Ankle Pain and Swelling
November 29, 2021 by Dr. Moore
The ankle is one of the more complicated joints in the body. It undergoes a high degree of stress, torque, and repetitive strain. It is also a much smaller joint that supports larger joints above. Ankle sprains, fractures, strains, swelling, ‘catching’, ‘giving out’, general ‘ankle instability‘ and active processes like arthritis cause pain and sometimes debilitating outcomes for a large number of patients in our practice.
Fortunately there are simpler and more effective treatments for these problems today. Ankle arthroscopic procedures can not only relieve and remove damage within the joint. Repairing cartilage and the bone that supports it have both new procedures, equipment and biologic products that enhance healing and speed recovery. Even ligament repairs are simpler with reinforcement devices and products that can return 100 % stability and strength. Ankle fracture surgical repairs have more options as well with more sophisticated hardware and fixation devices. And the end stage procedures like ankle replacements and fusions have evolved with better, more durable equipment. This also results in faster recovery times.
Initial x-rays and other testing like lab testing, MRI, CT scans can all be performed in the clinic visit or at an out patient facility. Temporary relief and target diagnostic testing with cortisone injections can give temporary or lasting relief depending upon the ankle disorder. Oral anti inflammatories, bracing, contrast ice/heat, and physical therapy are other options to treat ankle symptoms as well. Still in the research stages, biologics are also an option for healing injuries and cartilage damage with injection therapy.
Ankle Swelling and Pain FAQs
1. Why is my ankle swollen and painful?
From high blood pressure to venous insufficiency, there are many systemic medical conditions that can cause ankle swelling. More common are the injuries like sprains and fractures. Also common are long term conditions like osteoarthritis and other types of cartilage damage.
2. When should you see a doctor for swollen ankles?
If the swelling only lasts a day or two, monitor the changes with seated activities and also increased activities like high impact work/exercise. You should see a doctor if the swelling is consistent and/or associated with pain, redness, ‘popping’ noises, jamming, giving out, aching at night, or stiffness in the morning.
Ankle swelling has different levels of severity from mild, to ‘pitting edema, to ‘third spacing’ – the most severe form of swelling where fluid from the body leaks through the skin. Pitting edema is serious enough for a visit to the doctor’s office for an evaluation and to rule out other more serious systemic problems (Eg. Renal insufficiency, High Blood Pressure, etc.). Local problems like DVT (Deep Venous Thrombosis) are life threatening and third spacing can cause more serious problems like infection.
4. How do you reduce swelling and pain in ankles?
Simple elevation at or above the level of the heart is the simplest way to reduce ankle swelling. Diet modifications can help as well by consuming less salt and sugar. Medications like diuretics are effective, but can cause some side effects. A better and easier way to control ankle swelling during the day is wearing support stockings. Better known as ‘Dynamic Compression Stockings”, they come in different lengths (knee high, thigh high) and compression levels (8, 14, 20, 30 mmHg).