Pain and Swelling in the Ankle After a Fall

Dear Ask The Doctor: I triped and fell walking on heels on sat night aprrox 9-30pm i went to local accident and emergancy department on sunday afternoon they examined it and said it was badley sprained with NO XRAY. however since i have rested and taken anti imflamatorys the swelling and bruisin is still rele bad i crnt put full wait through my ankle at all and am in real pain infact worse now thank before now its a constant pain rathewr than just when i move it what should i do return for an xray or carry on

Dear Stacie: From all the ankle injuries, the sprains are the most common. Ankle sprains are classified in 3 grades as follows: Grade I: mild degree of swelling and stretch has occurred to the ligaments. Weight bearing is possible. Grade II: moderate swelling and an incomplete tearing of ligaments, also mild instability may be present and also pain with weight bearing. Grade III: severe swelling and pain, complete rupture of at least 1 ligament, there is remarkable instability.

First thing to do: apply ice and lift the affected limb for the first 24 hours, to control the pain and swelling. Physical therapy is recommended for sprains grade II and III. For less severe injuries, grade I, the strategy would be: immediate, protected ambulation, and physical therapy should emphasize exercises to get back the normal range of motion and strengthening of the ankle muscles and ligaments.

Treatment during this acute phase is aimed to minimize swelling and pain, allowing the patient to begin walking. The acute phase of treatment should last for 1-3 days after the injury. A combination of protection, relative rest, ice, compression, elevation, and support is used. Also the anti inflammatory drugs (as Ibuprofen) help in reducing swelling and pain. The healing time varies from patient to patient.