Initial treatment for an ankle sprain is summarized as the RICE approach:
- Rest. You may need to 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.
- 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.
If you are not taking any prescription pain relievers, you may want to take an over-the-counter pain reliever such as ibuprofen or naproxen to reduce pain and swelling. Be safe with medicines. Read and follow all instructions on the label.
It may help to wear hiking boots or other high-top, lace-up shoes for support. 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.
Almost all ankle sprains heal on their own with proper home treatment and rehabilitation (rehab) exercises.
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 rehab. Surgery is also a consideration if you have broken a bone.