Ankle Sprain

Treatment Overview

Initial treatment for an ankle sprain is summarized as the PRINCE approach:

• Protection. Use a protective brace, such as a brace with a built-in air cushion or other form of ankle support, along with a compression wrap, such as an elastic ACE bandage, for the first 24 to 36 hours.
• Rest. Use crutches until walking is not painful without them.
• Ice. For the first 48 to 72 hours or until swelling goes down, apply an ice pack for 10 to 20 minutes every 1 to 2 hours during the day. After 48 hours, you can continue with ice or try contrast baths. There is not good scientific evidence that ice or contrast baths help, but they are often used.
• NSAIDs or acetaminophen. Examples of non-steroidal anti-inflammatory drugs (NSAIDS) include ibuprofen (such as Advil, Motrin, or Nuprin). Common types of acetaminophen include Panadol, Tempra, or Tylenol.
• Compression. An elastic compression wrap will help decrease swelling and should be worn for the first 24 to 36 hours. A protective brace should also be worn if you try to bear weight on your injured ankle. Don't apply the wrap too tightly. Loosen the bandage if it gets too tight. Signs that the bandage is too tight include numbness, tingling, increased pain, coolness, or swelling in the area below the bandage. See instructions on how to wrap an ankle with an elastic bandage. Compression wraps do not offer protection, except by reminding you to be careful of your ankle.
• Elevation. Raise your ankle above the level of your heart for 2 to 3 hours a day if possible to decrease swelling and bruising.

Also, it can help to wear hiking boots or other high-top, lace-up shoes for support.¹ But use caution. Don't force your foot into a boot if you feel a lot of pain or discomfort.

Your doctor may suggest that you keep some or all of your weight off your ankle as it heals. If this happens, learn to use your crutches or walker properly and safely.

• Using crutches
• Using a walker

Almost all ankle sprains heal on their own with proper treatment and rehabilitation exercises. For more information, see the Home Treatment section of this topic.

Surgery to repair torn ligaments is usually only considered when there is a severe ligament tear (or tears) or if the ankle remains unstable after rehabilitation. Surgery is also a consideration if you have broken a bone.

For more information on the correct way to wrap a sprained ankle, see:

Applying a compression wrap for a sprained ankle.

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Author:	Douglas Dana Shannon Erstad, MBA/MPH	Last Updated: March 4, 2008
Medical Review:	William M. Green, MD - Emergency Medicine Anne C. Poinier, MD - Internal Medicine H. Michael O'Connor, MD - Emergency Medicine
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