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14 Common Causes of Ankle Pain

Ankle pain: symptoms, causes and treatment

Common Causes of Ankle Pain

Ankle pain refers to any kind of pain or discomfort affecting any part of the ankle. Ankle pain usually gets better with at-home treatments such as rest, ice and over-the-counter pain medication. A physical therapy program can help you strengthen muscles and prevent another injury. Providers treat more severe pain with braces and splits, injections and surgery.

Ankle pain refers to any type of pain or discomfort in your ankles. This pain could be caused by an injury, like a sprain, or by a medical condition, like arthritis.

Ankle pain can be caused by everything from a sprain to diabetes to arthritis. The most commonly reported ankle injury is a sprained ankle, and young people (under age 25) and females tend to get sprained ankles much more often than do men over the age of 25. Either way, people of all ages are susceptible to developing ankle pain thanks to one reason or another.

According to the National University of Health Sciences (NUHS), an ankle sprain is one of the most common causes of ankle pain — making up 85 percent of all ankle injuries. A sprain occurs when your ligaments (the tissues that connect bones) tear or get overstretched.

Most ankle sprains are lateral sprains, which occur when your foot rolls, causing your outside ankle to twist toward the ground. This action stretches or rips the ligaments.

A sprained ankle often swells and bruises for about 7 to 14 days. However, it may take a few months for a severe injury to heal fully.

Minor injuries, such as ankle strains and sprains, are a common cause of ankle pain. People can often treat minor injuries at home, but they should see a doctor about suspected medical conditions or injuries that get in the way of their daily life.

This article discusses some common reasons why a person’s ankle may hurt, as well as how to relieve the pain.

What Is Ankle Pain?

Ankle pain refers to any kind of pain or discomfort affecting any part of the ankle. Ankle pain can happen for many reasons. The most common causes include injury, arthritis and normal wear and tear. Depending on the cause, you may feel pain or stiffness anywhere around the ankle. Your ankle may also swell, and you may not be able to put any weight on it.

Usually, ankle pain gets better with rest, ice and over-the-counter pain medications. Healthcare providers can treat injuries and arthritis. Often times, conditions can be treated without surgery. However if the injury is severe, such as a broken ankle bone, or when your ankle pain fails to improve with nonsurgical treatment, surgery is needed. If you’ve had an ankle injury or surgery, a physical therapy (PT) plan can also help you heal. PT strengthens the muscles that support your feet and ankles. The therapy can relieve pain and prevent future injuries.

Symptoms of Ankle Pain

Ankle pain may be accompanied by a wide range of symptoms, including haematoma (an accumulation of blood under the skin), redness, swelling, stiffness or clicking sounds, misshapen bones, and tenderness or difficulty in moving your ankle. The pain could come on after an injury, during exercise or exertion, or even for no apparent reason. It may also come on suddenly or gradually, during a specific movement, or when you are resting.

A sprain is a common cause of ankle pain. Sprains are generally caused when the ankle rolls or twists so that the outside ankle moves toward the ground, tearing the ligaments of the ankle that hold the bones together.

Rolling the ankle can also cause damage to the cartilage or tendons of your ankle.

Pain can also be a result of:

  • arthritis, specifically osteoarthritis
  • gout
  • nerve damage or injury, such as sciatica
  • blocked blood vessels
  • infection in the joint

Gout occurs when uric acid builds up in the body. This higher-than-normal concentration of uric acid (a by-product of the body’s normal breakdown of old cells) can deposit crystals in the joints, causing sharp pain.

Pseudogout is a similar condition where calcium deposits build up in the joints. Symptoms of both gout and pseudogout include pain, swelling, and redness. Arthritis can also cause ankle pain. Arthritis is the inflammation of the joints.

Multiple types of arthritis can cause pain in the ankles, but osteoarthritis is the most common. Osteoarthritis is often caused by wear and tear on the joints. The older people are, the more likely they are to develop osteoarthritis.

Septic arthritis is arthritis that’s caused by a bacterial or fungal infection. This can cause pain in the ankles, if the ankles are one of the areas infected.

Causes of Ankle Pain

Following are four common causes of ankle pain. Your physician determines if your pain is caused by one of these conditions or something else and starts a course of treatment that gets you back in the game.

Ankle Sprain

We see lots of ankle sprains and strains in children and adults at Urgently Ortho. A sprain means you’ve damaged ligaments — tough, rope-like bands of tissue — that connect to your ankle bones.

