From the Research
Treatment for Ehlers-Danlos syndrome patients with valgus ankle, painful pes planus, and tendon/ligament damage requires a multimodal approach, with a focus on conservative measures and careful consideration of surgical intervention due to the high risk of complications. Initial management should include custom orthotic devices with medial arch support and lateral posting to correct foot alignment and redistribute pressure, as well as physical therapy emphasizing proprioceptive training, gentle strengthening of supporting muscles, and avoiding hypermobility exercises 1. Pain management typically includes NSAIDs like ibuprofen (400-800mg three times daily) or naproxen (250-500mg twice daily) for acute flares, with caution regarding gastrointestinal side effects, and for persistent pain, a short course of low-dose oral corticosteroids may be considered 2.
Some key considerations in managing these patients include:
- The use of ankle bracing or taping to provide additional support during activities
- Wearing supportive footwear with rigid soles and avoiding high-impact activities
- Regular monitoring due to increased tissue fragility and delayed healing, requiring more gradual rehabilitation progressions and potentially longer recovery periods than typical patients 3
- Careful consideration of surgical intervention, which is generally reserved for cases unresponsive to conservative treatment, with procedures including tendon repairs, ligament reconstructions, or arthrodesis, though healing complications are common in EDS patients 4, 5
It's also important to note that each patient with Ehlers-Danlos syndrome is unique, and a combination of several different treatments is usually needed for optimal symptom control 1. Therefore, a personalized treatment plan should be developed for each patient, taking into account their specific needs and circumstances.