When Should You Worry About Foot Or Ankle Pain?
Some cases of foot and ankle pain require urgent attention.
Sudden Onset Foot Or Ankle Pain
Traumatic injuries that occur at speed or involve a multi-direction component such as twisting may result in foot or ankle fractures or significant soft tissue injuries, e.g. syndesmosis or high ankle sprains.
The Ottawa Ankle Rules determine the need for X-rays in acute ankle or foot injuries.
Ankle X-ray is only required if:
- There is any pain in the malleolar zone; and,
- Any one of the following:
- Bone tenderness along the distal 6 cm of the posterior edge of the tibia or tip of the medial malleolus, or
- Bone tenderness along the distal 6 cm of the posterior border of the fibula or end of the lateral malleolus, or
- An inability to bear weight immediately and in the emergency department for four steps.
Foot X-ray is indicated if:
- There is any pain in the midfoot zone; and,
- Any one of the following:
- Bone tenderness at the base of the fifth metatarsal (for foot injuries), or
- Bone tenderness at the navicular bone (for foot injuries), or
- An inability to bear weight immediately and in the emergency department for four steps.
Chronic Ligament Instability
Chronic ligament instability in your foot and ankle can cause premature osteoarthritis and joint deformity. Some conditions can be safely rehabilitated without surgery, whereas other conditions, such as a Lisfacnc injury, may require surgical repair.
Please consult your doctor or physiotherapist for specific foot or ankle injury advice.
Gradual Onset Pain That Fails To Improve
Stress Fractures
Stress fractures can be serious. While you may not have had a sudden traumatic injury, the ankle and foot are highly susceptible to stress fractures. Several bones in your foot can have their blood supply compromised by a stress fracture, leading to bone necrosis (death). These potentially life-changing conditions should seek an early assessment from your doctor or physiotherapist.
The good news is that most ankle and foot pain is not sinister and improves with physiotherapy and other non-surgical options.
Please ask your physiotherapist or doctor for advice.
