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The Doctors Lounge - Orthopedics Answers

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Forum Name: Miscellaneous Orthopedic Topics

Question: unexplained ankle swelling and pain


sweetsugrbriches - Tue May 31, 2005 2:30 am

Hi - I am a 29 yr. old female who is at the end of my rope with my newly acquired "injury". For about the past four weeks, my ankles have been hurting and swelling for no obvious reason. By this I mean that I haven't injured them nor has anything in my life really changed recently. I have a follow-up appt. with an ortho specialist tomorrow afternoon but I am so confused by my symptoms and I want to make sure I cover everything with my doc. Hopefully there is someone else out there who has my same issues and can help put my mind at ease.

First, let me give you some background on me - I am 29 and work as a secretary. I have had a "desk job" most of the time since graduation from high school and therefore have been pretty inactive most of my adult life. I didn't play sports in high school (I was a band geek!) which probably helped me escape any major injury to any parts of my body. I've never had any broken bones - - not even stitches!

Medications: The only medications I am on are over-the-counter Naproxen for Headaches and PMS as needed, 1 mg Xanax nightly, 37. 5 mg Pentermine daily for weight loss and Desogen for birth control.

My new "injury" - Around the beginning of May, I noticed that my ankles kind of hurt. Anyone who wears heels all the time, has twisted an ankle at least once before in their lives. It kind of reminded me of that but not too painful. Just a little sore. But I can't remember injuring my ankles in anyway. About a week later I noticed slight swelling on the inside of my left ankle. Although both ankles hurt, it was the left that hurt the most. The right ankle didn't appear swollen but could have been just a little bit and I just couldn't tell because I was looking so hard. A few days later, I noticed significant swelling in the left ankle (inside only) and it was starting to turn a little pink and it felt warm to the touch. A week into this, my right ankle appeared obviously swollen but not as bad as the left. Again, only the inside of the ankle. The pain was getting worse and the swelling wouldn't stop so I started putting ice on them at night and elevating them. No help.

Labs - After 2 weeks of swelling, I went to my primary care doc and he told me to ice the swelling, elevate them and take some Naproxen for the pain. He also did the usual labwork. He said everything came back normal and referred me to an ortho doc. I got a copy of that labwork just the other day and everything was within normal ranges except two things under my white blood cell count. But apparently, it wasn't abnormal enough to alert the doc. Neutrophils were 40 (range 42-77) and Lymphocytes were 46 (range 16-43).

Tailbone - To make matters worse, my ankles hurt so bad one morning that I fell on my tailbone in the bathroom and I think I bruised it. Now that hurts!! My ankle pain is the worst in the mornings and starts to feel better throughout the day but still hurts all day to the point that I limp and have to walk slowly and carefully. On the day I fell on my tailbone, I noticed more swelling in my feet by late afternoon. Not only were my ankles swollen, but now the whole foot was swelling on both feet. Everything except my toes. So that evening, I got some Ace bandages and wrapped my ankles. I can't sleep in them cuz they drive me crazy at night but I do wear them to work. I still have to dress up for work so I've been wearing slacks and stuffing my fat feet into the only two pair of low heels I have that I can with Ace bandages on them. Again, I sit most of the day so I can kick my shoes off. However, it is rather difficult to elevate my feet while at work.

Ortho doc - I got in to see the ortho doc about a week later and his inital impression was some sort of Arthritis of unknown origin. He took x-rays and said they were normal. He also ordered more labwork and I go back tomorrow. He ordered RH factor, ANA test, C-reactive protien, Sed rate and uric acid level.

Now here is where I start getting paranoid. It's been almost a month and my ankles still hurt and they are still swollen. The Ace bandages seem to control it somewhat but I need to know why they are doing this and how to stop it, as I can't wear Ace bandages every day of my life! Starting the morning after I went to the ortho doc (this past Friday), I woke up in severe pain - everywhere! My left hip hurt, my left knee hurt, both my ankles hurt so bad and even my right elbow hurt! I almost didn't get out of bed because it hurt so much to move. Thank God that was my last day at work for the week. This weekend has been pretty bad. The pain has pretty bad in my hip, knee and ankles. The pain in the elbows comes and goes as does other pains. Like in my shoulder, wrist and thumb once. Today was the first day that I haven't hurt like hell. My ankles are still swollen and still hurt, though not as bad as they have all month long.

