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What Causes Persistent Pain In Left Ankle Despite Medication?
Question: Hi,
Last year I had pain in my left ankle just few cm above the base. I went to a physician and he diagnosed it as stress fracture. However there was no visible crack/hair line fracture in the x-ray. He gave me Buxoric 40mg for 10 days. He also advised me to use crepe bandage. Running 30 mins every day was the cause of this as I never did it before . I started the treatment around 18th XXXXXXX 2014. I stopped running and any other aggressive things. After one month i was not feeling any pain untill I press the bone gently. It further improved however I kept on feeling pain in the same are every morning after getting up from bed. After 3 months i tried to gradually started jogging in evening, i felt some pain in morning but it usually vanished after 1-2 hours. I stopped again as I was afraid. I went for another x-ray and again it was fine. Now I tried again in march and experienced same issue which again forced me to stop. RIght now I can only feel pain when I gently press it. Whenever I wakeup in morning I can feel little pain while taking first few steps. However I don't feel pain in morning if I didn't do any physical activity even like 10 minute walk last day.
check this url to know the location of pain in my ankle
http://www.techdezire.com/wp-content/uploads/2015/04/320px-Foot_Arche_PSF.png
Last year I had pain in my left ankle just few cm above the base. I went to a physician and he diagnosed it as stress fracture. However there was no visible crack/hair line fracture in the x-ray. He gave me Buxoric 40mg for 10 days. He also advised me to use crepe bandage. Running 30 mins every day was the cause of this as I never did it before . I started the treatment around 18th XXXXXXX 2014. I stopped running and any other aggressive things. After one month i was not feeling any pain untill I press the bone gently. It further improved however I kept on feeling pain in the same are every morning after getting up from bed. After 3 months i tried to gradually started jogging in evening, i felt some pain in morning but it usually vanished after 1-2 hours. I stopped again as I was afraid. I went for another x-ray and again it was fine. Now I tried again in march and experienced same issue which again forced me to stop. RIght now I can only feel pain when I gently press it. Whenever I wakeup in morning I can feel little pain while taking first few steps. However I don't feel pain in morning if I didn't do any physical activity even like 10 minute walk last day.
check this url to know the location of pain in my ankle
http://www.techdezire.com/wp-content/uploads/2015/04/320px-Foot_Arche_PSF.png
Brief Answer:
Cause of ankle pain
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well the location of the pain you are having does go more in favour of the soft tissue like tendon or ligament attachment.
There are a few loose ends here which i did not understand.
Firstly, the stress fracture without any history of twisting or trauma to the ankle is unsual. Just activity normally doesnt cause fracture in a normal bone. So I am not sure if you had any injury or is it something else which we are missing here.
Secondly, Buroxic 40 mg is mainly used for Gout. I doubt you had any episodes of gout here.
The pain you are describing sounds more of a mechanical one than the inflammatory one, that is why you have increased pain on application of pressure. X ray will only pick up bone related changes, but it wont pick up any soft tissue changes. I would suggest you go for an MRI of the ankle which will give us a clearer picture on what exactly is the problem. It is unusual for a stress fracture to last that long.
Do let me know for more queries
Would be happy to help out
REgards
Dr Naval
Cause of ankle pain
Detailed Answer:
Good evening
Thank you for writing on health care magic
Well the location of the pain you are having does go more in favour of the soft tissue like tendon or ligament attachment.
There are a few loose ends here which i did not understand.
Firstly, the stress fracture without any history of twisting or trauma to the ankle is unsual. Just activity normally doesnt cause fracture in a normal bone. So I am not sure if you had any injury or is it something else which we are missing here.
Secondly, Buroxic 40 mg is mainly used for Gout. I doubt you had any episodes of gout here.
The pain you are describing sounds more of a mechanical one than the inflammatory one, that is why you have increased pain on application of pressure. X ray will only pick up bone related changes, but it wont pick up any soft tissue changes. I would suggest you go for an MRI of the ankle which will give us a clearer picture on what exactly is the problem. It is unusual for a stress fracture to last that long.
Do let me know for more queries
Would be happy to help out
REgards
Dr Naval
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks for your response
That pain started last year only when I started running for more than 30 minutes. I used to run for 6 days in a week. I don't remember clearly but I guess I twisted my foot while running. Apart from this I don't remember anything else. Also I never had such issues prior to starting running. Do you really think MRI is the only option here? Is there anything else that can be tried first? Also what do you think may be the cause? Lets assume I have soft tissue damage than what should be the treatment and is it possible to fix this with medication and exercise?
That pain started last year only when I started running for more than 30 minutes. I used to run for 6 days in a week. I don't remember clearly but I guess I twisted my foot while running. Apart from this I don't remember anything else. Also I never had such issues prior to starting running. Do you really think MRI is the only option here? Is there anything else that can be tried first? Also what do you think may be the cause? Lets assume I have soft tissue damage than what should be the treatment and is it possible to fix this with medication and exercise?
Brief Answer:
Soft tissue injury
Detailed Answer:
Good evening
PErtaining to your queries:
1. The site of injury you have mentioned normally doesnt happen in a joint injury Ankle joints are more anterior( that is in front) than posterior. The Achilles tendon attaches at that point and it is a very common site for trauma/Injury. The heeling at that area can take months as it takes all the load. So at times, it is bests to give it a constant rest.
2. Cause could have been exertion itself which twisted it in the wrong direction or constant sprain . The other possibility in that location can be Retrocalcaneal bursitis. It is again a very beningn condition but if not treated can cause discomfort.
3. MRI is just to get to the diagnosis, whether it is stress fracture or ligament/tendon injury since you are still experiencing symptoms on prolonged walking. Moreover, if it is normal we wont have to worry about anything serious and you can focus on isometric exercises for the ankle( that is strengthening the muscles around).After injury, the muscles do tend to get weak. What we are right now thinking of injury or stress fracture, may be just de-conditioning of the joint due to minimum usage. In other words, it will remove the fear of something wrong and give you the confidence to resume your activities again
4. Soft tissue damage treatment does depend on the cause as tendon management is different and the bursitis management is different. It is mostly supportive with rest and exercises under guidance. But yes we need to know what exactly is wrong.
I hope the information was useful. Do let me know for more queries. Would be happy to answer
Regards
Dr Naval
Do let me know fo
Soft tissue injury
Detailed Answer:
Good evening
PErtaining to your queries:
1. The site of injury you have mentioned normally doesnt happen in a joint injury Ankle joints are more anterior( that is in front) than posterior. The Achilles tendon attaches at that point and it is a very common site for trauma/Injury. The heeling at that area can take months as it takes all the load. So at times, it is bests to give it a constant rest.
2. Cause could have been exertion itself which twisted it in the wrong direction or constant sprain . The other possibility in that location can be Retrocalcaneal bursitis. It is again a very beningn condition but if not treated can cause discomfort.
3. MRI is just to get to the diagnosis, whether it is stress fracture or ligament/tendon injury since you are still experiencing symptoms on prolonged walking. Moreover, if it is normal we wont have to worry about anything serious and you can focus on isometric exercises for the ankle( that is strengthening the muscles around).After injury, the muscles do tend to get weak. What we are right now thinking of injury or stress fracture, may be just de-conditioning of the joint due to minimum usage. In other words, it will remove the fear of something wrong and give you the confidence to resume your activities again
4. Soft tissue damage treatment does depend on the cause as tendon management is different and the bursitis management is different. It is mostly supportive with rest and exercises under guidance. But yes we need to know what exactly is wrong.
I hope the information was useful. Do let me know for more queries. Would be happy to answer
Regards
Dr Naval
Do let me know fo
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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