What conditions should be considered if pain continues after rehabilitation of an ankle sprain?

Updated: Jan 14, 2019
  • Author: Craig C Young, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

Continued pain after rehabilitation

If pain persists despite rehabilitation, diagnoses to consider include the following:

  • Intra-articular meniscoid lesions represent localized fibrotic synovitis in the lateral ankle following inversion sprains; the condition also is known as impingement syndrome.

  • Peroneal tendon subluxation is due to detachment of the peroneal retinaculum from its normal insertion on the posterior border of the fibula to the lateral surface of the fibula.

  • Talar dome fracture occurs with inversion and eversion injuries, but it may not be readily seen on radiographs.

  • Anterior process fracture of the calcaneus occurs with inversion injuries. Patients commonly display bony tenderness rather than ligamentous point tenderness.

  • Complex regional pain syndrome (CRPS), or reflex sympathetic dystrophy, can develop after ankle sprains. The reason for this is unknown; however, the condition may arise from an abnormal response to disuse and/or splinting of the foot and ankle. Early, controlled activity and rehabilitation may prevent the development of CRPS.


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