Ankle Injections

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Ankle Injections 2016-10-24T13:56:18+00:00

What Is An Ankle Injection?

An ankle injection involves the administration of several medications to the ankle joint and the soft tissue that surrounds it. Corticosteroids and an anesthetic are usually injected into the affected ankle. Chronic ankle pain is often the result of tissue damage and inflammation that may develop due to various conditions (e.g., bursitis, arthritis) or blunt trauma to the ankle.

Pain-Doctor-Ankle-Injection-5Ankle injections are usually recommended if over-the-counter pain relievers (e.g., aspirin, ibuprofen) have been ineffective at treating the ankle pain and an individual is beginning to suffer from significant mobility problems, swelling, tenderness, deformity, or cracking and popping sounds during movement. Ankle injections may also be recommended before more invasive approaches, such as surgery, are considered.

In addition to being used as a therapeutic treatment to reduce or alleviate pain, ankle injections are also used as a diagnostic tool to determine if a patient may respond well to more invasive forms of treatment, such as a nerve block. The nerve block procedure involves injecting strong medication that temporarily prevents nerves from transmitting pain signals to the brain or destroys the nerves that are responsible for the pain. A series of successful ankle injections indicates that a nerve block would probably be effective.

How Is An Ankle Injection Performed?

Pain-Doctor-Ankle-Injection-6An ankle injection is a non-invasive procedure that takes a few minutes to complete. The injection site is initially cleaned and then topical anesthesia is applied to the affected area. A needle is carefully inserted into the ankle and its correct placement is confirmed. Next, a corticosteroid (e.g., cortisone) and anesthesia are administered through the needle. The steroid reduces the inflammation, while the anesthesia relieves the pain. Some patients report feeling mild pain and pressure while the medication is being injected.

It is usually recommended that patients stay off of the affected foot for several days in order to protect the ankle.  Accordingly, people who walk or stand frequently at their jobs typically have to take a few days off or find ways to avoid putting unnecessary pressure on the ankle until the pain subsides.

The use of a cold compress for 20 minutes several times throughout the day and non-steroidal anti-inflammatory medicine such as ibuprofen is often suggested for temporary pain and swelling after the injection. Dramatic pain relief usually begins one to two days after the injection for most patients, but if pain persists for more than a few days, it should be reported to a doctor.

Pain-Doctor-Ankle-Injection-8Risks that are associated with ankle injections include an infection, the potential puncturing of an artery or vein, a possible tendon rupture or a weakened tendon, cartilage deterioration, thinning of the bone (osteoporosis), or the death of surrounding bone (osteonecrosis). The Achilles tendon, in particular, must be avoided during the insertion of the needle.

Having a history of allergic responses to injections, autoimmune diseases that disrupt the body’s ability to fight injections, skin or blood infections, or diabetes that is poorly controlled makes individuals more susceptible to experiencing complications after the procedure.

Doctors typically avoid administering more than three to four injections during one year in order to prevent these types of complications from occurring. Patients who are taking herbal supplements or medication that thins the blood are instructed to discontinue taking them several days before the injection to minimize bleeding and bruising at the injection site.

Conditions Related To Ankle Injections

Conditions that may cause tissue damage, inflammation, and chronic pain in the ankles include:

  • Rheumatoid arthritis
  • Osteoarthritis
  • Bursitis
  • Tendinitis
  • Gout
  • Synovitis
  • Tarsal tunnel syndrome

Both arthritis and tarsal tunnel syndrome may result in symptoms such as pain, burning, tingling, and pricking sensations that become worse during weight-bearing activities. Arthritis that develops in the ankles often affects athletes who had repeated ankle injuries in the past, as well as older individuals. Tarsal tunnel syndrome refers to the compression of the tibial nerve in the ankle region.

Doctors typically discuss the option of receiving an ankle injection treatment with individuals who did not experience relief from their symptoms after resting the ankles, receiving physical therapy, or taking non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen. Ankle injections reduce pain and improve mobility for most patients who have arthritis or tarsal tunnel syndrome.

Gout is another form of arthritis that causes stiffness and inflammation. In addition, bursitis and tendinitis are similar forms of inflammatory conditions. Synovitis refers to the inflammation of the lining in the joints. Ankle injections have demonstrated the ability to reduce inflammation caused by each of these conditions.

Conclusion

Pain-Doctor-Ankle-Injection-1An ankle injection is a common treatment approach for chronic ankle pain. This non-invasive approach involves administering medication such as lidocaine and cortisone to the ankle joint. Cortisone is a steroid that reduces inflammation and lidocaine is an anesthetic that relieves pain. Ankle injections are usually suggested for patients who were previously treated with physical therapy, extended rest, or NSAIDs but did not experience significant relief.

Despite the potential complications, this is an effective treatment approach. There are a number of conditions that are treated with ankle injections such as rheumatoid arthritis, osteoarthritis, bursitis, tendinitis, gout, synovitis, and tarsal tunnel syndrome. Improved mobility as well as pain relief is typically reported after undergoing this procedure.

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References

  1. Cardone DA, Tallia AF. Joint and soft tissue injection. Am Fam Physician. 2002;66:283-288.
  2. Tallia AF, Cardone DA. Diagnostic and therapeutic injection of the ankle and foot. Am Fam Physician. 2003;68(7):1356-1362.
  3. Khoury NJ, el-Khoury GY, Saltzman CL, Brandser EA. Intraarticular foot and ankle injections to identify source of pain before arthrodesis. AJR Am J Roentgenol. 1996;167:669–73.
  4. Omey ML, Micheli LJ. Foot and ankle problems in the young athlete. Med Sci Sports Exerc. 1999;31(7 suppl):S470-486.
  5. Stone DA, Abt JP, House AJ, Akins JS, Pederson JJ, Keenan KA, Lephart SM. Local anaesthetics use does not suppress muscle activity following an ankle injection. Knee Surg Sports Traumatol Arthrosc. 2013;21(6):1269-1278.

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