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Have flat feet. MRI showed mild effusion in the tibiotalar ligament. How to cure this?

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Orthopaedic Surgeon
Practicing since : 1994
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I had an ankle sprain 8 months ago. The MRI scan shows mild effusion in tibiotalar ligament and some injury in deltoid ligament. Have tried various treatments from various doctors including physiotherepy and a 6 wk plaster. Every treatment has led to relief for a few days but the pain keeps coming back as i resume normal activity/increase workload. The pain comes without any specific movement or trigger, starts from one area in the ankle (mostly inside), travels in the whole foot and stays for 10-15 minutes, during which its impossible to walk or stand properly. It goes away gradually in the day, on very bad days it re occurs everytime i get up to walk. On good days, it doesnt come at all but even on these days i cant do anything extreme (like running). Im totally frustrated as there's no pattern to when and how much and how often these pain attacks occur. Doctors are refusing to do arthroscopy as the diagonosis is not conclusive towards any tear. I also have flat feet which some doctors say is adding to the problem. What are my options, really want to get rid of this problem and return to full fitness activities like running, playing. Regards, XXXXXXX
Posted Thu, 21 Mar 2013 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 22 minutes later
Thanks for posting your query.
The mild effusion in the tibiotalar ligament is likely to be due to a post traumatic inflammation which is causing the recurrent pain attacks. An arthroscopy will not help you much unless there is a diagnosed tear of the ligament present.
In such inflammatory pains, the best treatment is regular hot fomentation with heating pads to increase the blood circulation in the area. In addition to this, you can get local steroid injections to reduce the local inflammation.
Please do not worry as the inflammation is likely to improve with rest, steroid injections.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.
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