Sprains - How to manage

Normally you will know immediately if you have sprained your ankle or wrist as the injury usually occurs when you roll the joint too far in one direction. The main symptoms are;

• pain
• swelling
• bruising
• limited ability to move the affected joint
• hearing or feeling a "pop" in your joint at the time of injury

If you suspect you have sprained a joint, you should follow the RICE or PRICE acronym.

• P – Protection. This is to prevent further injury, this can be done by avoiding using the affected joint initially.
• R – Rest. This is important to allow recovery, however, a more accurate term is “relevant rest” which describes rest that allows healing but does not restrict recovery. The joint should be gently exercised using pain-free range-of-motion exercises.
• I – Ice. This is to reduce swelling and inflammation to the area which can, in turn, reduce pain. It is important not to put ice directly onto the area, instead, wrap it in something such as a towel and only apply it for 10-15 mins at a time with 1-2 hours break between applications.
• C – Compression. You should apply a compression wrap or elasticated bandage to the area. This gently compresses the area to reduce swelling and provides mild support.
• E – Elevation. This is to prevent the pooling of fluid to the injured area which can reduce pain and reduce loss in motion while the area recovers. The elevation is accomplished by positioning the injured area above the level of the heart. Elevation during most of the waking hours, if possible, and positioning the injured limb on extra pillows for sleep is probably most effective in the initial 24 to 48 hours. If there is significant swelling that continues after 24 to 48 hours, or if swelling recurs during recovery, then continued periodic elevation is appropriate.

The best way to manage the pain from a sprain is with over-the-counter painkillers such as paracetamol and ibuprofen which are most effective in combination. As well as the pain relief effect, ibuprofen also has anti-inflammatory properties that will help reduce some of the swelling and inflammation in the joint. You may also consider trying diclofenac topical gel applied to the joint. Diclofenac is a stronger painkiller than ibuprofen, however, topical use means it will be better at working directly on the area you apply it to. For a more in-depth comparison, have a read here.

You should not take ibuprofen if you decide to use diclofenac gel as they belong to the same class of medication (non-steroidal anti-inflammatories – NSAIDs. Paracetamol is safe for use in combination with either one as it works differently from NSAIDs.

Mild sprains can be treated at home, but you have severe symptoms you may need a review with your doctor to rule out a bony injury. You should see a doctor if you can't move or bear weight on the affected joint, if you have severe pain, if there is any deformity to the joint, or if you have ongoing numbness to any part of the injured area. Your doctor may decide to arrange an X-ray to check there are no breaks to the bones in the area.