Ankle Impingement Syndrome Medication
- Author: Marc A Molis, MD, FAAFP; Chief Editor: Craig C Young, MD more...
Medication Summary
The goals of pharmacotherapy are to reduce morbidity and to prevent complications.
Nonsteroidal Anti-Inflammatory Drugs
Class Summary
NSAIDs have analgesic, anti-inflammatory, and antipyretic activities. The mechanism of action of these agents is not known, but they may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well; these may include inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation, and various cell-membrane functions.
Ibuprofen (Motrin, Ibuprin)
DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.
Ketoprofen (Actron, Orudis, Oruvail)
For the relief of mild to moderate pain and inflammation. Small dosages are initially indicated in small and elderly patients and in those with renal or liver disease.
Doses >75 mg do not increase the therapeutic effects. Administer high doses with caution and closely observe the patient for response.
Naproxen (Aleve, Naprosyn, Anaprox, Naprelan)
For the relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing the activity of cyclooxygenase, which results in a decrease of prostaglandin synthesis.
Sulindac (Clinoril)
Decreases the activity of cyclooxygenase which, in turn, inhibits prostaglandin synthesis. Results in a decreased formation of inflammatory mediators.
Flurbiprofen (Ansaid)
May inhibit the cyclooxygenase enzyme, which, in turn, inhibits prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.
Opioid Analgesics
Class Summary
Pain control is essential to quality patient care. Analgesics ensure patient comfort and have sedating properties, which are beneficial for patients who have sustained trauma or who have sustained injuries.
Acetaminophen and codeine (Tylenol #3)
May inhibit the cyclooxygenase enzyme, which, in turn, inhibits prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.
Hydrocodone and acetaminophen (Vicodin, Norcet, Lortab)
Drug combination indicated for moderate to severe pain.
Hydrocodone and ibuprofen (Vicoprofen)
Drug combination indicated for the short-term (< 10 d) relief of moderate to severe acute pain.
Propoxyphene and acetaminophen (Darvocet-N 100, Propacet, Wygesic)
Drug combination indicated for mild to moderate pain.
Ferkel RD. Soft tissue pathology of the ankle. In: McGinty JB, Caspari RB, Jackson RW, Poehling GG, eds. Operative Arthroscopy. 2nd ed. Philadelphia, Pa: Lippincott Raven; 1996:1141-55.
Ferkel RD. Ankle and foot injuries. In: Fu FH, Stone DA, eds. Sports Injuries. Baltimore, Md: Lippincott Williams & Wilkins; 1994.
Umans HR, Cerezal L. Anterior ankle impingement syndromes. Semin Musculoskelet Radiol. Jun 2008;12(2):146-53. [Medline].
Sanders TG, Rathur SK. Impingement syndromes of the ankle. Magn Reson Imaging Clin N Am. Feb 2008;16(1):29-38, v. [Medline].
Robinson P. Impingement syndromes of the ankle. Eur Radiol. Dec 2007;17(12):3056-65. [Medline].
Pfeffer GB, ed. Chronic Ankle Pain in the Athlete (monograph). Rosemont, Ill: American Academy of Orthopaedic Surgeons; Dec 2000. AAOS Monograph Series. No. 17.
Wolin I, Glassman F, Sideman S, Levinthal DH. Internal derangement of the talofibular component of the ankle. Surg Gynecol Obstet. Aug 1950;91(2):193-200. [Medline].
Waller JF. Hindfoot and midfoot problems. Symposium on the foot and leg. In: Mack RP, ed. Running Sports. St. Louis, Mo: Mosby; 1982:pp 64-71.
Bassett FH 3rd, Gates HS 3rd, Billys JB, Morris HB, Nikolaou PK. Talar impingement by the anteroinferior tibiofibular ligament. A cause of chronic pain in the ankle after inversion sprain. J Bone Joint Surg Am. Jan 1990;72(1):55-9. [Medline]. [Full Text].
Hamilton WG. Tendonitis about the ankle joint in classical ballet dancers. Am J Sports Med. Mar-Apr 1977;5(2):84-8. [Medline].
Maquirriain J. Posterior ankle impingement syndrome. J Am Acad Orthop Surg. Oct 2005;13(6):365-71. [Medline].
Alfredson H, Cook J, eds. Pain in the Achilles region. In: Brukner P, Khan K. Clinical Sports Medicine. 2nd ed. New York: McGraw-Hill; 2000.
Lee JC, Calder JD, Healy JC. Posterior impingement syndromes of the ankle. Semin Musculoskelet Radiol. Jun 2008;12(2):154-69. [Medline].
McCarthy CL, Wilson DJ, Coltman TP. Anterolateral ankle impingement: findings and diagnostic accuracy with ultrasound imaging. Skeletal Radiol. Mar 2008;37(3):209-16. [Medline].
Henderson I, La Valette D. Ankle impingement: combined anterior and posterior impingement syndrome of the ankle. Foot Ankle Int. Sep 2004;25(9):632-8. [Medline].
Ferkel RD. Arthroscopy of the foot and ankle. In: Coughlin MJ, Mann RA, eds. Surgery of the Foot and Ankle. 7th ed. St Louis, Mo: Mosby; 1999:1257-97.
Ogilvie-Harris DJ, Gilbart MK, Chorney K. Chronic pain following ankle sprains in athletes: the role of arthroscopic surgery. Arthroscopy. Oct 1997;13(5):564-74. [Medline].
Liu SH, Raskin A, Osti L, et al. Arthroscopic treatment of anterolateral ankle impingement. Arthroscopy. Apr 1994;10(2):215-8. [Medline].
Ferkel RD, Karzel RP, Del Pizzo W, Friedman MJ, Fischer SP. Arthroscopic treatment of anterolateral impingement of the ankle. Am J Sports Med. Sep-Oct 1991;19(5):440-6. [Medline].
Jackson DW, Ashley RL, Powell JW. Ankle sprains in young athletes. Relation of severity and disability. Clin Orthop Relat Res. Jun 1974;101:201-15. [Medline].
Print
