Medication for sprains: Newest treatment options
Written by Leann Poston M.D.
Ankle sprains are the most common sports injury sustained by athletes although foot and knee sprains also occur. In the arm, wrist, thumb, and finger sprains are common injuries. Spraining your ankle once is the strongest predictor for a second ankle injury. Injuries can affect your quality of life and keep you from the activities you enjoy. Trainers and health care providers are always looking for new medication and treatment options for sprains.
Four factors which reduce your risk for recurrent ankle sprains
- Use non-steroidal anti-inflammatory drugs (NSAIDs) with POLICE: protection, optimal loading, ice, compression, and elevation early in the rehabilitation process. Stop NSAIDs after 48 hours.
- Emphasize an early return to the activity rather than prolonged immobility
- Encourage the use of an ankle support, such as a brace or tape, for up to one year after the injury.
- Above all, as soon as weight-bearing can be tolerated, incorporate a rehabilitation program that includes a focus on balance, exercise, and coordination training (McKeon & Donovan, 2019).
Risk factors for ankle, knee, foot and finger sprains
- Being overweight: Puts more stress on the joints
- Lack of warm-up: Skipping the warm-up increases the risk for sprains
- Jumping: Increases the risk for foot, knee and ankle sprains
- Contact sports: increases the risk for a finger, thumb or neck sprain
Medications and Treatment for Ankle Sprains
The National Athletic Trainer’s Association evaluated evidence-based studies to determine the effectiveness of common medications and treatment options for sprains. Next, they rated them based on the strength, quality, and consistency of the recommendation as a level A, B, C with A demonstrating the highest strength, quality, and consistency.
Level A medications and treatment for sprains
- NSAIDs: To reduce pain, swelling, and improve function use NSAIDs for the first 48 hours.
- Functional rehabilitation: Use functional rehabilitation instead of immobilization for grade I and II ankle sprains.
- Balance Training: Incorporate balance training into all phases of rehabilitation and follow-up.
Level B medications and treatment for sprains
- Immobilization: Immobilize grade III sprains for at least ten days: Level B
- Rehabilitation: Include a comprehensive range of motion, flexibility, and strength training program into rehabilitation plans.
- Mobilizations: Use passive joint mobilizations and mobilizations with movement to increase function.
Level C medications and treatment for sprains
- Electrical Stimulation: To minimize swelling early in therapy.
- Ice: To minimize swelling and reduce pain.
- Compression: To minimize swelling.
- Elevation: To minimize swelling.
- Thermotherapy: The claim that clinicians should refrain from thermotherapy during the acute and subacute phase of an injury due to a lack of evidence and potential to exacerbate the injury.
- Cryokinetics: The claim that cryokinetics can reduce pain and allow for earlier rehabilitation.
Alternative treatments for sprains
Extracorporeal shock wave treatment
Extracorporeal shock wave therapy is a non-surgical procedure that uses high-energy shock waves to deliver a mechanical force to the tissue. It increases blood flow, decreases chronic inflammation, stimulates collagen production, breaks up scar tissue, and releases trigger points. Consider shock wave therapy after trying first-line treatments. Side effects can include mild bruising, swelling, pain, numbness, and tingling (Shockwave therapy, n. d.).
Therapeutic ultrasound treatment
Ultrasound therapy uses sound waves with frequencies beyond the range of human hearing. Ultrasound warms soft tissue to improve blood flow and accelerate healing. Similarly, ultrasound can assist the transport of medications into the skin. There is a low risk of burns from ultrasound therapy (Miller et al., 2012).
Prolotherapy is an alternative therapy that involves injecting irritants such as a saline or sugar solution into an injury to trigger the inflammatory response. It should help reduce pain, improve the strength and function of ligaments and other tissues (Cronin, 2013). The American College of Rheumatology does not recommend its use in osteoarthritis. The benefits of and long-term effects of prolotherapy need further research.
Platelet-rich plasma (PRP) treatments
Platelets and plasma from the patient’s blood are used in PRP therapy to expedite the healing process for injuries to muscles, tendons, and bones. Blood from the patient is spun in a centrifuge. The platelet-rich plasma is removed and then injected into the injury site. PRP therapy requires research before it becomes a mainstream treatment. However, it seems to be effective in the treatment of chronic tendon injuries (Kelly, 2011).
Stem cell treatments
Stem cells are called pluripotent, which means they can mature into other types of cells. They also serve critical messaging functions in tissue. Stem cell therapy holds much promise for the future, but there are potential problems that require additional research before they become a mainstream treatment option (Lim & Hee, 2010).
BPC-157 is a synthetic peptide that is derived from one typically found in the digestive juices of humans. In animal studies, it has been found to speed up healing in soft tissue, including ligaments and tendons injured in ankle, knee, foot, and elbow sprains. A telemedicine consultation with an Invigor health care provider can determine whether BPC-157, a supplement that requires a prescription, is the best choice for you.
Conclusion: medications and treatment for sprains
Overall, functional rehabilitation, the use of NSAIDs for the first 48 hours or so, and balance training seem to be endorsed as the best initial medication and treatment options for sprains. Of the alternative options, BPC-157 is a supplement that has been studied extensively in animals for its healing properties.
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.
- McKeon, P. O., & Donovan, L. (2019). A Perceptual Framework for Conservative Treatment and Rehabilitation of Ankle Sprains: An Evidence-Based Paradigm Shift. Journal of Athletic Training (Allen Press), 54(6), 628–638. https://doi.org/10.4085/1062-6050-474-17
- Shockwave therapy. (n.d.). Retrieved from https://www.shockwavetherapy.eu/subpage
- Miller, D. L., Smith, N. B., Bailey, M. R., Czarnota, G. J., Hynynen, K., Makin, I. R., & Bioeffects Committee of the American Institute of Ultrasound in Medicine (2012). Overview of therapeutic ultrasound applications and safety considerations. Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine, 31(4), 623–634. https://doi.org/10.7863/jum.2012.31.4.623
- Cronin, M. (2013). Combining Prolotherapy and Platelet-rich Plasma Therapy for Joint Repair in a Case of Anterior Cruciate Ligament Disruption. Integrative Medicine: A Clinician’s Journal, 12(2), 46–50
- Kelly, F. (2011, September). Platelet-rich plasma. Retrieved from https://orthoinfo.aaos.org/en/treatment/platelet-rich-plasma-prp
- Chin Tat Lim, & Hwan Tak Hee. (2010). Stem Cell Therapy in Orthopaedic Surgery. Advances in Orthopaedics, 2(3), 81–87.