Ankle Pain(chronic)-Brace Yourself, this idea does not involve surgery

The ankle is a joint near and dear to my heart. Since I am a podiatrist, this region lies just north of the foot. Ankle pain comes in many shapes and sizes and presentations. What people do not realize is that if your ankle isn't functioning properly, the stress passes further upstream. The next major joint in the body would be the knee.

Know anybody with knee pain?

Closely related to the ankle is your midfoot. This region roughly corresponds to your ankle at the very back, to the base of your great toe (where you might see a bunion). Instability in this region as this area torques against your forefoot (think of this area as your toes) can cause pain that is perceived as ankle pain.

Let's also not forget those with achilles tendonitis, and plantar fasciitis. These two very important structures attach to bones in this area, and when they are abnormally tight or inflamed; you can also experience pain.

In addition, much like the more prevalent carpel tunnel syndrome, tarsal tunnel syndrome is something that affects your ankle region. If your posterior tibial nerve (which dives into the deeper regions of your foot at roughly the inside ankle area) gets pinched or crushed with the movement of the bones, this will result in that tingly, electric shock type pain so common with nerve injuries.

Probably the most common ankle ailment of all is ankle arthritis. As the bones wear down with age, the cartilage gets thinner and thinner, resulting in an almost bone on bone type of joint. As you can imagine, bones were not meant to move in this fashion.

People with extremely flat feet may have problems with their posterior tibial tendon. If you have difficulty or pain standing on your tip toes, you may have some dysfunction with this tendon. This is an extremely difficult condition to control with an orthotic alone, and may require some extra stabilization.

Finally, and perhaps most dramatically, patients can become affected by something called "rocker-bottom" foot. This malady was first categorized by a Frenchman named Charcot. Think of the problem this way. You've heard of flat feet, right? A rockerbottom foot is one step beyond that. Think of the curvature of a rocking chair bottom. Roughly, it's a foot in the guise of a smile, not a frown. And, it can lead to horrendous problems and ulcerations.

What most, if not all, of these conditions have in common is that they result in pain when your ankle and midfoot bones (most commonly your talus, calcaneus, and tibia) move against each other. Some condition has caused this movement to be less than ideal, and you have pain as a result.

Another interesting common point, is that all of these conditions can result in surgery. For anyone with a job to go to during this rough economic period, any time off work is less than ideal. Especially if you are not paid for your downtime.

Wouldn't it be more advantageous to try an ankle brace or gauntlet? This is a conservative treatment, and most of these braces would be covered under your DME portion of your insurance policy. Check with your doctor or insurance policy to confirm this. Ask to see if durable medical equipment is covered.

Surgery can always be addressed afterward, if the ankle gauntlet proves not to be helpful.

The almost universal initial response I get from my patients when their custom molded brace arrives is, "ohmygosh, I have to wear that!"? Admittedly, one of the reasons I don't specifically show my patients what they look like prior to my casting for them, is that I don't want any pre-conceived notion about the aesthetics of the gauntlet to cloud their decision.

Understand that these braces are constructed from a mid leg cast of your ankle. As I mention to patients about orthotics, you wouldn't want to buy a pair of eye-wear off the shelf without a prescription, would you? The same applies for foot appliances.

After the patient gets over the shock, and gets beyond the break in period for these devices; they are amazed at the pain relief. What initially looked like a major inconvenience, turns into something they cannot live without. They somehow forgot about the difficulties associated with putting on and taking off of the brace.

Next time your doctor mentions some sort of foot surgery to help you with your ankle pain, or worse yet, discusses some sort of ankle fusion, remember to ask him about this wonderful piece of durable medical equipment.