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Problems with ankle

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Hi, I have Limited/Crest Scleroderma, and have had it now for 2 1/2 years. Since the beginning, I have lots of pain in the feet and lower leg areas. I have had many ultrasounds and x-rays in the past, and basically been told that I need to stretches, wear orthotics etc.


My question is how do you know whether to apply ice or heat packs to a certain area?


My main problem at the moment is constant nagging throbbing pain on the outside of one ankle going towards the middle of the foot. It is slightly swollen, and is excruciating to touch, even the bone is sore.


Any suggestions would be of great value.





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Hi Summer,


I'm sorry you are in pain and hope you find something to alleviate it soon!


Something you may want to keep in mind is that even with a chronic condition, such as your sore feet and legs, new complications can arise. For example, you might be developing issues with edema, have a new injury, tendonitis, or even possibly a blood clot. So if this particular round of symptoms is different or worse than your others, it would be terrific to get it examined by a doctor right away.


Please keep in mind I have no medical training at all; I can't even wrap an elastic bandage correctly! So here's my for-what-it's-worth idea: If it's totally same-o, same-o and *all* of the symptoms together have been evaluated in the past, then you might want to try either hot or cold packs and see what is most helpful for it. I'd think cold packs might help reduce the swelling. However, in general, cold packs are something we want to avoid with systemic scleroderma as they might inspire attacks of Raynaud's. Still, I use them occasionally (but cautiously) for injuries or even some headaches.


You might want to look up our page on Skeletal Involvement which includes tendinitis. I wear custom orthotic shoes and insoles all the time, and regularly do stretches, as well as treatment for edema which can make my feet swell up like balloons. However, that is generally both ankles at the same time (even if in varying degrees) so I would actually be more concerned about swelling in just one ankle.


I don't like the idea that the area is excruciating to touch. I wish/hope you'll see a doctor very soon and let us know what happens.

Warm Hugs,


Shelley Ensz

Founder and President

International Scleroderma Network (ISN)

Hotline and Donations: 1-800-564-7099


The most important thing in the world to know about scleroderma is sclero.org.

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Hi there Summer,


I fully agree with Shelley that you need to have your ankle troubles evaluated by a doctor and would suggest finding an Orthopaedic Specialist that specializes with foot and ankle injuries.


I am not a doctor (cannot even play one on TV) but I do have vast experience with a bad foot/ankle of my own and after 19 surgeries on it in the past 10 years I can tell you from experience that if the issue is not dealt with in the beginning you may be looking at years of troubles with a cascade of effects.


Pain in the mid-foot can very well be tendinitis or bursitis that is brought on because your stride has changed slightly to adapt to tighter skin and joints. With feet, your stride being off can cause a cascade effect because as one thing changes the anatomy of your foot changes to try to keep your center of gravity in the proper place, putting strain on new joints and muscles. Orthotics do definitely help, but they must be professionally fitted and crafted for your feet and need to be replaced a couple of times a year to make sure that they offer the proper support since they can wear down and "crush" with every day wear and tear.


The usual thing to do for acute pain is R.I.C.E., rest, ice, compression and elevation, applying ice no more than 10 minutes at a time a few times a day but as Shelley has said, ice can cause Raynaud's and should not be used if you have this. After the acute stage the rule of thumb is usually basically the same only with heat instead of ice. Just make sure never to place heat or ice directly on your skin; always use a buffer of a cloth and to use it only 10-15 minutes at a time several times a day.


I state the above from personal experience and advice from physical therapists and my own Orthopaedic Surgeons, but as always, your best action would be to get checked out to make sure that there is not something going on in that foot of yours. I went to a stand alone quick care facility when I initially injured my foot and they dismissed it as a sprain without really looking. A month later I went back and saw a different doctor who took an x-ray and saw problems, within a week I was seeing a specialist and getting scheduled for surgery, but it was that month of thinking it would go away and using it when I shouldn't that has caused the past 10 years of surgery after surgery. Mine is a worst case scenario, but I tell it because I do not want anyone else to ever go through this. The end result for me is an amputation that is in the wings waiting for other issues to calm down before they schedule it.


I hope that your foot feels better soon, but urge you to have it evaluated by a specialist just to make sure that there is not something bigger hiding there.


Please keep us informed...

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Hello Summer


I have very painful ankles and feet, even to the touch. I also had shooting pains down the ankle and back of the foot which my rheumatologist said was a trapped nerve caused by the sking tightening and thickening. Well, since starting amitrptilyne for nerve pain, the shooting sensation has almost gone. Pity the rest of the pain hangs on.


Rather than try and work it out see your doctor as already suggested.


Take care.



Amanda Thorpe

ISN Sclero Forums Senior Support Specialist

ISN Video Presentations Manager

ISN Blogger

(Retired) ISN Sclero Forums Assistant Manager

(Retired) ISN Email Support Specialist

International Scleroderma Network (ISN)

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Thanks for the replies. I have a whole lot of problems with both feet, ankles, and Achilles tendons. Xrays done 2 years ago showed: Right Ankle Joint Arthropathy, spurs and tendonitis. The swelling is only mild, but it hurts to bend the foot and walk. My Physiotherapist has also told me that I have collapsed arches in both feet, and my Achilles tendons are not where they should be, hence, the problems. I will see how I get on the next couple of weeks, hopefully all will settle down.




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