I've read about all the types of Arthritis, lupus and Fibromyalgia and I have some of the symptoms of each but they could all be because of other minor things too. My mom has multiple sclerosis and I've read that some doctors think some of the auto immune things are hereditary. The biggest symptom, other than joint pain, of all these auto immune things is fatigue which I don't really think I have. Because I sit all day, I am always kind of sleepy but I don't really think that is fatigue. On the weekends, I prefer to be a homebody most of the time, but I don't think that is fatigue either. I think I am just lazy actually. I haven't had any rashes as with lupus nor any increased hair loss. I do get ulcers in my nose but I just thought they were cold sores since I get those on my lips all the time! I keep telling myself that I am making too much out of this but I don't know how to explain why so many different parts of my body hurt all of the sudden. Every morning I wake up wondering what is going to hurt today and how long is it going to last. I can't wait to go to the doc tomorrow! On one hand, I hope he finds something in my lab work so I'll have a definite answer, but on the other hand, I don't want anything to seriously be wrong with me.

Sorry this is so long but even if no one reads it or responds to it - - at least I feel better now for getting it off my chest!

Thanks in advance for anyone who takes the time to read this long sob story!!
sweetsugrbriches - Mon Jun 06, 2005 2:43 am

Just thought I'd share my new lab results that the ortho specialist ordered:
ANA - Negative
Uric acid - I can't read the number on my copy but it's within normal limits
RF - 25
CRP - 15. 40
ESR - 29

My doctor wasn't available Friday when my lab results came in so I haven't talked to him yet to get his interpretation of them, but I can read... so according to the reference ranges, the only elevated levels were the CRP and the ESR. The ESR was slightly elevated (should have been between 0 and 20) and the CRP is elevated.

I probably shouldn't have had the results faxed to me before I could talk to the doc but I was going crazy waiting. Based on what I've read, I guess I have some sort of infection or immflamation in my body. I bet the next step is going to be more tests to try to figure out what kind of infection or immflamation.

So I feel like this is good and bad news. Good because I probably don't have lupus or rheumatoid Arthritis but bad because who knows what kind of infection I could have! My ortho doc will be in the office on Monday afternoon and I expect to hear from him then, but in the meantime, this waiting is DRIVING ME CRAZY! And the joint stiffness isn't getting any better. Actually, my ankles hurt MORE now than they did last week. And the migrating joint pain elsewhere in my body is really getting annoying and more intense. It's been one month now since this all startd, and I am really getting worried!

Any responses would be appreciated!
jaki - Mon Aug 22, 2005 8:48 am

:lol: after (another) bad night with virtually no sleep, I decided to see if I could find out the cause of my ankle, knee pain for myself, when I stumbled on your posting it was like reading about myself, with the exception of my age -55yrs. I have had Arthritis in spine for many years now but always managed to keep reasonably active, but, since the appearance of sore/swollen ankles 4 months ago, I am struggling with my mobility, I am on weight loss programme to try and ease the load on my joints, I lost 5st but this has slowed down dramatically now, because -I think- of the lack of mobility, I try and get outdoors for a walk each day regardless of weather but by the time I get home I am totally drained because of pain. my ankles are only moderately swollen in morning, but by the time I am up and dressed and start going about my daily chores, they have swollen up and turned red. I have appointment with my practioner later in the week and expect to be told when I lose weight things will improve, as I am within 2stones of my target weight, I thought improvement would be evident by now. I am very interested in the outcome of your problem and if you can recommend any exercises or drugs that have helped your case, I live in uk and realise things might be different regarding drugs but it would give me an idea of what course to take to alleviate this debilitating pain, I thank you in advance for your reply[/list][/I][/b]
sweetsugrbriches - Tue Aug 23, 2005 2:28 am

Hi jaki!

I'm so sorry you are in pain. I'm not sure how much help I can be of but I'll tell you my story. I am a 29 yr old female and have been in relatively good health most of my life. I wasn't very active in high school (I. e. sports) but I was in band. After graduation, my activity level decreased A LOT! I gained so much weight over the next ten years after graduation. I was probably about 110 when I graduated from high school in 1994 and by 2004, I was 190! I didn't have children to blame the weight gain on and I didn't think I ate a lot but something had to change. It's hard to change your lifestyle when it's been the same for 10 years! I never had any major health problems except for a cyst on my right ovary. I had surgery to have my right ovary taken out just before my senior year of high school. Other than that, I never had anything really wrong with me. I don't exercise and since I never really have, it's kind of hard to make myself stick to an exercise routine. I am a legal secretary and I work a lot - mostly sitting at my computer - so just thinking of exercise exhausts me! When I hit 190 pounds, I decided to go to my primary care doctor and ask for diet pills. I had some problems with Depression and Anxiety over the past 10 years, but nothing too serious. I had been on anitdepressants but decided to get off of them hoping that would help stop some of the weight gain. I was doing pretty good except my weight was out of control and that started depressing me again. Mostly it was Anxiety. So when I went to my primary care doc for the diet pills, I decided to ask for Xanax again. I had been on it previously and loved it! I didn't abuse it or take it during the day all the time. I only take it at night to help me sleep throughout the night. My mind starts working overtime once it's time to go to sleep so the Xanax allows me to relax, stop thinking about things, and go to sleep. My doc gave me Phenteramine for weight loss too. I love it! I'm down to 147 and my goal is 130. I started the Phenteramine in Dec. 2004. Well, that's my background.

