Associated Joint Pain With Controlled Ankle Movement Walker Boot Wear

BACKGROUND: Controlled ankle movement (CAM) walker boots may cause gait alterations and leg-length discrepancy. This study evaluates secondary site pain relating to immobilization in a CAM walker boot. METHODS: Patients wearing a CAM walker boot were prospectively enrolled and evaluated for new or worsened secondary site pain. Surveys at four time points were completed to evaluate secondary site pain severity and its effect on function. RESULTS: The study included 46 patients (mean age, 49 years). At transition out of the boot (mean, 4.2 weeks), 31 patients (67%) reported pain which was new or worse than at baseline. The sites most susceptible to pain were lower back, contralateral hip, and ipsilateral knee. Most pains (84%) began within the first 2 weeks of boot wear. Secondary site pain was less common after transition out of the boot: 18 patients (39%) at 1 month and 15 patients (33%) at 3 months. CONCLUSION: Secondary site pain after CAM walker boot wear is common. The frequency and severity of pain lessened after transition out of the boot. Yet, one-third of patients still had new or worsened secondary site pain 3 months after cessation of boot wear.