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Pain in front feet, pain after walking or standing for long time. Had ankle sprain, no fracture. Taken myospaz forte. Why the persisting pain?

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General & Family Physician
Practicing since : 2005
Answered : 15 Questions
Hi,Need some help on my ankle sprain. I had an ankle sprain about a month back while playing tennis. It was very painful initially and I had taken Myospaz Forte for pain and inflammation for few days and applied a pain relieving ointment with crepe bandage (mainly at night). Pain got relieved and swelling also subsided in few days, but I still got an ex-ray done to rule out any kind of fracture. There was no fracture detected of any form. But the pain is still persisting and it is in the front portion of my feet (where the front portion of ankle touches the shoe). Pain starts to develop whenever I wear a tight fitting shoes and/or when I walk for a prolonged time or have to stand for longer duration. Sometimes it is very painful and I have to take Myospaz forte. I am also realizing that ankle starts paining while sleeping/lying down whenever I move my ankle towards front postion (that means raise my front foot while resting my heel on ground or bed). Please advise
Posted Sun, 15 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Puneet Oberoi 1 hour later
Thank you for your query.
Well from the history you have told me, it points out to a ligament tear, as its already been confirmed that you don’t have a fracture as per the X-RAY report .I would strongly suggest that you need to undergo a MRI scan as that will tell the extent of the tear.

Don’t put pressure on the affected ankle. Keep it elevated. You can prop it up on stacked pillows as you sleep. You could also benefit from physical therapy sessions. Before indulging in any physical activity, make sure that the torn ligament in ankle has healed completely. For a torn ligament in ankle, recovery time will vary depending on the severity of ligament tear. If it is a first degree sprain, it might take 2-6 weeks to heal. In case of a partially torn ligament in ankle, the symptoms will disappear in about 4-8 weeks. In case of a complete rupture, the ligament could take 8-12 weeks to heal, like I have mentioned before that the extent will be known to us thru the MRI scan.

Rest is very important. Any strain to the torn ligament in ankle can cause complications. So, take adequate rest, also avoid tight fitting shoes as that will only delay the healing process
Occasionally, when the ligaments heal, they are weaker or looser then prior to the injury. This results in an ankle that is more likely to be unstable and twist more easily. So that’s why physical therapy is recommended as it allows the adjacent muscles to strengthen and stabilize that joint.

As far as the pain killer medication you are taking, you can carry on with it but ONLY UNDER SUPERVISOIN of your physician.
I will also suggest few range of motion exercise that you should do

1)      While seated or lying down, take a towel and loop it around your toes. Pull the ends of the towel, pulling your toes upwards, and feel the stretch in the back of the ankle. Perform this 3-4 times a day for several minutes
2)     While seated or lying down, write the alphabet in the air with your toes. Make the letters as big as possible.

3)     Walk on your toes for one minute, then on your heels for one minute. Alternate walking on your heel and toes, and work up in time to a total of 10 minutes, repeating 4 times each day.

I will be available to answer your follow up queries as well.
Take care
Wishing you a speedy recovery
Dr Puneet Oberoi

Above answer was peer-reviewed by
Follow-up: Pain in front feet, pain after walking or standing for long time. Had ankle sprain, no fracture. Taken myospaz forte. Why the persisting pain? 17 hours later
Thanks for the reply Dr. XXXXXXX MRI is an expensive affair. As an alternative can you subscribe a medication considering it is a Ligament rapture (kind what normally happenes in an ankle sprain), since fracture has already been ruled out, hence Ligament rapture will be the only cause of pain. If after medication pain still persist then I can go for the MRI scan.

Do youy think it makes sense
Answered by Dr. Puneet Oberoi 4 hours later
well I can understand your concern about the expense of an MRI, but the fact remains that only a MRI will show us the extent of a ligament or any tissue damage, which is necessary to asses in your case , since its been more than a month without any relief so the next best step would be to consider a MRI. The medications will only give temporary relief to pain but will not cure the underline cause, so i will recommend that you should not wait any further and get the MRI done.
Take care
Dr Puneet Oberoi
Above answer was peer-reviewed by
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