What causes ankle pain? 17 possible conditions
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, such as arthritis.
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 seven to fourteen days. However, it may take a few months for a severe injury to heal fully.
Once healed, the sprained ankle is sometimes permanently weaker and less stable than the other ankle. According to a paper published by the American Academy of Family Physicians (AAFP), the greatest risk factor for ankle sprain is having a previous ankle sprain.
A sprain is a common cause of ankle pain. Pain can also be a result of:
- arthritis (specifically osteoarthritis)
- nerve damage or injury, such as sciatica
- blocked blood vessels
- infection in the joint
A sprain is 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.
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 is caused by a bacterial or fungal infection. This can cause pain in the ankles, if the ankles are one of the areas infected.
For immediate at-home treatment of ankle pain, the RICE method is recommended. This includes:
- Rest — Avoid putting weight on your ankle. Try to move as little as possible for the first few days. Use crutches or a cane if you have to walk or move.
- Ice — Begin by putting a bag of ice on your ankle for at least 20 minutes at a time. Do this three to five times a day for three days after the injury. This helps reduce swelling and numb pain. Give yourself about 90 minutes between icing sessions.
- Compression — Wrap your injured ankle with an elastic bandage, like an ACE bandage. Do not wrap it so tightly that your ankle becomes numb or that your toes turn blue.
- Elevation — Whenever possible, keep your ankle raised above heart level on a stack of pillows or other type of support structure.
You can take over-the-counter drugs, such as acetaminophen or ibuprofen, to relieve pain and swelling.
Once your pain subsides, gently exercise your ankle by rotating it in circles. Rotate both directions, and stop if it begins to hurt. You can also use your hands to gently flex the ankle up and down. These exercises will return your range of motion and help exercise your ankle, lowering your risk of re-injury.
If your ankle pain is a result of arthritis, you will not be able to heal or eliminate the pain. However, there are ways you can manage it. It may help to:
- use topical pain relievers
- take NSAIDs (nonsteroidal anti-inflammatory drugs) to reduce pain, swelling, and inflammation
- stay physically active and follow a fitness program focusing on moderate exercise
- practice healthy eating habits
- stretch to maintain a good range of motion in your joints
- keep your body weight within a healthy range, which will lessen stress on the joints
You should visit your nearest emergency room or call 911 if:
- you cannot put any weight on your ankle and the joint looks visibly disfigured — this might mean your ankle is broken
- you have intense pain even when you are not moving or putting weight on your ankle
- your ankle makes a popping sound when you try to move it
In some cases, you will need to visit your doctor due to your ankle pain. You should check in with your doctor if your pain does not go away after a few weeks, or if the swelling in your ankle does not go down in two to three days.
You will also need to see your doctor if you develop an infection in your ankle. Signs of an infection include an ankle that becomes warm, tender, and red, or a fever that is over 100.4 degrees Fahrenheit.
Your doctor may order an X-ray of your ankle. In some cases, he or she will remove fluid from the joint using a needle. You may be given nonsteroidal anti-inflammatory medications, braces, or other special protective gear. In severe cases, ankle pain may require surgery.
A sprained ankle will often heal on its own if you follow the RICE method. However, a sprained ankle is weakened and more likely to be sprained again. A severe sprain may require surgery. An infection may require medication.
Osteoarthritis is considered a chronic condition. Septic arthritis can be chronic as well. Nothing can completely eliminate the ankle pain associated with arthritis or keep it from returning. However, you can talk to your doctor about treatment options and home remedies to help you deal with your condition.
Pain caused by medical conditions, such as arthritis, cannot be prevented. Still, you can do the following to avoid sprains, and other lifestyle-related injuries to your ankles:
- wear shoes that fit well and provide ample ankle support
- avoid wearing high-heeled shoes
- stretch your ankles and legs before exercising
- wear ankle support gear while doing activities that put strain on your ankles
- lose weight if you are overweight to reduce the stress on your ankles
Poor balance is another well-established risk factor for ankle injury. A review from BioMed Research International details research from the last 30 years, which has found that people with poor balance may be two to four times as likely to experience ankle injuries compared to those with normal balance. Consider practicing some simple balancing exercises to improve your balance and prevent future ankle injuries. These can be as easy as standing on one leg without support.
- Ankle Injury. (n.d.) Retrieved from http://sma.org.au/resources-advice/injury-fact-sheets/ankle-injury/
- Arthritis. (n.d.) Retrieved from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002223/
- Han, J., Anson, J., Waddington, G., Adams, R., & Liu, Y. (2015, June 11). The Role of Ankle Proprioception for Balance Control in relation to Sports Performance and Injury. BioMed Research International. Retrieved from http://www.hindawi.com/journals/bmri/aa/842804/#B2
- Mayo Clinic Staff. (2014, August 21). Sprained ankle. Retrieved from http://www.mayoclinic.com/health/sprained-ankle/DS01014/DSECTION=complications
- Osteoarthritis (n.d.). Retrieved from http://www.arthritis.org/about-arthritis/types/osteoarthritis/
- Osteoarthritis (2013, March 29). Retrieved from http://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=55
- Preventing Youth Sports Injuries. (n.d.). Retrieved from http://www.nuhs.edu/patients/health-information/articles/youth-sports-injuries/
- Sprains, Strains & Fractures. (n.d.). Retrieved from http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=982
Tiemstra, J.D. (2012, June 15). Update on Acute Ankle Sprains. American Family Physician, 85(12), 1170-6. Retrieved from http://www.aafp.org/afp/2012/0615/p1170.html
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