As far as my family is concerned, my mom has multiple sclerosis and I have a second cousin or maybe third cousin or something like that that has MG. I have one cousin with Downs and high blood pressure seems to run in my family. I don't know my father or anyone on his side of the family so I don't know about their medical history. Obesity seems to run in the family too! Since MS and MG are auto immune disorders, I know I am sort of predisposed or something, but I've never had any problems to warrant going to the doctor for lots of tests - - until recently!

In March of 2005, I went for an eye exam and decided to switch to contacts. In May 2005, while I was fully frustrated with getting used to contacts, I went for a follow up with my primary care doc. Everything was going good with me, the weight was slowly coming off and I was feeling pretty good - with the exception of not being able to find any brand of contacts that were comfortable! My eyes were always so dry with every brand I tried. I never really noticed that I had dry eye before but now, in trying to wear contacts, my eyes were always dry. Even on the days I didn't wear them! Then, not two days after my doctor appointment, my ankles started bothering me. They just felt a little achey. About a week or so later, I notice that my left ankle seemed a little swollen. Another week later, I noticed that it was started to turn a little red and sometimes kind of blue and purple, like a bruise. Then my right ankle started swelling and they felt very warm. After several weeks of this and taking 400 to 600 mg of Naproxen two to three times a day, I decided to go back to the doctor. While he was mashing around on my ankles I sort of felt some muscle pain. Kind of like a sore muscle and when he would hit just the right spot, it felt pretty good. Like when you rub a sore muscle. The joint pain was puzzling though. It wasn't a distinct joint pain either. It was hard to explain. It felt sort of like I had sprained my ankles but I knew I hadn't. Primary Doc ordered labwork but it all came back mostly normal. He ordered a CBC, Chemistry and Thyroid tests. The only abnormality was in my white blood cell count. Lmyphocytes came back slightly elevated and Neutrophils came back slightly lowered. Otherwise, everything was normal.

Primary Doc referred me to an orthopedic doctor. Ortho Doc took x-rays and said they looked ok. I didn't have any pain anywhere else except in my right elbow and I thought I had just slept on it funny the night before. Ortho Doc didn't have a clue so he ordered more labwork. He did a complete Arthritis panel and tested for lupus and rheumatoid Arthritis. The very next day, I woke up with joint pain all over my body! Hips, knees, ankles, elbows! I was miserable for the next few weeks! The pain would migrate. One day it was my left hip, then the next it was my right knee. Everyday a different combination of joints would hurt. My ankles got so bad that I almost couldn't walk because they hurt so bad! I had to keep them wrapped with Ace bandages all day just to make it through work. My labs finally came back and my CRP was elevated and so was my Sed rate. Rheumatoid factor came back normal and ANA screening was negative. So infllamation of some sort was present but none of that gave him a real answer. He prescribed me a one-week packet of steroids, Prednisolone I think, and I felt better in only three days! It was great! Steroids work wonders! It was only a one-week prescription, thank God! I only gained two pounds while on them so it wasn't too hard to drop it again! Ortho decided that neither my diet, my other prescriptions, nor my lack of exercise had anything to do with my pain. He said it was something systemic but he couldn't pinpoint it. He told me to take Mobic (an Anti-inflammatory) daily and see if that kept everything in check. If not, he could refer me to a Rheumatologist for further workup.

I tried the Mobic but a few days later, my ankles started swelling again. None of the other joint pain came back and my ankles didn't hurt near as bad but I was worried that they would. Ortho Doc told me to switch back to Naproxen as anti-inflammatories tend to increase water retention and maybe I would do better with Naproxen. Then again, it might not be water retention. I switched back to Naproxen and it didn't really help but the swelling and pain didn't get worse do I just left it at that. I took the Naproxen, about 400 mg twice daily, for the next several weeks. Slowly but surely the swelling and discoloration started to go away.

