Foot and ankle pain Q&A

Foot pain, ankle pain and pain in both your foot and ankle are all very common and is often nothing to worry about. Often the pain will go away on its own, perhaps after a little rest or some home management techniques.

Still, it's not always easy to identify the cause of pain in your foot and ankle. Below I'll discuss some of the most common causes of foot and ankle pain, which might help you to understand the type of pain you're feeling.

Although foot pain and ankle pain tend to go away on their own, it's always a good idea to check in with a healthcare professional for advice. Even something minor can become a significant problem if not treated properly, and we use our feet and ankles more than we even realise, meaning we rarely give them a real rest.

If you are worried about aches and pains and you're unsure about the underlying cause, speak to your GP. If you know what has caused the pain in your foot and ankle but would like help to manage or reduce it, a physiotherapist should be your first port of call. They can help you to build a programme of stretches and exercises to support healing, and if they feel anything needs further investigation, they can easily refer you to a specialist.

What are the common causes of foot and ankle pain?

There are many reasons why your ankle or foot might hurt. You might have a condition such as arthritis or bunions, you might have injured yourself, or you might be in pain because of overuse, wear and tear, or even because you're wearing shoes that don't fit properly.

Common conditions causing foot and ankle pain include:

• Various types of arthritis, including osteoarthritis and rheumatoid arthritis
• Bunions
• Bursitis
• Achilles tendonitis
• Tendon dysfunctions
• Plantar fasciitis
• Fallen arches
• Sprains
• Gout

Common foot and ankle injuries include sprains, damaged tendons or ligaments, and broken bones. If you think you have injured your foot, it is always best to see a doctor. Even a small injury can get worse if it's not treated correctly and early enough. Once you have your foot and ankle pain diagnosis, you can start the road to recovery.

Who is most likely to get foot or ankle pain?

Foot and ankle pain is not restricted to any particular group of people. Both active and inactive people can be equally affected, there are no age limits, and both men and women are equally affected.

What should I do or not do when my foot or ankle starts aching?

A useful approach is the RICE method: rest, ice, compression and elevation.

• Rest - taking the appropriate amount of rest
• Ice - applying ice to reduce swelling
• Compression - compressing or wrapping the foot/ankle with a bandage
• Elevation - keep your foot elevated on a pillow when lying down

Other ways to manage short-term pain in your foot or ankle include over the counter painkillers and anti-inflammatory drugs (NSAIDs). If you follow these treatments for two weeks and you don't see an improvement, speak to your GP or to a specialist physiotherapist or consultant.

If you have been diagnosed with a long-term condition that's causing your pain, your doctor or physiotherapist will give you tailored advice on how to manage your condition and any flare-ups. One of the most important pieces of advice is to remain active. This must be in conjunction with looking after your joints, muscle strength and function.

If your symptoms aren't responding to your usual methods, seek further advice from your specialist.

How do I know if my foot or ankle pain is a symptom of an underlying condition?

Usually, the first symptoms of any foot or ankle problem will be swelling, pain and/or deformity. This is your body reacting to the underlying issue.

These symptoms will eventually start to limit your activities. Active people tend to notice this more quickly. If this happens, it's time to seek medical advice.

When should I seek medical advice for foot and ankle pain?

If you have pain in your foot or ankle, see a GP if:

• The pain is so bad that it's keeping you from normal daily life
• Your pain gets worse or keeps coming back
• You have tingling or loss of sensation in your foot
• The pain doesn't go away after two weeks of rest and home management

Don't put off seeing a doctor. If you're in pain for long periods of time, speak to a professional.

How are different types of ankle pain and types of foot pain diagnosed?

Different conditions will have different symptoms, presenting with pain or swelling in different places. For example, an ankle sprain will likely cause a swollen ankle, while pain in the ball of your foot can be caused by a sprained metatarsal.

After an initial assessment, your consultant may want to undertake further investigations, for example X-rays, ultrasound, MRI scans or CT scans. These can confirm the diagnosis.

What treatments are available for ankle pain?

Depending on the cause of your foot or ankle pain, you will normally first be prescribed a course of non-operative treatment.

For example, physiotherapy can be very effective at treating pain in the ankle and foot. It can help you to build the muscle around your joints and improve flexibility, which should reduce your pain and help you to move around more freely. You might also be recommended steroid injections, which reduce swelling and inflammation in your foot or ankle.

However, if you do not respond to non-invasive treatments, and if your condition is very advanced, you may be recommended foot surgery or ankle surgery. Common types of foot surgery and ankle surgery include:

• Bunion surgery
• Ankle arthroscopy (keyhole surgery)
• Ankle replacement surgery

Surgery can be very effective, but it will only be recommended when other options have been exhausted.