Common causes of ankle pain

If you're dealing with pain, swelling, or stiffness in your ankle, you're not alone. Ankle pain is a common complaint that can disrupt your ability to walk, exercise, or even perform daily activities.

The ankle joint connects the bones of the lower leg to the foot, bearing the weight of your body with every step. It's one of your hardest-working joints, making it vulnerable to acute injuries as well as chronic conditions, which can cause ongoing achiness and inflammation.

Understanding the most likely causes of ankle pain can help you seek proper treatment and find relief. From sudden sprains to various forms of arthritis, many issues can provoke symptoms. In this article we'll explore some of the most frequent sources of ankle discomfort, ranging from traumatic injuries to long-term conditions. Learning to identify what's causing your pain is the first step on the road to recovery.

• Our feet and ankles are directly linked; what hurts one can often be felt in the other. Read what our consultant has to say about foot and ankle pain

Acute ankle injuries

Acute injuries to the ankle typically occur suddenly and can cause severe pain. They are some of the most common reasons people end up visiting their doctor or an urgent care facility for ankle pain treatment. We take a look at some of the most common types of ankle injury.

Ankle sprains

Ankle sprains are by far the most frequent cause of acute ankle pain. They happen when the ligaments that hold the ankle bones together become partially or completely torn. These ligaments stabilise your ankle joint, so any damage to them can cause the joint to become unstable and painful.

Causes

Ankle sprains usually occur when you roll your ankle forcefully to the outside. They can also happen if you twist your ankle awkwardly, have a fall, or collide with another player during sports.

Symptoms

Symptoms of a sprained ankle include intense pain, swelling, bruising, and stiffness in the joint. You'll likely have difficulty putting weight on the injured foot.

Treatment

The RICE method - rest, ice, compression, and elevation - can help reduce pain and swelling after a sprain. Over-the-counter pain medication, anti-inflammatory drugs and wearing an ankle brace can also aid healing. Physical If you need further help, physiotherapy focuses on restoring strength and stability. Severe sprains sometimes require surgery to repair torn ligaments, but this is uncommon.

Fractures

Fractures are breaks in one or more of the ankle bones. Like sprains, they usually occur after an injury such as a fall. Fractures range from mild cracks to complete breaks, causing swelling, bruising, and an inability to walk on the ankle.

Causes

Twisting the ankle forcefully, falls, and trauma from car accidents or sports collisions can all cause ankle fractures. As we get older, bones weaken from osteoporosis, making fractures more likely even after a minor injury.

Symptoms

Symptoms of a broken ankle include severe pain, obvious deformity or change in shape, bruising, and difficulty bearing weight on the leg. The ankle may appear crooked or have a bone protruding.

Treatment

Any ankle fracture requires prompt medical attention, and you should go to your nearest emergency department. Doctors will usually need X-rays to diagnose the break and determine treatment options. Fractures often require surgery to stabilise the bones, followed by a cast, splint or walking boot to protect the ankle during healing.

Achilles tendon injuries

The Achilles tendon attaches the calf muscles to the heel bone (called the calcaneus). When the Achilles tendon tears or ruptures, it can cause sudden and extreme ankle pain.

Causes

Achilles tendon tears often occur from sudden overstretching of the tendon during sports or exercise. Prior wear and tear from repetitive stress can weaken the tendon over time, making complete ruptures more likely.

Symptoms

You may hear a popping sound at the moment the Achilles tears. Symptoms include pain and swelling at the back of the ankle, difficulty pointing the toe downward, and a gap in the tendon.

Treatment

As with other ankle injuries, the RICE method can relieve pain and swelling after an Achilles tendon tear. Your doctor will likely immobilise your ankle in a cast or walking boot for several weeks to allow the tendon to heal. You might have physiotherapy, which usually focuses on gently stretching the Achilles and improving ankle and calf strength. Complete ruptures sometimes require surgery to stitch the torn ends back together.

Chronic ankle conditions

Not all sources of ankle pain come on suddenly. Various chronic conditions can provoke ongoing aches or stiffness in the joint. These long-term issues may flare up and cause acute pain at times.

Arthritis

Arthritis causes pain and inflammation in your ankle. It often occurs when the protective cartilage cushioning the ankle bones gradually wears away over time. This causes the bones to rub directly against each other, resulting in swelling, stiffness, and pain in the joint. Other types of arthritis can come on more suddenly or can come and go in what's known as 'flare ups'.

Causes

Post-traumatic arthritis can develop after injuries damage the cartilage in the ankle. General wear and tear as we age is another common cause; this is known as osteoarthritis, which is the most common type. Other forms like rheumatoid arthritis and gout won't always have a clear cause.

Symptoms

Early signs of ankle arthritis include joint stiffness, especially first thing in the morning. You may develop persistent achiness and swelling. The joint often hurts more with activity and exercise.

