Ankle pain

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 9, 2015
StartSymptomsAnkle pain

Various medical conditions account for ankle pain due to the anatomy of your ankle and feet being complex body parts that supports your entire body's weight. Some ankle maladies are swelling, ankle sprains, bursitis, osteoarthritis, gout, bone fractures, and tendinitis. If the diagnosis is on the simple end of the spectrum, a person affected by an ankle problem can opt for an anti-inflammatory medication, ice, and rest the ankle. In other instances, sometimes a doctor's expertise is required to diagnose more severe problems that may require surgery, prescription drugs, or injections.


Definition & Facts

The ankle is a large joint comprised of three bones – the tibia, fibula, and talus. The human foot and ankle combine into a strong mechanism that consists of 26 bones, 33 joints, and more than 100 muscles, tendons, and ligaments.

The ankle connects the foot bones to the leg bones, with the aid of three groups of ligaments, and allows for movement, such as walking, bicycling, or skipping. These bones attach to ligaments, muscles, and tendons that support your body weight and allow for flexibility and motion.


Patients often seek out care for the following ankle conditions when they cause excessive pain or mobility difficulties, and affect quality of life. Ankle sprains are extremely common due to the anatomy of the ankle and the likelihood of the ankle to turn inward, also know as ankle inversion.

A simple jump or fall can cause ankle ligaments to tear or over-stretch, which is referred to as an ankle sprain. When a person exercising avoids rest, an overuse injury can occur that can put overexertion strain on muscles and tendons. Ankle bursitis is painful due to inflammation of the fluid-filled sac, also known as a bursa.

Osteoarthritis is a chronic condition that can plague the cartilage where the ankle bones meet which results in pain and stiffness in the ankle joint. Gout is a type of arthritis that is due to uric acid forming in the joints as crystals, which causes sharp pains.

Even though gout usually afflicts the big toe, subsequent attacks can affect the ankle. Tendinitis is inflammation of the tendon. Poor balance has been shown to cause a higher risk of ankle injury. Other causes of ankle pain can be affected by nerve damage, such as a sciatic injury, blood flow problems, or infection in the ankle joint.

When to see a doctor

When the ankle affects quality of life and mobility, a doctor or primary care doctor's opinion should definitely be sought out. If weight can not be put on the ankle or if the ankle looks obviously disfigured, it could be broken.

Popping sounds in the ankle are not acceptable either. After treatment with rest, ice, compression, and elevation of the ankle, if no improvement is seen or the ankle feels worse, medical attention is necessary. If a patient notices the ankle is not healing after an ankle twist or sprain with over-the-counter non-steroidal anti-inflammatory pills, a doctor's appointment should be scheduled.

If the ankle is puffy and swollen, red, or warm to the touch, or if the patient has a fever over 100.4 degrees Fahrenheit (38 °C), it could be a sign of infection and prompt attention is needed. Another warning sign is ankle instability or weakness in the ankle or leg.

Untreated ankle sprains and bone fractures can lead to more difficult to treat problems that could involve surgery. It is best to get the affected ankle looked at by a professional to prevent further injury and allow for proper healing.

Treatment & Therapy

Home treatment of sprains and muscle or ligament strains usually involves R.I.C.E., an acronym for rest, ice, compression, and elevation of the ankle. Compression with an elastic ankle wrap helps keep the ankle from a large range of motion, which can prevent further injury or stress to the joint, and subsequently help it to heal.

Some more severe injuries require more heavy duty immobilization in the form of a cast or splint. Significant fractures or bone breakages call for surgical repair. After being evaluated and treated by a doctor, you may be sent to a specialist called an orthopedic surgeon for specialized care. An orthopedic surgeon is a doctor who specializes in the treatment of muscles and bones, whether via the means of surgery, a physical therapy recommendation, or a course of treatment such as pills or injections, to name a few.

This specialist often orders an X-ray or MRI to be taken of your ankle and foot. Sometimes fluid may have to be removed from the ankle joint or an ankle brace may have to be worn. If there is infection, an antibiotic should be taken. If the cause is osteoarthritis, a chronic, long-term condition, pain management techniques will be taught to the patient.

Sometimes physical therapy is a necessity to heal and strengthen the ankle, muscles, and ligaments back into working order. In serious causes, ankle replacement is an option for specific cases of advanced arthritis under certain conditions.

Prevention & Prophylaxis

Many know that an ounce of prevention is worth a pound of cure, meaning it is more effective to prevent than treat a problem. In the case of ankle pain and injury, preventing an ankle's inward rotation, sprains, and ligament tears is a commendable goal, even though accidents still happen.

It is important to wear proper-fitting shoes that provide sufficient ankle support, and to avoid high heels because they put an intense amount of weight and pressure on the forefront of your foot. Also, wearing insufficient footwear for certain sports can cause injury to your feet. Incorrect sport training and running on unsuitable surfaces puts a person at risk of foot and ankle injuries.

If overweight or obese, it is recommended to lose weight to reduce the pressure and stress and your ankles. Before exercise, proper stretching of the ankles and legs is important. Also, rest after a certain amount of exercise time and avoid exercise that puts significant pressure on your ankles or causes unbearable foot pain. Improving balance by doing regular balance exercises, such as carefully standing on one leg, could prevent future ankle injuries.

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