Pain in people with chronic ankle instability

Abstract

Pain is one of the commonly reported impairments in participants with chronic ankle instability (CAI). The findings of this thesis showed that the prevalence of pain was high in participants with CAI. Persistent ankle pain was significantly associated with some characteristics of CAI and included ankle instability, age, and unilateral ankle sprain. When participants with CAI and pain were compared to other participants (CAI without pain, health, coper), there was no difference between groups on the primary outcome measures (Balance perturbation, limb literality recognition test). However, participants with CAI and pain showed a significantly lower score in the Foot and Ankle Ability Measure (FAAM) (low functional level). Although there was a high frequency of reported ankle pain, the characteristics of this pain was not clearly understood. The central and peripheral nociceptive pathways could play a significant role in the existence and persistence of ankle pain. Therefore, we used the quantitative sensory testing (QST) as a psychophysical testing to provide broad information about pain perception and central sensitization. Significant differences were found in participants with CAI and pain compared to other CAI participants without pain in Heat Pain Threshold (HPT), Vibration Detection Test (VDT), and Conditioned Pain Modulation (CPM). These differences suggest reorganization of nervous system and central nociplastic changes. Future longitudinal studies are required to investigate how pain may impact in quality of life and include specific psychological questionnaires for ankle injuries.