The Prevalence of Pain in People With Chronic Ankle Instability: A Systematic Review

Abstract

Objective To identify the prevalence of pain in people with chronic ankle instability (CAI) and how pain is related to the impairments of CAI. Data Sources We searched the databases of AMED, CINAHL, EMBASE, MEDLINE, PubMed, Scopus, SPORTDiscus, and Web of Science from inception to March 2017. Study Selection Eligible studies were peer-reviewed research in which investigators reported the presence of ankle pain or assessed the effects of pain on impairments in participants with CAI. Age and language were not restricted. Studies that included only surgical interventions were excluded. Data Extraction Studies identified by the search strategy were screened according to the eligibility criteria, and 2 independent reviewers extracted the data. Outcome measurements were (1) pain ratings using measures such as a visual analog scale and (2) other residual impairments, such as feelings of weakness, giving way, or deficits in functional performance. Data Synthesis Of the 5907 records identified through the database search, 14 studies were included in this review. All authors assessed ankle pain by self-report questionnaires or physical examination, or both. Pain was self-reported by 23% to 79% of participants and present on physical examination in 25% to 75% of participants, depending on the test applied. Among these studies, the highest reported pain level was 4.9 on the 11-point visual analog scale. Studies were heterogeneous for pain measures, participant groups, interventions, and follow-up periods. The relationship between pain and the structural and functional impairments associated with CAI was not investigated in the included studies. Conclusions Pain was present in a large proportion of people who had CAI, but pain levels were low. Information about the effects of pain was not reported, so researchers should examine the association between pain and function, balance, or other activities in people with CAI.

Health-Related Quality of Life Among Middle-Aged Adults With Chronic Ankle Instability, Copers, and Uninjured Controls

“…13 We selected the FADI for this investigation because of its emphasis on evaluating pain. In a recent systematic review, Al Adal et al 14 demonstrated that 50% to 79% of individuals with CAI reported ankle pain. Therefore, we selected a questionnaire that is used to evaluate this important symptom.…”

The fibula and talus position difference in functional and mechanical ankle instability: MRI findings

“…Since the measurement of IMI was only based on the medial malleolus, the rotation of the talus was not taken into account in this measurement. A positive value indicates the lateral malleolus was posterior to the 2 Journal of Orthopaedic Surgery 29 (1) plane of the medial malleolus. A negative value indicates the lateral malleolus was actually anterior to the plane of the medial malleolus.…”

Persistent Pain After Operative Treatment for Chronic Lateral Ankle Instability

“…In a recent systematic review, most studies reported that ankle pain was present in 50% to 79% of participants with chronic ankle instability. 7 Those pain was usually mild and intermittent and related to strenuous physical activity. 7 Surgical treatment is applied after comprehensive consideration of the degree of mechanical instability of the ankle joint evaluated by a surgeon and results of rehabilitation.…”

“…7 Those pain was usually mild and intermittent and related to strenuous physical activity. 7 Surgical treatment is applied after comprehensive consideration of the degree of mechanical instability of the ankle joint evaluated by a surgeon and results of rehabilitation. Patients with ankle instability and chronic pain during walking or activity must be carefully screened for peroneal tendon injury, deltoid ligament or distal tibiofibular syndesmosis injury, osteochondral lesions, and traction injury of the nerves around the ankle joint, which are often accompanied by repetitive lateral ankle sprain (Figure 1).…”

“…Patients with ankle instability and chronic pain during walking or activity must be carefully screened for peroneal tendon injury, deltoid ligament or distal tibiofibular syndesmosis injury, osteochondral lesions, and traction injury of the nerves around the ankle joint, which are often accompanied by repetitive lateral ankle sprain (Figure 1). [6][7][8][9][10][11][12] Careful history-taking and physical examination are the most important diagnostic methods not to miss accompanying pathologies. Various pathologies should be considered as causes of chronic ankle pain.…”