Ankle Pain
Causes
- Congenital - Club foot, Flat foot
- Ankle Sprain
- Achilles Tendonitis
- Nerve Injury
- Fractures
- Ligament Injuries
- Repetitive Stress Injuries
- Degenerative Diseases
Symptoms
- Pain especially while weight bearing on the foot
- Tenderness
- Swelling
- Bruising
- Restricted movement of Ankle
- Instability in Ankle
Types of Conditions in Ankle Pain:
Sprained Ankle
It is the term used for Ligament injuries of the ankle. Commonly, it is an inversion injury, and the lateral collateral ligament is sprained. Sometimes, an eversion force may result in a sprain of the medial collateral ligament of the ankle. The patient gives history of a twisting injury to the ankle followed by pain and swelling over the injured ligament. Weight bearing gives rise to excruciating pain.
Plantar Fasciitis
This is a common cause of pain in the heel. It occurs as a result of inflammation of plantar aponeurosis at its attachment on the tuberosity of the calcaneum. The pain is worst early in the morning, and often improves with activity. On examination, there is marked tenderness over the medial aspect of the calcaneal tuberosity, at the site of attachment of the plantar fascia. X-rays sometimes show a sharp bone spur projecting forwards from the tuberosity of the calcaneum.
Achilles Tendinitis
Achilles tendon is a band like tissue that connects calf muscle to the heel. Achilles tendinitis is the inflammation of Achilles tendon which is caused due to overuse of tendon. It is most commonly seen in runners, athletes.
Causes
- Achilles Tendinitis is Pain in the lower back of leg,
- Above the heel especially after running or other sports activities.
Calcaneal Spur
It is a spike of bone at the anterior edge of the Calcaneal Tuberosity (usually medial). It may be seen on the posterior aspect of the calcaneum also and is called the Retro-Calcaneal Spur.
Causes
- Due to repeated attacks of plantar fasciitis.
- Due to repeated trauma.
- Constant pulls of the shortened plantar fascia.
- Ill-fitting footwear.
- Fibromatosis of the plantar fascia.
Clinical Features
- The patient complains of pain over ball of the heel
- Tenderness on plantar aspect of the heel.
- Swelling at the attachment of plantar fascia. It is due to fibrositis or traumatic detachment of plantar fascia.
Foot Drop
In foot drop the foot remains in plantar flexion due to weakness of Dorsiflexors. Nerve supply to the Dorsiflexors of the foot is by common peroneal nerve. Any damage to common peroneal nerve leads to foot drop.
Causes
- Leprosy
- Poliomyelitis
- Spina bifida
- Fractures
- Tumors
- Disc prolepses
Symptoms
- Type-1: The patient cannot Dorsiflex, invert the foot but eversion is possible, front of the leg is wasted.
- Sensation over the dorsal web space is lost
- Type -2: The patient cannot Evert but can Dorsiflex and invert the foot. There is wasting of the outer half of the leg.
- Sensation is lost over outer leg and foot.
- The gait typical of foot-drop is a high stepping gait.
Arthritis
Gout
It is caused by excessive uric acid production in the body. Excessive uric acid production will trigger auto immune response which results in gout attack. Most commonly attacks the great toe.
Symptoms
- Pain- which is aggravated even when a cloth touches the foot
- Swelling
- Redness
Osteoarthritis
It is most common type, which is caused due to wear and tear of the bones. Due to excessive usage of the joint the cartilage of the bones gets destroyed,
therefore cause severe pain while loading the limb.
Psoriatic Arthritis:
- Pain- which is aggravated even when a cloth touches the foot
- Swelling
- Redness
Rheumatoid Arthritis
It is an auto immune disease, that results in swelling, inflammation of joints. It mostly affects the distal joints
Symptoms
- Pain
- Swelling
- Enlarged joints
- Deformities like- hammer toe.
