) pain on the outer (lateral) side of the ankle often develops
after an injury such as a sprained ankle. However, several other conditions
may also cause chronic ankle pain.
Signs and symptoms
· Pain, usually on the outer side of the ankle. The pain may
be so intense that you have difficulty walking or participating in sports.
In some cases, the pain is a constant, dull ache.
· Difficulty walking on uneven ground or in high heels
· A feeling of giving way (instability)
· Repeated ankle sprains
Possible causes for chronic lateral ankle pain
The most common cause for a persistently painful ankle is incomplete
healing after an ankle sprain. When you sprain your ankle, the connecting
tissue (ligament) between the bones is stretched or torn. Without thorough
and complete rehabilitation, the ligament or surrounding muscles may
remain weak, resulting in recurrent instability. As a result, you may
experience additional ankle injuries. Other causes of chronic ankle
· An injury to the nerves that pass through the ankle. The nerves
may be stretched, torn, injured by a direct blow, or pinched under pressure
· A torn or inflamed tendon
· Arthritis of the ankle joint
· A break (fracture) in one of the bones that make up the ankle
· An inflammation of the joint lining (synovium)
· The development of scar tissue in the ankle after a sprain.
The scar tissue takes up space in the joint, thus putting pressure on
Evaluation and diagnosis
The first step in identifying the cause of chronic ankle pain is taking
a history of the condition. Dr. Morris may ask you several questions,
· Have you previously injured the ankle? If so, when?
· What kind of treatment did you receive for the injury?
· How long have you had the pain?
· Are there times when the pain worsens or disappears?
Because there are so many potential causes for chronic ankle pain, Dr.
Morris may do a number of tests to pinpoint the diagnosis, beginning
with a physical examination. He will feel for tender areas and look
for signs of swelling. He will have you move your foot and ankle to
assess range of motion and flexibility. Dr. Morris may also test the
sensation of the nerves, and may administer a shot of local anesthetic
to help pinpoint the source of the symptoms.
He may order several x-ray views of your ankle joint. You may also need
to get x-rays of the other ankle so he can compare the injured and non-injured
ankles. In some cases, additional tests such as a bone scan, computed
tomography (CT) scan, or magnetic resonance image (MRI) may be needed.
Treatment will depend on the final diagnosis and should be personalized
to your individual needs. Both conservative (non-operative) and surgical
treatment methods may be used. Conservative treatments include:
· Anti-inflammatory medications such as aspirin or ibuprofen
to reduce swelling
· Physical therapy, including tilt-board exercises, directed
at strengthening the muscles, restoring range of motion, and increasing
your perception of joint position
· An ankle brace or other support
· An injection of a steroid medication
· In the case of a fracture, immobilization to allow the bone
If your condition requires it, or if conservative treatment does not
bring relief, Dr. Morris may recommend surgery. Many surgical procedures
can be done on an outpatient basis. Some procedures use arthroscopic
techniques; other require open surgery. Rehabilitation may take 6 to
10 weeks to ensure proper healing. Surgical treatment options include:
· Removing (excising) loose fragments
· Cleaning (debriding) the joint or joint surface
· Repairing or reconstructing the ligaments or transferring tendons
Almost half of all people who sprain their ankle once will experience
additional ankle sprains and chronic pain. You can help prevent chronic
pain from developing by following these simple steps:
1. Follow your doctor's instructions carefully and complete the prescribed
physical rehabilitation program.
2. Do not return to activity until cleared by your physician.
3. When you do return to sports, use an ankle brace rather than taping
the ankle. Bracing is more effective than taping in preventing ankle
4. If you wear hi-top shoes, be sure to lace them properly and completely.