Eight months ago , I missed the last step going down the stairs and badly sprained my left ankle. I could barely walk on it for several days and it was severely bruised and swollen. I followed up on day 3 with my Orthopedic office by seeing the foot and ankle physician's assistant. Had x-rays which showed no break. Put in a walking boot. 3 weeks later followed with foot and ankle Orthopedic Surgeon, had x-rays, still no break, so moved onto lace-up brace despite still having swelling and pain.


Started physical therapy in beginning of month 3, but was referred back to Orthopedic surgeon after 4 visits due to excessive pain. Back in the walking boot until sent for an MRI at 3 month post-injury. Results showed torn lateral ligaments (all 3), torn medial ligaments, tendinitis, and talus bone bruise. The doctor said I had to have twisted my ankle 360 degrees to have these injuries and that you'd usually break a bone before this would all occur.


Continued with walking boot with little improvement. Put in a non-weight bearing (NWB) cast at 4 month mark for 3 weeks with little improvement. Cast removed. Sent for a bone scan which showed healing in 2 locations and ruled out regional pain syndrome. Back in the walking boot, and NWB for a total of about 7 weeks between the cast and boot. Worked back to weight bearing in walking boot.


Follow up MRI at 6 month mark showed ligaments and bone bruise were still healing but looked better then 3-month mark MRI. Cortisone shot in ankle joint at the 6 month mark- got 50% improvement. Cortisone shot in subtalar joint at 7 month mark. Felt great for a week, then some pain returning. Now at month 8, it seems both cortisone shots have completely worn off so I'm back to pain- made worse if I walk or stand for any length of time. Also irritated while driving. Still swollen. More swollen on lateral side, but more pain on medial side. Also, some pain at bone bruise location.


In addition to what's noted above, did RICE, alternating hot/cold soaks, anti-inflammatory (oral and gel), oral prednisone, and massage. I've had multiple more minor sprains before and broken my other foot 4 times, but I've always healed in 6-8 weeks. Any idea how to proceed from here? What else to consider in terms of diagnosis and/or treatment?

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