Why is My Ankle Still Hurting?

Eric H. Williams MD
Specializing in reconstructive surgery and pain relief in the Greater Baltimore area.

Sure, it’s natural to expect a certain degree of pain following an ankle sprain. When there’s still a pain six months after the condition has been treated appropriately, though, the problem might actually be a damaged nerve. If this describes your situation, we will be happy to take a look and evaluate potential treatment options.

One of the most common problems we see in our office is long-lasting pain following an ankle sprain. For some patients, nerves in or around the ankle may be pinched, stretched, or otherwise damaged. Unfortunately, this may go unrecognized for extended periods of time. Knowing what has happened and what to look for, though, is instrumental in finding the relief you need.

Ankle PainYour first line of defense following an ankle sprain—one of the most common injuries humans sustain—is typically the first aid administered by a coach, athletic trainer, or even yourself. Rest, ice, compression, and elevation (RICE therapy) work wonders for many sprained ankles. When this is not enough, you need to move on to the second line of defense – professional treatment from a podiatrist or orthopedic specialist.

An orthopedic or foot doctor will assess structural damage to the ankle with regards to connective tissues. Theses medical professionals may prescribe either conservative or surgical treatment, depending on the severity of your injury. When six months of treatment have lapsed and your doctor is telling you there’s nothing wrong—even though you are experiencing tremendous pain—he or she may recommend seeing a doctor who specializes in pain management.

Pain management doctors perform a valuable service, but actually resolving the problem responsible for your pain isn’t what they do. These doctors offer options to relieve pain. They are often highly-trained in pharmaceutical solutions, but not fixing structural issues (including those compromising nerve function).

Many people who have issues after an extended period (6 months and more) following an ankle sprain experience neuropathic symptoms – like buzzing, searing, and burning pain, or tingling sensations. In some cases, there is muscular or joint weakness when motor nerves are damaged during the injury. There are certain differences in which symptoms are presented, but the fact remains that they can all be rather debilitating and keep you from your favorite activities.

If the symptoms have been present for an extended period of time, it is likely they are caused by nerves that have been compressed (pinched) or have too much pressure placed upon them. These issues can develop after physical trauma, long-lasting repetitive motion, and microtrauma from simple, everyday use.

Our practice specializes in taking pressure off of nerves and relieving the compression causing pain. A common example of this is when we treat carpal tunnel syndrome. Due to how frequently keyboards are used in jobs and school, carpal tunnel syndrome has become a pretty well-known condition. It develops when the nerves that run through the carpal tunnel in your wrist are compressed on a frequent basis. Less-commonly known is tarsal tunnel syndrome.

The tarsal tunnel is found in the back of your ankle and contains a portion of the posterior tibial nerve. When pressure on the anatomical structure causes it to compress this nerve, you may experience any of the aforementioned neuropathic symptoms.

In some cases, an ankle sprain leads to compression on the nerve in the tarsal tunnel. If this is the source of the problems you are experiencing—and you have undergone at least 6 months of traditional treatment for an ankle sprain—we may be able to help. Contact our Baltimore, MD office for a consultation, and we can evaluate your condition. Give us a call at (410) 709-3868 and our staff can answer any questions and help schedule your appointment.

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