To investigate the application of acupuncture combined with sports acupuncture in the treatment of chronic ankle synovitis based on the theory of " Treating Lower Diseases by Acting on the Upper Body".

98 patients with chronic ankle synovitis admitted to the Department of Soft Tissue Injury of Sichuan Orthopedic Hospital from September 2024 to April 2025 were selected and divided into two groups using the random number method, each with 49 cases. The control group was given conventional treatment, and the treatment group was treated with the 'lower disease upper treatment' theory of acupuncture combined with sports acupuncture for two consecutive weeks. Clinical efficacy, Visual Analog Scale (VAS) scores, degree of ankle swelling, most painful point, pain threshold, ankle joint range of motion, American Orthopaedic Foot and Ankle Society (AOFAS) scores were compared between the two groups.

Treatment group had a higher clinical efficacy rate in contrast to control group (P < 0.05). After treatment, the VAS score, degree of ankle joint swelling and pain threshold in both groups decreased compared with those before treatment, while the AOFAS score and range of motion of the ankle joint increased compared with those before treatment (P < 0.05). Compared with the control group, the treatment group exhibited lower VAS scores, reduced ankle swelling, and lower pain thresholds, while demonstrating higher AOFAS scores, greater ankle range of motion, and a higher number of patients with improvement in the most painful point (P <0.05).

Under the guidance of the " treating the lower disease from the upper" theory, acupuncture combined with sports acupuncture therapy can effectively relieve the pain and swelling symptoms of patients with chronic ankle synovitis, promote the recovery of joint function, and significantly improve the therapeutic effect.