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Descripción general del dolor de tobillo

Ankle pain can significantly impact your daily life and mobility. It can result from acute and chronic conditions and affect individuals of all ages. Understanding the root cause of the pain is the first step in determining available treatment options. Whether you've recently experienced an ankle injury or are dealing with persistent pain, our healthcare team will create a personalized treatment plan to get you moving again.

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Common causes of pain in the ankle

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Ankle pain affects people of all ages and backgrounds. Understanding the causes of ankle pain is crucial to providing an accurate diagnosis and a tailored treatment plan. From the common ankle sprain to the more complex ankle arthritis, there are many reasons why you might experience ankle pain.

  • Esguinces

    Esguinces

    Ankle sprains are among the most common causes of ankle pain. They typically result from stretching or tearing ligaments due to sudden twisting or rolling of the ankle. Stretching or tearing ligaments can lead to varying degrees of pain, swelling and instability, making sprains painful for athletes and individuals with an active lifestyle. Usually, ankle sprains will improve with a short rest period and a simple rehab program. Occasionally, people can have persistent pain after an ankle sprain or develop repeated ankle sprains, which may require further diagnosis and treatment.

  • Inestabilidad del tobillo

    Inestabilidad del tobillo

    When a person sustains multiple ankle sprains, whether from trauma or due to an underlying deformity, this may lead to a condition known as functional instability (FI). FI is where the ankle is unstable to the point that you watch your step very carefully, are wary on uneven ground, or even feel the need to wear ankle braces with daily activity for fear of experiencing another sprain. This condition may also be associated with cartilage injury in the ankle joint itself.

  • Osteochondral defects (OCDs)

    Osteochondral defects (OCDs)

    Osteochondral defects (OCDs) are abnormalities that involve both the cartilage and underlying bone in a joint. The surfaces of our bones are coated in cartilage, which is responsible for the smooth, gliding motion of the joint. Trauma, wear and tear and arthritis can cause pieces of cartilage to become loose or dented, causing ankle pain.

  • Artritis

    Artritis

    Artritis can affect the ankle joint or the joint below the ankle (called the subtalar joint) and cause pain and stiffness. Around 80-90% of arthritis around the ankle is post-traumatic, meaning it is due to a prior injury. Less commonly, rheumatoid arthritis or another inflammatory arthropathy (autoimmune disorder) can cause ankle arthritis. Arthritic ankle pain is often characterized by stiffness, decreased range of motion and swelling around the joint.

  • Tendinitis

    Tendinitis

    Tendinitis in the ankle occurs when the tendons around the joint become inflamed. It can result from overuse, injury, or an underlying foot deformity, causing the tendons to overwork or tear. Tendonitis often leads to pain and swelling around the ankle and can be uncomfortable during weight-bearing activities or sports.

  • Fractures (Broken bones)

    Fractures (Broken bones)

    Fractured or broken bones in the ankle can be a source of acute pain. These injuries can occur due to falls, accidents or direct trauma to the ankle. Pain intensity depends on the fracture's type and location, with some fractures causing severe discomfort and limited mobility. An ankle fracture can mean a break at the end of your tibia, fibula, or both, commonly occurring with a ligament injury.

  • Bone bruises

    Bone bruises

    Bone bruises are often a result of traumatic injury and can be very painful. These deep bruises can result in prolonged discomfort, especially when walking or putting weight on the affected ankle.

  • Less common causes of ankle pain

    Less common causes of ankle pain

    • Gout: A form of arthritis, gout is caused by the buildup of uric acid crystals in the joints, leading to sudden and intense pain in the ankle or toes.
    • Bone infection: Infections within the bone, such as Osteomielitis, can lead to localized pain and swelling.
    • Tarsal tunnel syndrome: Tarsal tunnel syndrome is similar to carpal tunnel syndrome but affects the ankle, resulting in nerve-related pain, usually radiating to the bottom of the foot.
    • Peroneal nerve injury (Foot drop): Nerve compression or damage high up the leg or in the back can cause ankle pain and weakness.
    • Tumors: Ankle tumors are rare but can cause persistent pain, particularly when they pressure surrounding structures. Benign soft tissue tumors, like ganglion cysts, can cause ankle pain and difficulty with shoes.

Diagnosing ankle pain

Ankle pain requires a thorough examination by a medical professional to establish an effective treatment plan. By obtaining a thorough medical history, performing a clinical examination and reviewing imagery such as X-rays, your provider can diagnose the cause of your pain and develop a treatment plan with you.