As of now, my ankles hurt everyday but it is minor. No more swelling or discoloration and no more joint pain anywhere else. They really bother me if I am on my feet a lot. I forgot to mention that when they first started hurting, before I went to the doctor, I tried elevation and ice but nothing helped. Now, if I am on my feet too much, I just put them up when I get home, keep them warm and take some extra Naproxen and they are usually okay in a few days.

That's the other strange thing. My feet are always cold. They never really used to be but since I work in an office all day and sit at a desk all day and since I live in Texas and it's so hot all the time, I wear sandles A LOT! So when I'm at my desk all day, my feet got cold. But over the past year, I've noticed that I can't even get them warm at home. I'll have socks on and be sitting on my feet and still they are freezing! Unless I'm active and on my feet, they get soooooo cold soooooooo fast! And the coldness seems to make them hurt more too.

My dry eye is what is bothering me the most now. I went to an opthomologist and was able to get him to prescribe me Restasis. My left eye tested somewhat dry so he said I could try the Restasis and see if it helps. I was told that it usually takes a full 6 o 8 weeks before the Restasis really starts to work so I am still waiting for it to work. I've been on it for about a month now and I can't wait for it to start working! I'd really like to wear my contacts again! That is if I can find a brand that won't dry my eyes out so bad! Hopefully the Restasis will help that but I'm sure I'll have to find a good contact too.

Other than a very strange lack of sex drive, I don't think I have any other symptoms. It's not normal for a 29 year old to have absolutely NO sex drive! But that doctor's appointment is on August 30th and we'll deal with that when we get there.

I am thinking that I probably have some sort of autoimmune disorder but it is probably so borderline right now that it would be impossible to diagnose. I could probably go to a rheumatologist and have more labwork done and possibly narrow it down to something, maybe, but until I have a "flare-up", I guess I'll just keep taking my Naproxen. I probably don't want to know what's wrong with me anyways!

So, that's my story. I know it's long but hopefully it's of some help to you. Good luck and I wish you well!
jaki - Tue Aug 23, 2005 6:13 pm

thank you for your quick response funnily enough I have trouble with dry gritty eyes as well, I wonder if this is significant, well done on your weight loss, my sister in law lives in texas and I think she tried your slimming tablet, but gave up on it due to side effects, I am on xenical and find it helps to keep me motivated, it is not a suppressant but produces side effects if anything too fatty is eaten, so as long as I eat properly I'm fine. the only way to get your kind of pill over here is from private clinic, my daughter in law has lost two and half stone on them and looks really well. I'm glad you feel a bit better than before, if you are anything like me you will be very frustrated and down with all the pains etc., I was always 8st and when I had my son who is now 32yrs I took Depression and then began years of anti depressants and tranquelisers and thats when weight began to creep up, I blame all the prescription drugs I took for all this time on my weight gain. nowadays I only take painkillers and amytriptiline at night for nerve pain and although it is an anti depressant, I only take 50mg, which my doc tells me is a minute dose and won't do any harm, so I trust him, I not got any choice I suppose. once again thank you for your reply, take care and I hope things continue to improve for you.
graciegirl - Mon Sep 26, 2005 10:59 pm

Hi there. I will tell you..it's nice to know I am not the only one (though I wouldn't wish the worry on anyone). I wanted to see if you were still checking this post as I would love to talk to you about this....it's eerie. I am also 29 and in August...the exact thing happened with my ankles...had similar tests...similar results....please post or email me at gratefy1@yahoo. com if you are still checking this.....this is the only post I have found that explains exactly what happened to me.....so strange....

Thanks!
graciegirl
butterflyA32 - Thu Sep 29, 2005 7:26 am


I have the same problem it has only gotten worse it has now when it strikes moved to my hands stomach and I get the same thing starts on one side then moves to the other side with the heating feeling intensify more each time. my doctor done ever test imagible and still nothing I go see him in october and maybe then we can come up to the sudden systomps and the sudden weight gain . I gained 30 pounds in a period of 3 months for no appartent reason . I also suffer from a rare bladder diease that is not linked to this and a Fast heart rate that no one can figure out why that has occured. So maybe one of us will get some answers to this and can then share it and hopefully find a medince or cure for this problem good luck to you all. if there is answer out there please help me I am getting so frustred living like this.
butterflyA
marajade - Wed Oct 05, 2005 4:25 pm

This is so weird! I just searched "unexplained ankle pain" on google and came up with this.