It’s easy to sprain these hardworking ligaments. When you’re taking a walk or running, you may be looking at the scenery; you don’t notice an indentation or pothole in the ground. The uneven surface causes your leg to twist underneath you, and your ankle turns at an awkward angle. Wearing high heels or playing sports exacerbates your risk for an ankle sprain.

Ankle sprains can be mild, meaning a stretched ligament, moderate (partial tear) or severe (a total tear). Mild or moderate sprains rarely require surgery. Use the RICE method (rest, ice, compression, elevation) until you can see one of our Urgently Ortho physicians.

Ankle Strain

An ankle strain is similar to an ankle sprain, except that this time, you’ve stretched or torn a tendon or muscle around your ankle. The muscle or tendon is inflamed; like an ankle sprain, you have pain and swelling at the site, and it hurts to walk. 

Ankle Arthritis

Three bones form your ankle joint. Each bone has cartilage, soft tissue that helps cushion the space between the bones so they work together smoothly when you move. As you age, your cartilage ages as well. It can become frayed and thin so that you experience pain when the bones begin to rub against each other. You have ankle osteoarthritis.

Pain in the ankle and/or foot can be a sign of rheumatoid arthritis, a chronic autoimmune disease. This form of arthritis often targets parallel joints; if both ankles are painful and you haven’t injured yourself otherwise, it’s important to investigate whether rheumatoid arthritis is the cause. 

If you previously experienced a traumatic injury to your ankle like a dislocation or a fracture, you’re seven times more likely to develop posttraumatic arthritis than someone without that type of injury. The same principle applies to other joints in your body like your knee.  

Achilles Tendonitis

Achilles tendonitis is an overuse injury of your calf muscles. If you’re a runner or play a sport like tennis or racquetball on the weekend, Achilles tendonitis may be the cause of your ankle pain. The Achilles tendon runs from your calf muscles down to your heel bone, so you can have pain in your ankle with this injury. You need to rest the ankle right away with this injury to prevent a tendon tear that could require surgery.

There are several reasons aside from these four for ankle pain. Call Urgently Ortho for an appointment today, or book one online, if you have ankle pain and for all of your musculoskeletal needs. We’re here for you.

Psoriatic Arthritis

Psoriatic arthritis is a form of arthritis that usually involves the skin disease, psoriasis. The condition more commonly causes swelling of the fingers or toes (dactylitis) or the back of the heel (enthesitis), but it may also cause ankle pain.

Juvenile Arthritis

Juvenile arthritis is the term used to describe arthritis when it begins before age 16. There are several types of juvenile arthritis that can cause pain and swelling in the ankles.

Rheumatoid Arthritis

Your immune system normally fights off germs. Sometimes it attacks the joints by mistake. Doctors call it rheumatoid arthritis. It usually impacts the same joint on both sides of your body. If you get it, it would damage your ankles. Pain, swelling, and stiffness often begin in the toes and the front of the foot and slowly return to the ankle.

Lupus

This autoimmune disease causes your body to attack healthy tissues. It could directly affect the ankles or cause kidney problems that cause fluid to build up in the joints. There is no cure for lupus, but your doctor can prescribe medicine to keep it under control.

Flat Feet

The space between your heel and the ball of your foot is your arch. It is supposed to create a hollow area when you stand. If yours lies flat, it could result from injury or wear and tear. You could also inherit it. It is usually painless, but the ankles can be sore or swollen if they go beyond the knee line.

Chronic Lateral Ankle Pain

There are many causes of ongoing pain on the outside of the ankle. It is most likely because of a ligament not healing properly after a sprain and remains weak. This makes it less safe for the whole joint, which leads to more fracture and discomfort. The treatment depends on the cause.

Bursitis

Your ankle has two fluid-filled sacs, or bursae, that cushion space between tendons and bones. They can become inflamed because of arthritis, overuse, high-heeled shoes, recent shoe changes, or resuming workouts after time off. Your ankle may feel stiff, tender, hot, and swollen.

Osteochondral Lesions Of The Talus (OLT)

A sudden injury, such as a sprain, can damage the cartilage of the talus (heel bone) or cause fractures, blisters, or sores in the bone underneath. You may notice a lock on your ankle, or it may become locked or still sore months after a treated injury, which could be an OLT.

Diabetes

Diabetics are keenly aware of their susceptibility to foot issues, and those can include ankle issues. This is because this condition can create neuropathy, which makes the patient unaware of foot injury, so an injury can go untreated until it is too late. Frequent self-checks and medical care can help prevent an ankle injury from turning into an infection.

Infection

A previous cut, trauma, or surgery can allow bacteria to enter the skin or joint around the ankle and cause an infection.

