May
31

Q&A: What should I do about ankle pain after standing for long periods of time?

Ask A Doctor Question: 

I have a 22 year old wound on my ankle. For the past 6 months I have been experiencing pain when I am standing for prolonged periods of time or when I walk or run a mile or so. What gives?

- Deidre

Answer: 

Howard R. Fox, DPM, FACFS - LocateADoc.com

Deidre,
 
It’s hard to give you a truly meaningful answer without knowing more about you, this wound and other medical issues, but I’ll try my best. 
 
The key to closing ulcers, and I am assuming that your “wound” is an ulcer by virtue of the fact it’s celebrating its 22nd birthday, is in identifying the underlying cause of the ulcer.  One of the more common lower leg ulcers, usually just above the inside of the ankle, is a venous stasis ulcer which results from deep varicose veins that cause the blood to pool and collect in your lower legs.  This causes swelling and over time, a brownish-red staining of the skin called hemosiderin, and induration (a hardness and loss of elasticity of the skin in the area).  Since stasis or a pooling of the blood is the culprit in these cases, the treatment lies in compression, to help milk the blood back up to the heart.  In mild or early cases, this is done with compression stockings or support hose.  Once an ulcer develops, compression in the form of a soft cast (“Unna’s boot”) or a venous compression machine is used.  Keep in mind I am only guessing that the 22 year-old wound you have is a venous stasis ulcer.  Other leg ulcers that can be chronic are due to hypertension or other underlying disease.  If this is the case, nothing will close the ulcer without first addressing the underlying problem.
 
Venous stasis ulcers are usually painless.  They become painful when they get infected or the ulcer becomes very deep.  Pain is also associated with poor arterial circulation, which is a separate issue altogether.
 
The best advice I can give you is to not give up.  If this has been present for 22 years, I would speculate that you’ve been to your share of doctors about this and have gotten nowhere.  Leg ulcers are a specialized field and most doctors aren’t adept at diagnosing and treating them.  A vascular surgeon would be the best starting point for you, but if there is an underlying medical condition that is associated with the ulcer, an appropriate specialist would need to work together with your vascular surgeon to close it up.  There could very well be a serious problem here that can put your entire leg at risk, so please seek professional assistance without delay.
 
The best of luck to you Deidre.  I hope this helps.

--Howard R. Fox, DPM, FACFS
718-987-5366
Staten Island, NY

Answer: 

Roger Friedman, DPM - LocateADoc.com

Hello Diedre - 
 
If I understand your question correctly, it sounds as if you have a wound on your ankle that has been present for 22 years. Is the wound closed or open? Is it on the outside of the ankle or inside of the ankle? These are important questions to consider when answering your question. At least I can tell you this much, pain in the ankle is not normal and should be investigated further through a visit to a foot and ankle specialist.

--Roger Friedman, DPM
Elyria, OH

Answer: 

John Doolan, DPM - LocateADoc.com

when you say "wound" it is open or an old healed wound?
 
sounds like it may be venous stasis, is there swelling, if so you will need compression and elevation.
 
obviously an in person exam would help
 
I wish you well 

--John Doolan, DPM
New York, NY

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