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Overview of Ankle Pain: Types, symptoms, causes and treatment

Team AckoJun 20, 2024

That terrible feeling when you trip and twist your foot, and suddenly, your leg is unable to support your body weight is one example of the many causes of Ankle Pain. The ankle is the part where the calf and the foot meet, and it consists of bones and supporting tissues. This area is a complex network of joints, ligaments, muscles, and tendons. The bones of the ankle play a major role in weight-bearing and supporting your body when you stand up or walk. Thus, Ankle Pain can be difficult to manage. Read ahead to understand more about Ankle Pain, its types, symptoms, causes and treatment.

Ankle

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Causes of Ankle Pain

There are many causes of pain in the ankle. The most common ones are:

  • Injury to the ankle

  • Infection of the joint

  • Inflammation secondary to autoimmune conditions

  • Ageing and associated wear and tear

Ankle Sprain

A sprain refers to a twisting injury that damages the ligaments. Ligament is the tissue that connects the different bones of the body to one another. It can be a stretching of the ligaments resulting in poor support, or it can be a tear.

The ankle is the commonest site of a sprain, and it occurs due to injury during walking or exercising. The symptoms of an ankle sprain include ankle swelling and pain while walking. 

The best thing you can do for an ankle sprain is follow to RICE:

  • R - Rest

  • I - Ice pack application

  • C - Compression of the joint with an elastic bandage

  • E - Elevation of the limb to decrease swelling. 

Over-the-counter painkillers like paracetamol and ibuprofen can be taken. A severe sprain may require cast immobilisation or surgery. 

Ankle Fracture

A fracture refers to a break in the bone. Ankle fractures can be of varying severity depending on the magnitude of injury; it can be a small crack to a large break with an open wound. It can even involve nearby nerves and blood vessels in case of more serious injury

The symptoms of an ankle fracture include:

  • Severe Ankle Pain and tenderness

  • Swelling of the joint

  • Deformity (abnormal resting position of the joint)

  • Inability to move the joint 

  • Bruising of the joint

The treatment of an ankle fracture depends on the site of the fracture and its severity. Your doctor will usually order an X-ray of the joint before deciding between conservative or surgical management.

Conservative management includes the application of a cast to immobilise the joint, leg elevation, pain management, and bed rest. Some fractures require surgical repair, where they may use support structures like plates/rods/screws to fix the fracture and reconstruct the affected ankle. 

Tendon Pathologies

Tendons are bands of fibrous tissue that connect muscles to bones. The Achilles tendon is one tendon that many people are familiar with. It is the thick band you can feel running from your heel into your leg.

Tendons can also undergo tears and get inflamed (called tendinitis), resulting in Ankle Pain. For those who exercise regularly, improper form or wearing shoes without enough support can put a lot of strain on the tendons and cause tendinitis.

RICE treatment is effective in this case as well. In some cases, doctors may prescribe steroids. Physiotherapy is an important part of the recovery process to avoid repeated injuries.

Bursitis

Bursae (singular - bursa) are small sacs filled with fluid present between a bone and other structures like tendons/muscles. The bursa helps to cushion the bone, provide lubrication and prevent friction between the structures. 

If the bursa gets infected and inflamed, it is called bursitis. This condition is seen more in people who overuse the joint (physical exercise, increased walking/jumping) and in those who wear poorly fitted shoes & footwear.

It can cause pain and swelling of the region, with redness and limited mobility. It can sometimes result in a fever with chills, a sign of spreading infection. Your doctor may order an x-ray or ultrasound of the joint after evaluating you clinically to aid the diagnosis. 

The main treatment for bursitis is rest. Ice pack application and painkillers may provide symptomatic relief. If there is evidence of infection, you may be prescribed antibiotics. Your doctor may also recommend injection of steroids to decrease inflammation and pain. 

Flat Foot

The feet are normally arched, which serves the important role of supporting the weight of the body with the least amount of stress on the bones of the feet. Sometimes, these arches are completely or nearly flattened, in a condition called flat feet or pes planus.

This can result in Foot and Ankle Pain, muscle cramps of the leg, change in your gait and foot deformities. This condition can be congenital, or acquired through the course of life. The treatment mainly involves pain medication, physiotherapy to strengthen the support structures of the feet, and using specialised footwear and braces to accentuate support.

Arthritis of the Ankle 

Arthritis is a generic terminology used to describe inflammation of the joint. The ankle joint can become inflamed due to many conditions.

  • Osteoarthritis - a degenerative condition of the joint typically seen with ageing

  • Rheumatoid arthritis - an autoimmune condition which affects joints

  • Gouty arthritis - a condition caused due to deposition of crystals made of uric acid in the joints 

Arthritis can result in painful swelling of the joints with decreased range of movement and loss of weight bearing. Progressively, it can result in permanent deformity and loss of function of the joint.

The treatment depends on the cause. In general, conservative measures like rest, joint elevation and physiotherapy can be adopted. Rheumatoid arthritis is an autoimmune condition that requires treatment with specific disease-modifying, anti-inflammatory drugs. Gouty arthritis requires the use of medications to decrease the levels of uric acid, to prevent crystal formation and deposition. In addition, painkillers and steroid injections are also used to manage arthritis. 

Prevention of Ankle Pain

There are several causes of Ankle Pain, each having specific treatments that are beyond the scope of this piece. To prevent repeated issues to the ankle, the following recommendations are helpful:

  • Maintain good bone health with appropriate nutrition

  • Regular exercise with proper stretches and warm-up

  • The use of appropriate footwear

  • Adequate blood sugar control in patients with Diabetes

  • Maintaining a healthy weight

If you feel pain in your ankle, make sure you get it evaluated at the earliest. An early intervention begets fewer complications.

Frequently Asked Questions (FAQs)

Here’s a list of some commonly asked questions and their answers about Ankle Pain.

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I twisted my leg and now I have Ankle Pain. Can I apply a heating pad to relieve the pain?

No. For any kind of ankle sprain, it is recommended to apply an ice pack to reduce inflammation and relieve pain.

How do I know when to visit a doctor for Ankle Pain?

All forms of Ankle Pain should be evaluated by a doctor. As there are so many structures around the ankle, the doctor can assess the seriousness of the situation and prescribe treatment accordingly.

Which is the best medicine that I can take for Ankle Pain?

Most doctors prescribe painkillers such as paracetamol, ibuprofen, or aceclofenac for Ankle Pain. However, it is not recommended to take medications without consulting an expert first.

Can I get Ankle Pain from wearing high heels?

Yes. Incorrect footwear is one of the most common causes of Ankle Pain. High heels affect the distribution of body weight and increase strain on the ankle hence causing pain.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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