Chronic Pain After Right Ankle Fracture Recovery

Closed fracture of the right ankle bone?

Hello, a year ago I slipped and fractured my bone.
I had a cast for over two months, and since the cast was removed, my foot has been experiencing a dull pain.
When lying flat, my right foot cannot rest as it used to (with the heel on the ground), and my heel hurts.
I also have difficulty standing on my toes due to weakness.
If I exert myself suddenly while walking, my foot feels weak and sore.
Additionally, moving my ankle side to side causes pain.
Does this mean that after a fracture, my foot will not be able to walk normally like before? I used to walk quickly, but now I feel soreness in my foot after a short while.
Thank you for your response.

Wang Fu, 30~39 year old female. Ask Date: 2016/02/11

Dr. Shi Guozheng reply Orthopedics

After a fracture has completely healed, there should typically be no pain.
If pain persists, it is important to consider whether there may be an issue with the joint.
It is advisable to consult a physician for an examination and possibly an X-ray to check for any other problems or signs of arthritis.

Reply Date: 2016/02/11

More Info

Chronic pain following an ankle fracture can be a frustrating and concerning experience, especially when it persists long after the initial injury has healed. Your symptoms, including pain when lying flat, difficulty with heel placement, weakness when trying to stand on your toes, and discomfort during sudden movements, are not uncommon in individuals recovering from an ankle fracture.
Firstly, it’s important to understand that the healing process for bones and surrounding tissues can vary significantly from person to person. After a fracture, the body undergoes a complex healing process that involves not only the bone itself but also the surrounding muscles, ligaments, and tendons. Even after the bone has healed, you may experience residual pain and discomfort due to several factors:
1. Soft Tissue Damage: The trauma from the fall and subsequent immobilization can lead to stiffness and weakness in the muscles and ligaments surrounding the ankle. This can result in chronic pain, particularly when you attempt to use the ankle in ways that require strength or flexibility.

2. Joint Stiffness: Prolonged immobilization in a cast can lead to stiffness in the joint. This stiffness can contribute to pain during movement and may affect your range of motion. The inability to fully rotate or flex the ankle can lead to compensatory movements that may cause discomfort in other areas, such as the foot or knee.

3. Complex Regional Pain Syndrome (CRPS): In some cases, individuals may develop CRPS, a condition characterized by prolonged pain and changes in skin color, temperature, and swelling in the affected limb. This condition can occur after an injury and may require specialized treatment.

4. Nerve Sensitivity: Following an injury, the nerves in the area may become more sensitive, leading to pain that feels disproportionate to the physical condition of the ankle. This heightened sensitivity can persist long after the initial injury has healed.

5. Post-Traumatic Arthritis: In some cases, fractures can lead to changes in the joint that may predispose you to arthritis, even if the fracture itself has healed. This can result in chronic pain and discomfort during movement.

To address your concerns and improve your recovery, consider the following steps:
- Physical Therapy: Engaging in a structured physical therapy program can be highly beneficial. A physical therapist can help you regain strength, flexibility, and range of motion in your ankle. They can also provide exercises tailored to your specific needs and monitor your progress.

- Pain Management: Discuss pain management options with your healthcare provider. This may include over-the-counter pain relievers, prescription medications, or alternative therapies such as acupuncture or massage.

- Gradual Return to Activity: It’s essential to gradually increase your activity level. Avoid sudden or high-impact movements that could exacerbate your pain. Instead, focus on low-impact exercises that promote mobility without putting excessive strain on your ankle.

- Follow-Up Care: Regular follow-up appointments with your orthopedic specialist can help monitor your recovery and address any ongoing issues. If your pain persists or worsens, further imaging studies, such as an MRI, may be warranted to assess for any underlying issues.

- Lifestyle Modifications: Consider modifying your daily activities to reduce strain on your ankle. This may include using supportive footwear, avoiding uneven surfaces, and incorporating rest periods into your routine.

In conclusion, while it can be disheartening to experience chronic pain after an ankle fracture, it’s important to remember that recovery is a process. With appropriate rehabilitation and care, many individuals can regain function and reduce pain over time. If your symptoms continue to interfere with your daily life, don’t hesitate to seek further evaluation and treatment from your healthcare provider.

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