Chronic Ankle Pain – Os Trigonum Syndrome

Ballet dancers, soccer players and individuals who frequently plantarflex their foot (point their toes downwards) may experience chronic ankle pain located at the back of their ankle. Os trigonum is an accessory bone located on the lateral process of the talus – the back of the ankle. Most individuals are unaware they have an os trigonum until it becomes symptomatic. Severe plantarflexion can cause the accessory bone to become crushed between the ankle bone and the heel bone. This motion results in injury to the ligamentous attachments of the accessory bone leading to pain and swelling. Individuals complain of a deep aching pain at the back of their ankle when walking or when pointing their foot.
Conservative treatment options include:

  • Rest to allow the inflammation to subside

  • Immobilization with an ankle support/brace/ boot

  • Ice to decrease swelling

  • NSAIDs such as ibuprofen to help reduce pain and inflammation

  • Corticosteroid injection to reduce inflammation and pain

If conservative treatment fails to alleviate symptoms, surgical excision of the os trigonum may be necessary.

If you or a loved one is experiencing chronic ankle pain, come see us at Foot & Ankle Doctors, Inc.

Dr. Dardashti

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