Chronic Pain from an Ankle Sprain – When and How to Seek Help

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

There are few injuries as synonymous with “I really didn’t expect this to happen” than an ankle sprain.

Whether you were charging the field during a game, going out on a run, or simply getting on with your day at work, something just suddenly goes wrong. Your foot lands on something you didn’t expect, or you take a hit that sends your ankle in a direction it was never intended to go.

In most cases, sprains are minor enough to heal with some home care. More severe cases may require some professional intervention, and severe cases that include tears in a ligament or even fractures of surrounding bone may need surgery.

However the story goes, it is supposed to end with the pain eventually going away.

But what about when it doesn’t?

That is when the story can take some long and frustrating turns.

Seeking Answers for Chronic Ankle Pain

Finding the source of chronic pain is not always simple, and can unfortunately be a trying journey.

The first step on this journey should be consulting with your primary care physician or the specialist or surgeon who initially treated you, depending on the case. However, they may not always detect the source of the pain.

You might be told that they do not see anything is wrong. And, to their credit, they may not. The body is extremely complex, and a doctor whose specialty is in orthopedics, for example, is trained to see problems in muscles and bones. They may not know where to look for other potential causes.

That is little solace for someone who is in pain, however. How can they not know the cause of your pain when you feel it so readily? It may be burning, tingling, or numbing. You might feel hypersensitive to the point that sheets or shower water running against your ankle may set off a shot of pain. Socks or closed shoes can also be torture. How can something that has become such a terrible part of one’s life not be obvious to find?

In some cases, it might feel like an orthopedic specialist is blowing you off, or relegating you to pain management. Pills can help, of course, but they don’t cure the problem. Not being as active as you wish to be can lead to depression and deteriorating fitness.

So when do you consider branching out the search?

Time is a Factor

The fact is that, sometimes, pain does continue for a while following recovery from an injury or surgery—at least for a longer time than one might expect. Pain can naturally last as much as 6 months, depending on the circumstances surrounding the injury, treatment, and recovery period.

Now, does this mean you should sit and wait half a year to do anything about your pain? Certainly not! This is when it is time to consult with those who have had direct influence in diagnosing and treating your sprain.

If you have already done this, however, and they have not found a solution, and it has also been more than 6 months that you have been in pain? Then it may be time to consider whether there is a nerve-related issue at hand.

Potential Nerve-Related Causes of Ankle Pain

Nerve specialists may look for several possible causes of chronic pain following an ankle sprain.

If you have not had surgery, we will often determine whether you are experiencing entrapment of a peripheral nerve. In other words, a nerve may be compressed against a bone or other tissue.

This entrapment may not be in the area of the ankle itself, but elsewhere along the path of the nerve system. In addition to the inside and outside of the ankle, other known locations of such entrapments include the foot, back of the knee, and top of the knee. Although the sprain was caused by a direct injury to the ankle, it is possible that a location elsewhere was also affected.

If you have had surgery, we may search for areas of entrapment above, but it may also be possible that a nerve was damaged during the procedure—literally sliced as part of the surgery—or may be entrapped in scar tissue that developed as part of recovery.

It is also possible in some cases that the pain can stem from a condition with the spine.

When we perform an evaluation, we will review your history, including previous studies and procedures. We will also take the time to listen carefully to your description of your symptoms and how they affect your life. The ultimate goal is to help you as much as we are able to, or to direct you to someone who can help if your problem does not fall under our realm of expertise.

Others Share Your Story

It is not fair for someone to have to endure pain and not receive answers for some time. If this describes your situation, you are not alone.

Just one individual we have treated had twisted her ankle at work. She was diagnosed with a torn tendon and had surgery performed by a podiatrist. This, however, did not improve her condition. She then went to an orthopedic surgeon who revised her surgery. This helped somewhat with her pain, but not fully. Further care included physical therapy and wearing a boot for 6 months, but these did not solve the problem, either.

After a year, she was referred to our office, where we discovered a nerve issue that was responsible for her continued pain. While the orthopedic surgeon had performed their job to the best of their abilities and resolved the problem as it pertained to her torn tendon, there was also a nerve problem that they were unable to identify. The patient received care for that from us.

We also have further success stories from others who have received help from chronic pain following a sprain. One such story is below, and others can be found in our testimonials section.  

In our next blog, we will be going into procedures for nerve relief and what a patient should expect from recovery and follow-up.

If you would like further information on what we may be able to do for you concerning chronic pain after an ankle sprain or other injury, you can read more in the free digital guide we have on the topic. Simply head to our Guide Page and fill out the form to receive your digital copy.

If you would like to contact our office in Towson, there are two ways to do so. Please call us at (410) 709-3868 or fill out the online contact form you can find at the bottom of most of our webpages.

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