Historial médico

The diagnostic journey begins with a comprehensive review of your medical history. Information about prior injuries, medical conditions and lifestyle factors provides valuable insights for healthcare providers. Your descriptions of your symptoms and pain are essential in guiding the diagnosis.

Examen físico

A physical examination is fundamental in assessing ankle pain. Your provider will press on particular areas around your foot and ankle to see where your pain is located. They will evaluate your overall foot alignment and check your range of motion, strength, sensation, and pulse.

Análisis de sangre

Sometimes, blood tests may be requested to rule out gout, infection or inflammatory arthritis. These tests can help detect elevated uric acid levels or specific antibodies, aiding in the differential diagnosis.



Imagen

X-rays are the first-line imaging tool for assessing ankle injuries, fractures and arthritis. In more complex cases or when soft tissue injuries are suspected, magnetic resonance imaging (MRI) or computed tomography (CT) scans may be recommended to provide more detail.

Differential diagnoses

Differential diagnoses are a group of diagnoses that can explain your symptoms. Through a careful history, physical examination and imaging review, your provider can hone their diagnosis and help you develop a treatment plan.

Tratamiento del dolor de tobillo

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Your treatment plan for ankle pain is created by your healthcare team and tailored to your needs. Your care will be guided by the nature of your condition, its severity and individual preferences. Addressing ankle pain ranges from non-invasive strategies to surgical options.

  • Support and stability

    Support and stability

    For mild ankle pain, supportive measures can make a significant difference. Utilizing ankle braces or wraps can help stabilize the joint, reduce strain and promote healing. Supportive footwear is also essential in maintaining proper alignment and minimizing discomfort.

  • Terapia física

    Terapia física

    Terapia física plays a pivotal role in rehabilitation. Tailored exercises and stretches are designed to improve ankle strength, flexibility and range of motion. Physical therapy not only aids in pain relief but also helps prevent future issues.

  • Medicamentos

    Medicamentos

    Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can provide temporary relief from pain and inflammation. Sometimes, healthcare providers may recommend prescription medications for more severe conditions, such as autoimmune-related arthritis.

  • Surgery

    Surgery

    When conservative treatments fail to alleviate the pain or when severe structural damage exists, surgical interventions become a consideration. The choice of ankle surgery depends on the specific condition, its severity and the patient's overall health. Orthopedic surgeons will carefully assess each case and consider the most suitable surgical approach to ensure the best possible outcome of ankle pain relief and improved joint function.

    Common surgical procedures include:

    • Arthrodesis (ankle fusion): This surgical procedure involves fusing the ankle joint by removing the cartilage and joining the bones. The procedure alleviates pain by eliminating motion in the ankle joint.
    • Arthroplasty (ankle replacement): Ankle arthroplasty focuses on replacing the damaged joint. The surgeon may replace damaged joint surfaces with artificial implants to maintain the ankle's range of motion and pain relief.
    • Fracture repair: Ankle fractures may require surgical repair. Depending on the type and location of the fracture, the surgeon may use screws, plates or pins to realign and stabilize the bones. Sometimes, ligament repair is required at the time of surgery.
    • Tendon or ligament surgery: Surgical procedures can repair damaged tendons or ligaments surrounding the ankle, often due to injury. These operations aim to restore the ankle's function and stability and alleviate pain.
    • Deformity correction: If an underlying deformity (such as flat feet or high arches) is part of the problem, the surgeon may correct this deformity by performing an osteotomy, which realigns or shifts the ankle bones or a tendon transfer.
    • Arthroscopy: Ankle arthroscopy is a procedure where a small camera is placed inside the joint, allowing the surgeon to evaluate cartilage injuries and treat them through small incisions. Sometimes, this means removing loose cartilage or adherent scar tissue, stimulating healing of prior injuries, or, more rarely, replacing damaged cartilage with healthy tissue from a donor source. Often, ankle arthroscopy is performed at the same time as another operation.
woman stretching to relieve ankle pain in living room

How to relieve ankle pain at home

Ankle pain can disrupt daily routines and hinder our mobility, but minor ankle pain doesn't have to be a major obstacle. Effective strategies and treatments can often be found in your home's comfort. Whether you've experienced a minor strain, have aching joints due to arthritis or are recovering from an injury, these techniques can provide relief. However, consult a healthcare professional for more severe or persistent symptoms to ensure a precise diagnosis and appropriate treatment plan.

