From the Guidelines
Treatment for your ankle spur should start with conservative approaches, prioritizing rest, ice, compression, and elevation, as well as physical therapy to strengthen the ankle and improve range of motion, as recommended by the most recent and highest quality study 1. Given your recent fall and the presence of an ankle spur, it's crucial to address both the immediate injury and the underlying condition. The initial steps should include:
- Rest to avoid further injury
- Ice application for 15-20 minutes several times daily to reduce pain and inflammation
- Compression with an elastic bandage to support the ankle
- Elevation of your foot above heart level to decrease swelling
Over-the-counter pain medications such as ibuprofen (400-800mg three times daily with food) or naproxen (220-440mg twice daily) can help reduce pain and inflammation, as suggested by earlier guidelines 1. However, the most recent evidence emphasizes the importance of functional treatment and support in the form of exercise and functional support (like a brace or tape) over immobilization 1.
Physical therapy focusing on ankle strengthening and range-of-motion exercises is crucial for stability improvement. Custom orthotics or supportive footwear with cushioning can reduce pressure on the spur. Corticosteroid injections administered by a healthcare provider may provide temporary relief for severe pain.
If conservative treatments fail after 6-12 months, surgical options such as spur removal (spurectomy) or endoscopic procedures with shorter recovery times may be considered. Surgery typically requires 4-8 weeks of recovery with physical therapy afterward. These treatments work by either reducing inflammation around the spur, strengthening supporting structures, or physically removing the bone growth causing irritation.
It's also important to consider prognostic factors for recovery and the risk of future injury, including pain levels, workload, and sports participation, as highlighted in recent research 1. Addressing these factors early in the treatment process can help prevent slow or incomplete rehabilitation and reduce the risk of future injury recurrence.
Given the complexity of ankle injuries and the potential for long-term unresolved symptoms, following the most recent and comprehensive guidelines 1 is essential for optimal recovery and minimizing the risk of chronic ankle instability (CAI).
From the Research
Treatment Options for Ankle Spur
- Conservative management is often the first-line treatment for ankle spurs, which may include orthotics, ankle braces, and physical therapy 2.
- For patients with chronic ankle instability, minimally invasive treatments such as arthroscopic surgery, steroid injections, and platelet-rich plasma injections may be considered 2.
- In cases where conservative management fails, surgical options such as arthrodesis or total ankle arthroplasty may be necessary 3, 4.
- Postoperative rehabilitation is crucial for patients who undergo surgery for chronic lateral ankle instability, and early weight-bearing and strengthening exercises can improve balance and functional outcomes 5.
Nonoperative Treatment
- Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injections, and orthotics are common nonoperative treatments for ankle arthritis and spurs 2, 4.
- Ankle braces and compression socks, such as the one you received, can also help to reduce pain and instability 2.
- Physical therapy and rehabilitation exercises can help to improve strength, balance, and range of motion in the ankle joint 5.
Surgical Options
- Arthrodesis, or ankle fusion, is a surgical procedure that involves fusing the bones in the ankle joint together to eliminate pain and instability 3, 4.
- Total ankle arthroplasty, or ankle replacement, is a surgical procedure that involves replacing the damaged ankle joint with an artificial one 3, 4.
- Arthroscopic surgery is a minimally invasive surgical procedure that involves inserting a small camera and instruments into the ankle joint to repair or remove damaged tissue 2.