Chronic ankle pain is relatively common in family medicine. Sequelae from lateral ankle sprains are the most common cause. Other etiologies include peroneal tendinopathy or subluxation, osteochondral injury, lateral ankle impingement, sinus tarsi syndrome, cuboid syndrome, bony stress injury, and other unusual factors. A thorough history focusing on the mechanism of injury (if traumatic) and the nature of the pain along with a targeted physical examination typically will provide the information needed to make the diagnosis. Imaging might be necessary for diagnosis or confirmation of the diagnosis. Early functional bracing, physical therapy for strengthening, and proprioceptive exercises are the preferred treatments for most patients. Daily pain drugs or full immobilization devices rarely are necessary.
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