Referred Ankle Pain
What is referred ankle pain?
Referred ankle pain is a term given to pain that is felt in the ankle although it originates from another region of the body. This is commonly seen in clinical practice.
There are several structures in the body that, when injured, may cause the patient to experience pain in the ankle region. This can occur even though there may be nothing wrong with the ankle itself.
Causes of referred ankle pain
The lower back and sciatic nerve are two of the most common structures in the body that when injured, may result in pain being felt in the ankle region. This can occur with or without pain being felt in the lower back or sciatic nerve. The superior tibiofibular joint can also be a source of referred pain to the ankle. Increased neural tension (tight nerves) may also contribute to the development of symptoms.
Some of the more common conditions which may cause these symptoms include:
- Lumbar Disc Bulge
- Lumbar Facet Joint Sprain
- Spinal Degeneration (Lumbar)
- Piriformis Syndrome
Signs and symptoms of referred ankle pain
Patients with ankle pain that is referred from another source may or may not experience symptoms from the originating source. Patients typically experience a dull ache in the ankle that is poorly localized and may vary in severity or location. They may also experience pain or stiffness in other locations in the body such as the lower back or buttock. Occasionally pain may also be felt in the thigh, knee, lower leg, or foot. These symptoms are usually experienced on the same side of the body as the ankle pain, although sometimes, the opposite side or both sides may be affected. Occasionally patients may also experience pins and needles or numbness in the affected leg. This most commonly affects the foot and can sometimes affect the other leg or both legs.
Patients with referred ankle pain normally experience restricted movement and abnormalities on assessment (such as tenderness on palpation) in the specific region of the body causing the pain. Local assessment of the ankle may demonstrate no significant abnormalities although patients may experience tenderness on firmly touching the ankle region. In long standing cases of ankle pain that is referred form another source, patients may develop muscle tightness or weakness in the muscles of the ankle.
Diagnosis of referred ankle pain
A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose referred pain to the ankle and the underlying cause of symptoms. Further investigations such as X-rays, MRI or CT scans are often required to assist with diagnosis.
Treatment for referred ankle pain
Treatment for patients with ankle pain that is referred from another source varies greatly depending on the cause. Accurate diagnosis from a physiotherapist or doctor is therefore required to determine the most appropriate treatment. Treatment of the underlying cause of symptoms should result in improvement in the ankle pain.
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