Ankle Sprain Nerve Injuries

Up to 85 percent of ankle sprains are caused by the foot turning inward.  More than just the ligaments are harmed in an ankle sprain.  Bones, joints and their capsules, muscles and tendons, and nerves can be injured.  The latter can result in numbness, tingling, burning, radiating/shooting pain, cramping, weakness or motor function deficits.  Fifteen percent of all grade 2 and 3 ankle sprains have some level of peroneal nerve damage, resulting in tingling/burning along the nerve’s course or decreased pedal sensation in the nerve’s area of distribution.  Grade II ankle sprains resulted in peroneal and tibial nerve injury in 17 and 10 percent of patients studied respectively.  These injury rates increased to 86 percent for the peroneal nerve and 83 percent for the tibial nerve in grade III sprains.

It is important to see Dr. John Hoy at the Seattle Foot and Ankle Center in Seattle, Washington when an ankle sprain happens to treat any nerve injuries.  Nerve injuries untreated can cause drop foot and complex regional pain syndrome (CRPS).

Treatments for ankle sprain nerve injuries include:

  1. Elevation and ice to decrease the localized swelling and external environmental pressure on the nerve.
  2. Immobilization, daily and nightly, allows removal of the aggravating motions.
  3. Topical non-steroidal anti-inflammatory drugs (NSAIDs) or topical medications such as lidocaine, capsaicin, and topical diclofenac 1-2%
  4. Oral medications including gabapentin, pregabalin (Lyrica, Pfizer), amitriptyline and clonazepam (Klonopin, Genentech)
  5. Local corticosteroid injection at the point of entrapment
  6. Physical therapy and manual therapy
  7. Surgery.