Ankle Pain: Causes, Diagnosis, and Treatment Options

Ankle joint pain

I previously injured my ankle from dancing and playing basketball.
Prolonged standing or walking causes significant pain.
The doctor mentioned that overuse has led to joint wear, resembling that of someone in their 40s.
Since I work in the kitchen during my military service, I have to stand for 15 to 16 hours a day.
Recently, the pain became unbearable, so I went to the Tri-Service General Hospital.
A doctor named Dr.
Pan reviewed my X-rays and noted the presence of small bone spurs, but said there was no major issue.
However, the medical certificate he provided diagnosed me with ankle tendonitis.
Could the pain be caused by the small bone spurs? If so, what would be the appropriate treatment?

Zhi Ming, 20~29 year old female. Ask Date: 2005/02/19

Dr. Shi Guozheng reply Orthopedics

Ankle joint injuries typically affect the ligaments surrounding the joint, which are present on both the medial and lateral sides.
The most commonly injured ligament is the anterior talofibular ligament, often damaged during activities such as basketball when the ankle is subjected to an inversion mechanism.
This ligament usually experiences partial tearing.
It is important to note that each ligament is composed of millions of fine fibers, and when a ligament is injured, it becomes lax, leading to pain and discomfort.
As for the joint, if there are only small bone spurs, they generally do not have a significant impact.
Tendonitis around the joint can be managed with medication and the use of an ankle brace for stabilization.
Adequate rest is essential to help reduce pain.

Reply Date: 2005/02/19

More Info

Ankle pain can be a complex issue, especially for individuals with a history of injuries or repetitive strain. In your case, it seems that your ankle pain is a result of both previous injuries from dancing and playing sports, as well as the prolonged standing required during your military service. The diagnosis of tendonitis and the presence of bone spurs (osteophytes) can contribute to your discomfort.

Understanding the Causes of Ankle Pain
1. Tendonitis: This condition occurs when the tendons around the ankle become inflamed due to overuse or injury. Symptoms typically include pain, swelling, and tenderness around the affected tendon. In your case, the diagnosis of ankle tendonitis suggests that the tendons supporting your ankle may be irritated from repetitive stress.

2. Bone Spurs: These are bony projections that develop along the edges of bones, often where bones meet each other in the joints. They can occur in response to joint damage, such as from osteoarthritis or chronic inflammation. While bone spurs themselves may not always cause pain, they can lead to discomfort if they impinge on surrounding tissues or nerves.

3. Osteoarthritis: Given your description of your ankle resembling that of a person in their 40s, it is possible that you may be experiencing early signs of osteoarthritis, which is characterized by the wear and tear of cartilage in the joints. This condition can lead to pain, stiffness, and swelling, particularly after prolonged activity.

4. Previous Injuries: Past injuries can lead to chronic pain and instability in the ankle joint. Scar tissue, changes in joint mechanics, and weakened muscles can all contribute to ongoing discomfort.

Diagnosis
To accurately diagnose the cause of your ankle pain, a thorough evaluation is necessary. This typically includes:
- Physical Examination: A healthcare provider will assess your range of motion, stability, and areas of tenderness.

- Imaging Studies: X-rays can reveal bone spurs and joint alignment, while MRI may be used to assess soft tissue injuries, such as tendon tears or inflammation.

Treatment Options
1. Rest and Activity Modification: Reducing activities that exacerbate your pain is crucial. Consider alternating between rest and gentle exercises to maintain mobility without overstraining the ankle.

2. Physical Therapy: A physical therapist can design a rehabilitation program tailored to strengthen the muscles around your ankle, improve flexibility, and enhance stability. They may also use modalities such as ultrasound or electrical stimulation to reduce pain and inflammation.

3. Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help alleviate pain and reduce inflammation. In some cases, corticosteroid injections may be recommended for more severe inflammation.

4. Orthotics: Custom shoe inserts or braces can provide additional support to the ankle and help distribute weight more evenly, reducing strain on the affected tendons and joints.

5. Surgery: In cases where conservative treatments fail, surgical options may be considered. This could involve removing bone spurs, repairing damaged tendons, or addressing any underlying structural issues in the ankle joint.

6. Alternative Therapies: Some individuals find relief through acupuncture, massage therapy, or other complementary approaches. These can be beneficial in managing pain and improving overall function.

Conclusion
In summary, your ankle pain may stem from a combination of tendonitis, the presence of bone spurs, and potential early osteoarthritis due to previous injuries and prolonged standing. It is essential to follow up with your healthcare provider for a comprehensive evaluation and to discuss the most appropriate treatment options tailored to your specific situation. By addressing the underlying causes and implementing a targeted treatment plan, you can work towards alleviating your pain and improving your ankle function.

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