  • Método ARROZ
    • Descanso: Give your ankle the rest it deserves. Avoid activities that place excessive strain on the affected joint. Rest allows the body to initiate the healing process.
    • Ice: Applying ice to the painful area can help reduce inflammation. Remember to wrap the ice pack in a cloth to prevent direct skin contact.
    • Compression: Utilize a compression wrap or socks to control swelling and stabilize the injured ankle. Ensure it's not too tight, as this can impede blood flow.
    • Elevation: Elevate your ankle above the level of your heart when at rest. Elevation helps reduce swelling by allowing excess fluid to drain away.
  • Over-the-counter pain medications

    Non-prescription pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can temporarily relieve pain and inflammation. Always follow the recommended dosage and do not take it if you have certain medical conditions, such as stomach ulcers. Be sure to ask your healthcare provider if you have any concerns.

  • Stretching and gentle exercises

    Gradual and controlled ankle exercises can improve flexibility and strength, aiding recovery.

How can I prevent ankle pain?

Ankle pain can be uncomfortable and disruptive to daily life, but taking proactive steps can help reduce the risk of such discomfort and help you maintain a healthier, more active lifestyle.

  • Stay physically active: Regular exercise not only strengthens the muscles around the ankle but also promotes joint stability.
  • Proper footwear: Invest in supportive and well-fitting footwear that provides adequate cushioning and arch support.
  • Maintain a healthy weight: Additional weight can add stress to the ankle joints, so strive to maintain a healthy weight through diet and exercise.
  • Warm-up and cool down: Before exercise, warm up with gentle stretches to prepare the muscles and joints, and afterward, cool down to help prevent stiffness.
  • Balance and flexibility: Include balance and flexibility exercises in your routine to enhance joint stability.

When should I call my doctor about ankle pain?

Seek medical attention if you're experiencing persistent ankle pain or noticing specific symptoms, especially if your pain doesn't respond to over-the-counter pain relievers.

Any visible deformity, such as swelling, bruising or a malformed joint, should be examined by a doctor. Prolonged symptoms or recurrent ankle pain, especially if you have a history of chronic issues, should also be addressed.

Lastly, if you notice signs of infection, such as redness, warmth, increased swelling or fever, contact your healthcare provider promptly. If ankle pain is accompanied by systemic symptoms like numbness, tingling or pain radiating down the leg, it may indicate a nerve-related issue requiring medical attention.

Early intervention often leads to better outcomes, so if you're uncertain when to contact your doctor regarding ankle pain, it's always safer to seek professional advice to rule out potentially serious conditions or injuries.

Preguntas frecuentes

  • Can ankle pain be caused by sciatica?

    Yes, sciatica can lead to radiating pain from the lower back down to the ankle. Sciatica often results from pressure on the sciatic nerve, which can cause discomfort in the leg, including the ankle. Most of the time, a compressed nerve in the back will cause numbness in the foot or ankle in a specific region.

  • How can I reduce ankle pain while running?

    To reduce ankle pain while running:

    • Ensure proper footwear with adequate cushioning and arch support. Your healthcare provider can help you understand your foot and what shoe or insert may be most supportive.
    • Gradually increase your running intensity and incorporate warm-up and cool-down exercises.
    • Consider consulting a foot and ankle surgeon for guidance.
  • What causes ankle pain without injury?

    Ankle pain without a specific injury can stem from various factors, including overuse, deformity (such as high arches or flat feet), wear and tear, underlying conditions like arthritis or even improper footwear. An evaluation by a healthcare provider is essential for an accurate diagnosis.

  • Why is my ankle pain worse in the morning?

    Morning ankle pain can be attributed to factors such as overnight inflammation or stiffness. Conditions like plantar fasciitis or arthritis often exhibit increased discomfort in the morning due to immobility during sleep.

  • Is ankle pain in pregnancy common?

    Ankle pain can occur during pregnancy due to hormonal changes and increased weight, adding pressure on the lower extremities. Swelling, commonly associated with pregnancy, can also contribute to ankle discomfort.

  • Can ankle pain be caused by flat feet?

    Yes, flat feet can lead to overpronation, affecting the alignment of the ankle joint. Over time, this can contribute to ankle pain and impingement on the outside of the ankle and foot. Supportive footwear or orthotic inserts may help improve this issue.

  • Why does my ankle hurt while popping?

    Ankle pain during popping movements may be due to tendon subluxation, ligament strain or a problem in the ankle joint. If the pain persists during popping, it's advisable to consult a medical provider.

  • Is there a connection between ankle pain and plantar fasciitis?

    Ankle pain can be connected to plantar fasciitis since the plantar fascia, a band of tissue running from the heel to the toes, is important for walking and running. Often, the pain from plantar fasciitis can cause you to change how you walk and can impact other joints, including the ankle, knee, hip or back.