Ankle Injections

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Ankle Injections 2016-11-17T09:51:26+00:00

What Is An Ankle Injection?

An ankle injection entails administering medication, usually an anti-inflammatory agent (e.g., steroid) and a pain reliever (e.g., anesthetic), to the ankle joint and the surrounding soft tissue. Persistent pain in the ankle is often caused by inflammation and tissue damage that has developed due to blunt force trauma or different conditions (e.g., osteoarthritis, bursitis).

An ankle injection is often recommended if conventional methods (e.g., ibuprofen, aspirin) have not helped relieve the pain and if a patient is having difficulty moving around, or is experiencing tenderness, swelling, or popping and cracking sounds while moving. In addition, an ankle injection is often performed before intensive treatment such as surgery is suggested.

However, ankle injections are not only used for therapeutic purposes to treat chronic pain. They are also used as a diagnostic approach to assess whether a patient could experience longer relief from a more invasive treatment method such as a nerve block. A nerve block entails administering stronger medications into the ankle joint that temporarily disrupt pain signal transmission from the targeted nerves or completely destroy the nerve tissue in the affected region. Two or more ankle injections that provide a patient with significant relief provide an indication that a nerve block could lead to long-term relief.

How Is An Ankle Injection Performed?

Pain-Doctor-Ankle-Injection-5Ankle injections are non-invasive procedures that can be performed in a few minutes. A doctor first cleans the injection site and then applies topical anesthesia to the ankle. Next, the injection needle is inserted into the targeted region. Once proper placement has been confirmed, a corticosteroid, such as cortisone, and an anesthetic are injected into the ankle. The corticosteroid targets the inflammation and the anesthetic provides pain relief. Mild pressure and pain may be felt as the medications are being injected.

Patients are usually told to stay off of the ankle that has been treated for a few days after receiving an injection to prevent unnecessary strain. Accordingly, people whose jobs require them to stand or walk frequently often need to stay home for a couple days or adjust their work habits so the ankle that was treated can be protected from excessive strain until discomfort diminishes.

Furthermore, it is often suggested that over-the-counter pain relievers (e.g., ibuprofen) be taken after the injection and cold compresses be applied to the ankle for 20 minutes throughout the day in order to relieve temporary swelling and pain. Most patients experience significant pain relief one or two days after undergoing this procedure. Patients should quickly report symptoms that persist for several days after the injection.

Ankle injections are associated with the following risks: cartilage deterioration, a weakened or ruptured tendon, the possible puncturing of a vein or artery, an infection, osteoporosis (thin bones), or osteonecrosis (the death of nearby bone). The Achilles tendon is especially susceptible to injury when the needle is being inserted into the ankle. Individuals who may be more susceptible to these types of complications include people who have blood or skin infections, a history of allergic reactions to injections, autoimmune conditions that make it harder for them to fight off infections, or poorly controlled diabetes.

In order to avoid the risks mentioned above, doctors typically limit the number of ankle injections a person can receive annually to three or four. It is also recommended that medication and herbal supplements that thin the blood be discontinued a couple days before receiving an ankle injection to reduce the occurrence of bruising and bleeding at the injection site.

Conditions Related To Ankle Injections

Several conditions cause inflammation, tissue damage, and persistent ankle pain. These include:

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

Foot and Ankle PainTarsal tunnel syndrome, which refers to tibial nerve compression in the ankle, and arthritis may present symptoms such as intense pain, tingling, pricking, and burning sensations that worsen when weight is placed on the ankle. Arthritis in the ankle often develops in older individuals as well as athletes who have a history of ankle trauma. Patients whose symptoms did not decrease after physical therapy, resting the ankle, or using non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are usually told to consider ankle injections as the next form of treatment. Most patients who suffer from tarsal tunnel syndrome or arthritis report improved mobility and pain relief after receiving an ankle injection.

Tendinitis and bursitis are similar conditions that are characterized by serious inflammation. Synovitis is described as inflammation in the lining of the joints and gout is also an inflammatory arthritic condition. Each of these types of inflammation can be effectively treated with ankle injections.

Conclusion

An ankle injection is a non-invasive procedure that involves injecting medication such as cortisone and lidocaine into the ankle joint. Cortisone is a corticosteroid that targets inflammation and lidocaine is a form of anesthesia that provides pain relief.  This treatment approach is typically suggested if an individual has tried NSAIDs, extended rest, or physical therapy, but the symptoms did not improve.

Although possible complications may arise, this procedure is quite effective and conditions that can be effectively treated with ankle injections include: osteoarthritis, rheumatoid arthritis, tarsal tunnel syndrome, bursitis, gout, tendinitis, and synovitis. Most patients report enhanced mobility in addition to pain relief after receiving this type of injection.

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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