Ankle Pain

The ankle joint ligaments are often at risk of severe sprain injury.  This is because the ankle is a complex weight-bearing structure that consists of several at-risk joints and ligaments that interact directly with the equally complex joints and ligaments of the lower leg and foot. 

Thus, ankle swelling and pain can be due to complex joint ligament sprain patterns—with the true cause often being masked and only discernable by a proper, complete physical examination and equally complete therapy.

Causes of Ankle Pain

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  • Normal wear-and-tear and osteoarthritis
  • Repetitive occupational or sports joint strain and sprain
  • Direct sprain injury to the skeletal, muscle or ligament tissues due to a traumatic accident
  • Short leg syndrome

Ankle Pain Treatments

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Osteopathic Manual Therapy (OMT) can be helpful in mobilizing the ankle joint.

Acute lateral collateral ligament (LCL) sprain, especially often responds very well to Neural Therapy.  Neural Therapy can cause a remarkable diminution of the LCL swelling and pain, often minimizing the need for follow-up Prolotherapy.

More chronic, extensive ankle sprain injuries are very responsive to Prolotherapy.  Prolotherapy is directed to ankle ligament or muscle tendon attachments—depending on history and findings on examination and X-ray.  Particular care needs to be taken as to how the tendinous injuries are treated.

Platelet-Rich Plasma (PRP) Therapy would be more appropriate if the sprain injury and dysfunction are due to significant ligament or tendon tearing.

The pain of ankle wear-and-tear osteoarthritis can often be relieved or, at least, minimized by treating the coexisting ligament sprain injuries by Prolotherapy.   Intra-articular therapy has been reported helpful in minimizing—in some cases restoring—articular cartilage loss.


Gary B. Clark, MD, MPA | 1790 30th Street, Suite 230, Boulder, CO | (303) 444-5131