Symptoms of an ankle infection include:

  • fatigue and feeling generally unwell
  • fever
  • pain
  • redness
  • swelling
  • warmth

A doctor may prescribe oral or intravenous antibiotics depending on the infection’s severity. People should try to seek treatment for the infection as quickly as possible to ensure that it does not get worse.

Diagnosis

The doctor will conduct a physical examination of the foot and ankle for any visible deformity, signs of infection, and changes to the skin.

A doctor may also conduct the following tests to determine the cause of the ankle pain:

  • imaging studies, such as X-rays, CT scans, or MRI scans
  • blood tests, which can help diagnose rheumatoid arthritis, gout, and infections
  • skin or fluid samples to test for the presence of bacteria, fungi, and viruses

Treatments and Home Remedies for Ankle Pain

Treatments for ankle pain depend upon the underlying cause. For example, a doctor will usually treat an ankle infection with prescription antibiotics. Doctors can also prescribe medications to help control medical conditions such as gout and rheumatoid arthritis.

For injuries, doctors will usually recommend taking over-the-counter (OTC) pain medication, resting, and exercising to improve recovery. However, severe ankle injuries and trauma may require surgery.

Home Remedies

One primary treatment for minor injuries is the RICE method. People can use this method at home to reduce pain and swelling around the ankle.

RICE stands for:

  • Rest: Resting the affected ankle joint allows it to heal and lessens the extent of damage.
  • Ice: Applying ice to the affected area can help minimize swelling. Apply a cloth-covered ice pack for 10–15 minutes at a time several times per day.
  • Compression: Wrapping the ankle or applying a compressive brace can help minimize swelling and provide support, which reduces the risk of causing further damage.
  • Elevation: Using several pillows to elevate the ankle can support it and promote blood and fluid flow toward the heart.
  • Taking OTC pain relievers such as acetaminophen and ibuprofen may also help minimize discomfort. Ibuprofen is available for purchase online.
  • Supportive footwear: Make sure your shoes provide adequate support for your feet and ankles. Avoid flip-flops, sandals and shoes that are too loose. It’s especially important to wear proper footwear when playing sports. Activities such as basketball and volleyball can lead to ankle injuries, especially without the right footwear.

Changing one’s shoes can often help a person reduce foot and ankle pain. Wearing supportive shoes with a wide toe box can relieve pressure on the ankle and reduce the likelihood of experiencing ankle pain in the future.

Sometimes, a doctor may recommend using a special insert called an orthotic insole. These range in consistency from soft to rigid and help support the feet. Orthotic insoles are available for purchase online.

According to a paper that appears in the journal Seminars in Arthritis and Rheumatism, footwear interventions such as orthotics are clinically proven to help those with rheumatoid arthritis and gout, among other medical conditions.

How do healthcare providers treat ankle pain?

Most ankle injuries heal with at-home treatments. More severe injuries may require surgery. Treatment depends on what’s causing ankle pain. Common treatments for ankle pain include:

  • Braces and splints: An ankle brace may relieve pain and stabilize your ankle. Some braces are better for certain activities. Ask your provider to recommend one that works best for your lifestyle.
  • Joint aspiration: During this procedure, your provider inserts a needle into the joint and removes excess fluid. Joint aspirations relieve pain and swelling.
  • Medications: Several types of medication can reduce inflammation and relieve ankle pain. Drugs to treat arthritis and gout can significantly reduce pain and swelling.
  • Orthotic inserts: Orthotics are inserts that fit into your shoes. You can buy them from the store, or your provider can custom-make them for your feet. Orthotics support and stabilize the foot while ensuring proper alignment.
  • Physical therapy (PT): A customized PT program will help you improve flexibility and strengthen muscles that support your ankle. Your physical therapist will create a PT plan with exercises and stretches designed just for you. Be sure to do your prescribed exercises and stretches regularly.
  • Steroid injections: Your provider uses a needle to inject anti-inflammatory medication directly into your joint. Cortisone shots reduce inflammation and pain.
  • Surgery: A wide range of ankle surgery procedures can repair torn ligaments or tendons. Some options relieve arthritis pain or correct flatfeet. Ankle joint replacement surgery can relieve pain and restore functionality.

When To Consult A Doctor

While most ankle sprains heal with a little TLC and at-home care, it’s important to know when the injury has progressed past that point.

Those who experience extreme swelling or bruising, along with the inability to put weight or pressure on the area without significant pain, should consult a doctor.

Another general rule is to seek medication attention if there’s been no improvement during the course of the first few days.

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