Treatment

Oral anti-inflammatories like ibuprofen can ease arthritis discomfort in some cases. Supportive splints, steroid injections and physiotherapy also help manage symptoms. If damage from arthritis becomes severe, ankle fusion or ankle replacement surgery may relieve pain.

Tendonitis

Repetitive overuse and injury can cause inflammation in the tendons around your ankle joint, such as the posterior tibial tendon. This condition, known as tendonitis, provokes localised ankle pain.

Causes

Activities with a lot of impact stress the ankle tendons, including running, jumping sports, hiking, and dancing. Suddenly increasing your activity level too quickly also contributes. Direct blows or trauma that strain the tendons lead to tendonitis as well.

Symptoms

Tendonitis causes pain focused on the affected tendon. You may notice swelling, stiffness, or crepitus (crackling) around the sore tendon. Symptoms often worsen with exercise and improve somewhat with rest.

Treatment

As with ankle sprains, the RICE protocol can ease new cases of tendonitis. Custom orthotics redistribute force to help reduce strain. Physiotherapy exercises can be used to improve flexibility and strength. For severe tendonitis, steroid injections or surgery may be necessary.

Nerve Pain

Irritated or damaged nerves around the ankle joint frequently produce burning, shooting pains or numbness in the foot. This nerve-generated discomfort has many potential causes.

Causes

Past ankle injuries, arthritis, or ankle effusions that compress nerves can provoke symptoms. Nerve problems like Morton's neuroma cause sharp ankle and foot pain. Diabetes and other conditions that damage nerves lead to tingling, pins-and-needles sensations.

Symptoms

Nerve-related ankle pain tends to involve numbness, tingling, shooting pains, burning sensations, weakness, or a pins-and-needles feeling in the foot.

Treatment

Treating any underlying health condition can alleviate nerve discomfort. Cushioning orthotics reduce pressure which may ease symptoms. Medications are available that can block nerve signals. For severe cases, injection therapy or surgery may help.

Gout

Gout results from deposits of uric acid crystals in the joints, causing intense inflammation. The foot is a prime target, and while you may think of it as something that affects the big toe, the ankle is also frequently affected.

Causes

There are various factors that can increase your likelihood of developing gout, however some people are simply more prone than others, and contrary to popular belief not all risk factors are avoidable with lifestyle changes.

Symptoms

Gout often comes on quickly. Sudden gout attacks cause red, hot swelling and throbbing pain.

Treatment

Oral medications reduce uric acid levels to prevent recurrences. Non-steroidal anti-inflammatory drugs (NSAIDs), steroids, and colchicine are often used to treat acute gout flares. Joint aspiration and draining fluid can quickly relieve pressure.

Other causes of ankle pain

Beyond acute injuries and chronic joint conditions, a few other issues occasionally provoke ankle pain as well:

Ankle impingement (Athlete's ankle)

Sometimes repetitive ankle sprains or bone deformities can cause bony overgrowths around the ankle joint. These bone spurs irritate the soft tissues of the ankle and restrict normal range of motion, leading to impaired function and pain, known as ankle impingement.

Treatment

Physiotherapy for ankle impingement aims to strengthen muscles supporting the joint in order to reduce symptoms. Anti-inflammatory medication and steroid injections can ease inflammation. Surgery removes irritating bone spurs if conservative treatment fails.

Infection

Though less common, bacterial infections like cellulitis can spread to the ankle joint or bones, causing redness, swelling and severe pain. Post-surgical and penetrating injuries increase infection risk.

Treatment

Doctors treat joint infections with antibiotics and often surgical drainage. In severe cases, debridement surgery may be needed to remove infected bone or tissue.

When should I seek help for ankle pain?

Home treatments like RICE and over-the-counter medications can ease many common causes of ankle discomfort. But you should see your doctor promptly if significant pain persists beyond a few days of self-care.

You should also seek help from a healthcare professional if you experience:

• Difficulty walking normally
• Severe swelling
• Bruising and deformity after injury
• Numbness or tingling

Tackling ankle pain

Common causes of ankle pain include everything from sprains and fractures to arthritis and tendonitis. Most ankle pain causes can be classified as either injuries or chronic conditions.

While home treatment can help ease many minor injuries, recurrent or worsening pain warrants medical attention. Seeing a doctor promptly allows proper diagnosis and treatment to relieve discomfort and get you back on your feet.

If over-the-counter methods aren't reducing your ankle pain, don't delay in scheduling an appointment. A podiatrist, orthopaedic consultant or physiotherapist can provide medications, therapies, or ankle supports to aid healing. Catching problems early often leads to quicker recovery and prevents complications down the road. Understanding what's provoking your ankle woes guides you down the path toward lasting relief.

Is it time to get help with your ankle pain? Book an appointment online today, or give us a call directly and we'll help you find the right specialist for you.