Joint sprain

A woman was exercising on an uneven surface which she had not noticed. When she jumped during her aerobic routine, her foot twisted and she fell to the ground. She experienced severe pain, and within the next 30 minutes she noticed a swelling on the outside of the ankle. She consulted the doctor who diagnosed it as severe ankle sprain.

Causes of Joint Sprains

The ligaments are tough elastic bands of fibrous tissue. They help in stabilizing the bones, connecting one bone to the other and prevent excess movement. When there is excess force that makes the ligaments go beyond their normal range and get damaged, this is called as a sprain.

A movement like a twist, turn or roll can cause a stretch or tear in the ligament causing a sprain.

There may be a visible swelling along with pain in the sprained area. Pain is mild, if the sprain is not severe. In case of a severe sprain, swelling and severe pain occurs.

The movement of the joint may be restricted. The person may find the sprained area, cold and numb. It might become difficult to bear the body weight on the affected leg.

Diagnosis

For diagnosing a joint sprain, an X-ray may be taken to capture images of the internal structure of the joint.

A bone scan may be conducted in which a radioactive substance is injected intravenously into the bone. This radioactive substance gets attached to the damaged bone which is clearly seen in the scan as bright spots.

The Magnetic resonance imaging (MRI) scan is done in which radio waves and a magnetic field is used to produce good images of the internal structure of the joint.

To get cross sectional images of the joint, a computerized tomography (CT scan) is done.

Symptoms

The following symptoms may appear in a person suffering with ankle sprain. They are:

  • Swelling
  • Tenderness
  • Inflammation
  • Pain
  • Stiffness
  • Skin discoloration
  • Inability to put weight on the affected area
  • Bruising

Following is the treatment for sprained ankle. For initial management of a sprain, the RICE approach may be followed.

The letter ‘R’ stands for rest; letter ‘I’ stands for ice; letter ‘C’ stands for Compression and ‘E’ stands for elevation.

According to the RICE approach, one must rest the joint sufficiently and use crutches, if needed.

To decrease swelling, muscle spasms, bruising and pain, ice packs should be applied for at least for 3 days after injury.

Compressing the joint with wraps helps in preventing bruising and swelling.

Elastic bandage is wrapped around the joint in a figure ‘8’ pattern leaving the joint exposed.

One must make sure that it is not wrapped so tightly that the blood flow is stopped.

With adhesive strips one can attach the elastic bandage firmly. The joint wrap can be kept in place for up to a week.

To prevent the swelling from getting worse, one must raise the joint above heart level and keep it that way for 2 to 3 hours every day.

The medications used for reducing swelling include acetaminophen (Tylenol), Ibuprofen (Motrin, Advil), naproxen (Aleve).

Physical therapy is given after swelling comes down. This increases the balance, flexibility, motion and strength of the joint.

A cast or a walking boot may be necessary for proper healing of joint.

Surgery is needed for ligament tear.

  • Ice has to be placed not more than 20 minutes at a time on the affected part of the joint. The minute the person feels numb, the ice has to be removed.
  • Ice should be used once in every 2 to 4 hours for the first 3 days after sprain.
  • The ice pack can be made by crushing ice and placing it in a plastic bag. After placing the ice pack one must wrap an elastic band around it to hold it in place.
  • For a good ice massage, ice should be first frozen in a Styrofoam cup (4 to 8 ounce).
  • The top part of cup is torn to expose the ice and then it is massage on to the affected area for not more than 30 seconds.
  • For an ice slush bath, one must fill the bucket with ice and water, and then place the joint in it till it gets numb.