Editing Sprain (section)

=== Non-surgical ===
Depending on the mechanism of injury, joint involvement, and severity, most sprains can be treated using conservative measures following the acronym [[RICE (medicine)|RICE]] within the first 24 hours of sustaining an injury.<ref>{{MedicalMnemonics|235|||}}</ref> However, it is important to recognize that treatments should be individualized depending on the patient's particular injury and symptoms.<ref>{{Cite journal|last1=van den Bekerom|first1=Michel P.J|last2=Struijs|first2=Peter A.A|last3=Blankevoort|first3=Leendert|last4=Welling|first4=Lieke|last5=van Dijk|first5=C. Niek|last6=Kerkhoffs|first6=Gino M.M.J|date=August 2012|title=What Is the Evidence for Rest, Ice, Compression, and Elevation Therapy in the Treatment of Ankle Sprains in Adults?|journal=Journal of Athletic Training|volume=47|issue=4|pages=435–443|doi=10.4085/1062-6050-47.4.14|issn=1062-6050|pmc=3396304|pmid=22889660}}</ref> Over-the-counter medications such as [[non-steroidal anti-inflammatory drugs]] (NSAIDs) can help relieve pain, and [[Topical medication|topical]] NSAIDs can be as effective as medications taken by mouth.<ref>{{cite journal | vauthors = Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ | title = Topical NSAIDs for acute musculoskeletal pain in adults | journal = The Cochrane Database of Systematic Reviews | volume = 6 | issue = 6 | pages = CD007402 | date = June 2015 | pmid = 26068955 | doi = 10.1002/14651858.CD007402.pub3 | pmc = 6426435 }}</ref>

* '''Protect:''' The injured site should be protected and immobilized, as there is an increased risk of recurrent injury to the affected ligaments.<ref name=":1">{{cite journal | vauthors = Bleakley CM, O'Connor SR, Tully MA, Rocke LG, Macauley DC, Bradbury I, Keegan S, McDonough SM | title = Effect of accelerated rehabilitation on function after ankle sprain: randomised controlled trial | journal = BMJ | volume = 340 | pages = c1964 | date = 10 May 2010 | pmid = 20457737 | doi = 10.1136/bmj.c1964 | doi-access = free }}</ref>
* '''Rest:''' The joint affected should be immobilized and bearing weight should be minimized. For example, [[walking]] should be limited in cases of [[sprained ankle]]s.<ref name="AAOS">{{cite web|url=http://orthoinfo.aaos.org/topic.cfm?topic=A00150 |title=Sprained Ankle |access-date=2008-04-01 |date=March 2005 |publisher=American Academy of Orthopaedic Surgeons}}</ref>
* '''Ice:''' Ice should be applied immediately to the sprain to reduce swelling and pain.<ref>{{Cite journal|last1=Hubbard|first1=Tricia J.|last2=Denegar|first2=Craig R.|date=2004|title=Does Cryotherapy Improve Outcomes With Soft Tissue Injury?|journal=Journal of Athletic Training|volume=39|issue=3|pages=278–279|issn=1062-6050|pmid=15496998|pmc=522152}}</ref> Ice can be applied 3–4 times a day for 10–15 minutes at a time or until the swelling subsides and can be combined with a wrapping for support.<ref name="AAOS" /> Ice can also be used to numb pain but should only be applied for a short period of time (less than twenty minutes) for this purpose.<ref>{{cite journal | vauthors = Cramer H, Ostermann T, Dobos G | title = Injuries and other adverse events associated with yoga practice: A systematic review of epidemiological studies | journal = Journal of Science and Medicine in Sport | volume = 21 | issue = 2 | pages = 147–154 | date = February 2018 | pmid = 28958637 | doi = 10.1016/j.jsams.2017.08.026 }}</ref> Prolonged ice exposure can reduce blood flow to the injured area and slow the healing process.<ref>{{Cite journal|last1=Singh|first1=Daniel P.|last2=Barani Lonbani|first2=Zohreh|last3=Woodruff|first3=Maria A.|last4=Parker|first4=Tony J.|last5=Steck|first5=Roland|last6=Peake|first6=Jonathan M.|date=2017-03-07|title=Effects of Topical Icing on Inflammation, Angiogenesis, Revascularization, and Myofiber Regeneration in Skeletal Muscle Following Contusion Injury|journal=Frontiers in Physiology|volume=8|pages=93|doi=10.3389/fphys.2017.00093|issn=1664-042X|pmc=5339266|pmid=28326040|doi-access=free}}</ref>
* '''Compression:''' Dressings, bandages, or wraps should be used to immobilize the sprain and provide support. When wrapping the injury, more pressure should be applied to the [[distal]] end of the injury and decrease in the direction of the heart. This helps circulate the blood from the extremities to the heart. Careful management of swelling through [[cold compression therapy]] is critical to the healing process by preventing further pooling of fluid in the sprained area. However, compression should not impede circulation of the limb.<ref name="AAOS" />
* '''Elevation:''' Keeping the sprained joint elevated (in relation to the rest of the body) can minimize swelling.<ref name="AAOS" />

Other non-operative therapies including the [[continuous passive motion|continuous passive motion machine]] (moves joint without patient exertion) and cryocuff (type of cold compress that is activated similarly to a blood pressure cuff) have been effective in reducing swelling and improving range of motion.<ref>{{Cite journal|last1=Liao|first1=Chun-De|last2=Tsauo|first2=Jau-Yih|last3=Huang|first3=Shih-Wei|last4=Chen|first4=Hung-Chou|last5=Chiu|first5=Yen-Shuo|last6=Liou|first6=Tsan-Hon|date=April 2019|title=Preoperative range of motion and applications of continuous passive motion predict outcomes after knee arthroplasty in patients with arthritis|journal=Knee Surgery, Sports Traumatology, Arthroscopy|volume=27|issue=4|pages=1259–1269|doi=10.1007/s00167-018-5257-z|issn=1433-7347|pmid=30523369|s2cid=54446697|doi-access=free}}</ref>  Recent studies have shown that traction is just as effective as the RICE technique in treating ankle sprains in pediatric patients.<ref>{{Cite journal|last1=Iammarino|first1=Kathryn|last2=Marrie|first2=James|last3=Selhorst|first3=Mitchell|last4=Lowes|first4=Linda P.|title=Efficacy of the Stretch Band Ankle Traction Technique in the Treatment of Pediatric Patients with Acute Ankle Sprains: A Randomized Control Trial|date=February 2018|journal=International Journal of Sports Physical Therapy|volume=13|issue=1|pages=1–11|doi=10.26603/ijspt20180001|issn=2159-2896|pmc=5808004|pmid=29484236}}</ref>