User:Lavendar Vallery/Chronic Ankle Instability (Draft)

Chronic ankle instability (CAI) is a condition characterized by poor balance, chronic pain, or both. CAI most commonly occurs following an ankle injury such as a sprained ankle that has been left untreated and not allowed to heal properly. Chronic ankle instability is usually preventable through proper care and medical intervention. Minor sprains are relatively common, especially in sports injury, and usually heal on their own within 6 weeks without the need for medical intervention. More severe sprains may take a longer time to heal or never fully heal, requiring treatment and even surgery.

Possible complications from chronic ankle instability include:


 * chronic swelling at the site of injury
 * chronic pain
 * poor balance|
 * inflammation
 * weakness in ankle
 * loss of mobility

Chronic ankle instability is not exclusively limited to the site of injury. Since chronic ankle instability can lead to chronic pain, patients may suffer psychological effects such as depression and irritation from pain and discomfort caused by the injury. Exercise may become difficult leading to decreased activity which can be detrimental to both physical and mental health.

Weakness and poor balance associated with chronic ankle instability may leave people vulnerable to falls and repeated injury to the ankle causing further damage and exacerbating the condition. To avoid injury and limiting pressure to the affected ankle when walking, a mobility aid such as a walking cane may be used. Strenuous use of the injured ankle such as running is not advised as it may damage the ankle and lead to further complications.

Ankle injuries
The human ankle is a complex anatomical structure with numerous joints, ligaments, tendons, and bones. Due to the larger number of components, there are many different parts of the ankle that can be injured, each leading to different varieties of ankle injuries with different effects on ankle function. Anatomical variants are not uncommon and some people may end up injuring body parts that do not typically exist in most ankles. In some cases this may be a source of pain that may be overlooked since it is unexpected.

Diagnosis
Diagnosis typically consists of obtaining a patient history of the events leading up to the injury as well as a physical examination to look for swelling, inflammation, and to test mobility. Blood samples may be used to check for inflammation markers. Depending on the severity, an x-ray may be performed to check for bone fractures. Chronic ankle instability is a broadly defined term which includes persistent problems associated with ankle injuries that do not heal within the expected time frame.

Treatment
Since there are a variety of different possible injuries, treatment is individualized based on the type of sprain. The first line of treatment usually involves a form of physiotherapy but sometimes surgical interventions are needed to repair torn ligaments or parts of the ankle that have healed improperly.

An issue with chronic ankle instability is that people tend to use their injured ankle less which causes the ankle to become weaker which can further exasperate their condition and lead to muscle weakness and risk of re-injury. It is therefore recommended that when the ankle has healed to a usable extent, that patients do light exercise such as walking for 30 minutes a day to build up strength.

Pain Management
Treating pain from chronic ankle instability comes with a few challenges. While effective short-term, chronic use of opioids is generally contraindicated due to the risk of dependence, tolerance, risk of overdose, and the development of hyperalgesia, worsening of pain over time. A possible risk associated with strong analgesia is that individuals may be unaware of significant pain when performing certain activities. This may lead to further injury to the ankle without the individual noticing it.

Prognosis
(will it heal?)

Epidemiology
(how common is this and which demographics, risk factors etc.)