I am having the same problems as the both of you. I take a tranquilizer as well and I am a 28 year old female (29 in 2 months), and I too have a desk job.

What is going on?! :shock:

How is it that we have the same type of jobs, we are the same age, take somewhat the same medication and are all having this problem? I have not gone to the doctor because I figured they would tell me to wrap it up and take some Ibuprofen. It sounds like that would be the diaganosis.

If anyone gets an answer let me know because I can't take this pain anymore. :?
cankles - Tue Oct 18, 2005 12:57 am

It has been a while since you guys have been on this page, but maybe you will see this. I hope you don't because maybe you have been blessed with health. I am a 28 year old female. 3 weeks ago, my ankles started swelling and I was have tremendous pain on the inside of my ankles. It has progressed and the swelling is around every side of the ankles. I too have a desk job. Additional background: I have chronic migraines, I have been tired my whole life. Even when I was playing sports in school. I would be ok during the games and practice, but I crashed extra hard afterward. My doc is testing me for Rheumatoid and Lupus. I do not have the results yet. I am just so tired of health problems. I have had daily Headaches for 10 years, and only recently have a found a doctor, who has been able to pinpoint the problem. Throughout the last 5 years, doctors have found cysts in my brain, sinuses, eye, lip (thank God that was removed, I was looking like Bubba Gump! Haha!) Once I found a doctor who was able to diagnose and treat me, unfortunately because of Hurricane Katrina, I am unable to go there. Now, I have another unexplained "canklitis". At least that's what I am calling it since my ankles are an extension of my calves. We have to laugh at. Please let me know if you read this. Let me know if you have had diagnosis lately if any. Take care.
jmo - Thu Oct 20, 2005 6:15 pm

I am 28 years old and am also suffering from AM ankle pain. The one thing that interests me is that there are so many of us with nearly the exact mystery symptoms and nothing is being done. My Primary has done labs and it show inflammatory problems but this does not answer the underlying issue of what has caused young women to have the problems we are experiencing. I have been searching for an answer since 2000 that started with migraines where I lose my vision. Then after years of obvious immune related issues a Dx of Fibromyalgia was tacked on me. There has to be a correlation in our stories, we are young relatively healthy and suffering. Why?
swollenankles - Mon Oct 31, 2005 9:54 pm

I too am a 28 year old female with mysterious swollen ankles and now hip pain. It was really weird to read these posts and find the similarities in our situations. I am a lawyer and work both from home and in an office. I am also very active with sports. So, I was very shocked when my ankle swelled up for no reason. I had not twisted it or injured it playing sports, rather I woke up one morning and my right ankle was extremely swollen on the outside. There was pain when I tried to walk. It eventually went down but the same thing happened to me last night. And, this past weekend, I noticed that my hip joints are hurting. If I sit for more than 20 minutes at a time my hips are really stiff and hurt when I get up.
The bad thing for me is that I don't have insurance yet so I can't even go to the doctor for tests.
The ankle swelling seems to come and go but the hip pain seems like it is here to stay for a while.
Does anyone else have hip pain too?
The only drugs I take is an occasional abuterol inhaler for sporadic Asthma and Dexitrim for hunger curbing. Other than that I eat pretty healthy and exercise. I don't smoke and I rarely drink.
I'd love some advice or someone to share concerns and symptoms with.
Thanks.
kwragg - Sat Feb 25, 2006 1:01 am

I am 50 and fit. I got this large lump above my ankle in one day. It is positioned about 8" up, at 11:00 looking down at my right ankle. It is 65mm x 35mm or about the size of an egg cut lengthwise. I went to my family doctor. He did not know what it was. He sent me to an orthopedic surgeon. He did not know what it was. He checked it with a flashlight and said it was liquid. He stuck it with a needle and said it was not a ganglion sis. He could not get much out of it with the needle. So he and the nurse "milked" it with their thumbs and were able to flatten it by 70%. However, it returned to its original size soon after I got home. I was able to ream the needle hole out and "milk" it myself. I did this twice before going to bed. It returned to size by morning and the needle hole healed shut. Its been on me three weeks now. Hardly any pain, <1. Today is the fist day I noticed any pain... about a 1 unless I bump it ... then it really hurts for a short period. No samples were taken by ether doctor. I'm going back to the surgeon in a week. Any thoughts or advice? Thank you for your time.
Ken

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