Ankle pain treatment: injection

Ankle Pain treatment in Paris, ile-de-france

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Ankle pain?

A ankle est une articulation très complexe, constituée de plusieurs structures. L’atteinte mécanique (douleur qui augmente avec l’activité physique et qui diminue au repos) ou inflammatoire (inflammatory pain which increases at rest and especially at night) of any structure can cause a range of symptoms.

Qu’est-ce qu’une infiltration de la cheville ?

An Ankle Pain Treatment involves injecting a drug into the painful joint.

Ankle infiltration can be used for diagnostic purposes, when there are several possible causes of ankle pain.
Un but thérapeutique : en général, on commence à traiter la cheville douloureuse par un traitement non médicamenteux (repos) et plus ou moins médicamenteux (antalgique et anti-inflammatoires). Si malgré les traitements de première intention la douleur persiste, une ankle injection will be indicated.

Dans quels sites possibles de la cheville l’infiltration peut-elle être faite ?

Ankle pain treatment can be performed in several regions of the ankle, depending on the etiology. These include :

A tibio-talar joint The joint between the tibia and talus.
A subtalar joint This is the joint below the talus.

In general, these two injections are under radiological control.

Injection de l’aponévrose plantaire : L’aponévrose plantaire (ou fascia plantaire) est un épais tissu élastique servant d’amortisseur à la plante du pied et contribuant à sa forme de voûte. Elle se tend en éventail du talon vers les orteils. Elle fait partie d’un système complexe, le système sura-chilléo-plantaire, s’étendant du genou aux orteils.
Tendon injection

In general, these two injections are performed under ultrasound control.

As with other joints, injection can be either intra-articular (within the joint) or periarticular (around the joint).

How does this therapeutic technique work ?

Our radiologists are experts in this field.

The procedure takes 10 minutes.

You will lie on your back. This procedure sometimes requires a local anaesthetic.

De façon générale, ce geste nécessitera un guidage radiologique (sous échographie ou radiographie déjà expliqué ci-dessus). L’ankle injection radioguided treatment means that the needle's path and position can be continuously monitored. As a result, the procedure is more precise and targeted.

Many patients question the performance of this test.

Is ankle pain treatment by injection always effective?

L’efficacité n’est pas immédiate. Il faut attendre 3 à 4 jours pour avoir une diminution de la douleur. Un repos sera donc indiqué pour augmenter la chance d’efficacité du traitement. Par ailleurs, l’efficacité n’est pas certaine. En cas d’échec, une réinfiltration sera donc indiquée. A maximum of 3 injections is recommendedA maximum of 3 injections is recommended. If, despite these attempts, the pain persists, other therapeutic strategies will be considered by your General Practitioner (GP).

What's important to know is that pain should not be ignored if it persists.

What are the risks associated with ankle infiltration?

There are several reasons why your doctor may recommend steroid infiltration to relieve ankle pain. This procedure may be considered when drug treatments or physiotherapy have failed to alleviate your symptoms. Steroid infiltrations can offer fast, targeted pain relief, especially when inflammation is present in the joints or surrounding tissues. In fact, steroids are effective in reducing inflammation and can improve mobility, enabling you to pursue other forms of rehabilitation, such as physiotherapy.

Steroid infiltration is also an option to consider before contemplating ankle surgery. Many patients prefer this approach, as it has fewer side effects than oral steroids taken systemically.

However, it is important to be aware of the risks associated with this procedure. Steroid injections into the ankle can lead to complications such as the risk of infection at the injection site, or accidental puncture of a vein. In addition, repeated use can weaken tendons and lead to deterioration of articular cartilage. Another potential effect is bone thinning, which can contribute to osteoporosis or localized bone deterioration, known as osteonecrosis.

Because of these risks, your doctor may recommend limiting the number of injections to a few treatments per year, to maximize benefits while minimizing potential complications. This ensures that your condition is properly monitored and managed.

When should I consult a radiologist?

Toute douleur qui persiste plus de 6 semaines should prompt consultation of a radiologist.

What tests does the doctor order for ankle pain?

In general, the radiologist will perform a clinical examination of your ankle. Puis, il demande si nécessaire des examens complémentaires comme la radiographie, l’échographie, le scanner, L’IRM et l’arthroscanner.

What causes ankle pain?

If you have a special shape of foot or knee (pied creux, pied varus : pied et cheville tordus vers l’intérieur, pied valgus : pied et cheville tordus vers l’extérieur, pied plat), vous pouvez avoir une ankle misalignment and then pain.
Osteoarthritis
Inflammatory disease: rheumatoid arthritis or others.
Bone pain following a fracture.
Une douleur articulaire.
Ligament pain in case of sprain.
Une douleur tendineuse en cas de tendinopathie (pathologie des tendons).
Une douleur circulatoire (œdème et gonflement).

What symptoms can accompany such pain?

Along with the pain, other symptoms can occur:
Boiterie : difficulté à bouger.
Swelling
Redness
Ankle stiffness

This can help with ankle pain:

Application of ice to reduce pain.
Analgesic and anti-inflammatory.
At ease.
Rehabilitation sessions.
Compression can reduce swelling.

Dernière mise à jour : le 1ᵉʳ novembre 2024
Controlled by Dr Laurence Bellaiche