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What Causes Pain In The Right Leg?
Question: I have had a pain in my ankle for a couple of days now. There is no swelling. The pain is on my right leg coming from the front right of low ankle bone. It is very tender to the touch and it just simply hurts.
Brief Answer:
Ankle Sprain
Detailed Answer:
Hello and Welcome
I appreciate your concern
Based on your description , Sprained Ankle is the most likely diagnosis. To avoid any further damage to the ligaments in your ankle , the ankle should be properly rested by using crutches if possible, wearing loose slippers, applying ice wrapped in a cotton cloth to reduce the pain and inflammation. Compression stockings like ACE bandage can be helpful along with daily elevation of the ankle for 3 to 5 minutes above the level of the heart.
NSAIDs like Ibuprofen can be taken for now and an E.R doctor should be consulted to physically examine the ankle. To be safe , your doctor may advise X rays of the foot and ankle. If no fracture is found, NSAIDs can be prescribed for a week with follow up that includes physiotherapy for proper rehabilitation to achieve the full range of movement. If adequate recovery is not made then an MRI can be advised to visualize the anterior and posterior talofibular ligaments for any detachment or irregularity, in consult with your doctor.
Wishing you best of health
Thanks
Please consult your doctor before deciding on any further course of action.
Dr. M.S. Khalil
Ankle Sprain
Detailed Answer:
Hello and Welcome
I appreciate your concern
Based on your description , Sprained Ankle is the most likely diagnosis. To avoid any further damage to the ligaments in your ankle , the ankle should be properly rested by using crutches if possible, wearing loose slippers, applying ice wrapped in a cotton cloth to reduce the pain and inflammation. Compression stockings like ACE bandage can be helpful along with daily elevation of the ankle for 3 to 5 minutes above the level of the heart.
NSAIDs like Ibuprofen can be taken for now and an E.R doctor should be consulted to physically examine the ankle. To be safe , your doctor may advise X rays of the foot and ankle. If no fracture is found, NSAIDs can be prescribed for a week with follow up that includes physiotherapy for proper rehabilitation to achieve the full range of movement. If adequate recovery is not made then an MRI can be advised to visualize the anterior and posterior talofibular ligaments for any detachment or irregularity, in consult with your doctor.
Wishing you best of health
Thanks
Please consult your doctor before deciding on any further course of action.
Dr. M.S. Khalil
Above answer was peer-reviewed by :
Dr. Raju A.T
I would tend to agree. The only problem is that I did not do anything to sprain my ankle. I do believe that I would have remembered doing such a thing. I have had sprained ankles before and I know what it feels like when you do sprain an ankle. I am doing the treatments as if I did sprain the ankle. I am just beside my self trying to figure out what happen to my ankle. Have you heard of anyone spraining their ankle while they are sleeping? I literally went to bed fine and woke up the next morning in pain. I went through the day like normal. The pain had subsided enough that I did not even think about it. I went to bed that night again not thinking about it and woke up around 4 in the morning in pain and not being able to get into a position where it did not hurt. I was dumb founded. It is now a continuous pain and it seams to do better for a while after ice treatment. I have it elevated. I guess I will see how I feel in the morning. If there is any thing you can think of that might also have the same symptoms? I would appreciate the feed back.
Brief Answer:
Causes other than ankle sprain, workup , rheumatology consult
Detailed Answer:
Hello again,
An Ankle can be sprained while asleep as its all about the stretching force with a susceptible position that can be attained involuntarily during sleep. However, This presentation can be worked up if the pain doesn't respond to empiric treatment, with some labs to rule out some causes related to such ankle pain. As mentioned in the previous reply, x rays of the foot and ankle would be required. Calcium and uric acid levels should be checked along with CBC and ESR/CRP. Hypocalcemia and gout are two possibilities that can be related to your presentation. Though uric acid levels don't go towards diagnosing gout but can give a hint towards plasma levels. Joint aspiration can be planned for accurate diagnosis of gout and ruling out an infection in the joint/ acute septic arthritis. ANA profile with ds and sm antibodies, anti CCP antibodies should be done if the ankle pain episodes occur chronically. ANA would be to rule out LUPUS and CCP Abs to look for Rheumatoid arthritis. You may consult a rheumatologist to physically examine your foot and ankle before any further investigation is done. For now the above measures explained in the previous answer would suffice.
Thanks.
Dr. M.S. Khalil
Causes other than ankle sprain, workup , rheumatology consult
Detailed Answer:
Hello again,
An Ankle can be sprained while asleep as its all about the stretching force with a susceptible position that can be attained involuntarily during sleep. However, This presentation can be worked up if the pain doesn't respond to empiric treatment, with some labs to rule out some causes related to such ankle pain. As mentioned in the previous reply, x rays of the foot and ankle would be required. Calcium and uric acid levels should be checked along with CBC and ESR/CRP. Hypocalcemia and gout are two possibilities that can be related to your presentation. Though uric acid levels don't go towards diagnosing gout but can give a hint towards plasma levels. Joint aspiration can be planned for accurate diagnosis of gout and ruling out an infection in the joint/ acute septic arthritis. ANA profile with ds and sm antibodies, anti CCP antibodies should be done if the ankle pain episodes occur chronically. ANA would be to rule out LUPUS and CCP Abs to look for Rheumatoid arthritis. You may consult a rheumatologist to physically examine your foot and ankle before any further investigation is done. For now the above measures explained in the previous answer would suffice.
Thanks.
Dr. M.S. Khalil
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Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
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