What Is Ankle Pain?

The ankle is the joint that connects the bones of the lower leg to the foot. It is responsible for the upward and downward movement of the foot, allowing standing, walking, running, and other similar functions.

Ankle pain is common, especially in the elderly, obese, and physically active. Outside of this group, ankle pain occurs as a symptom of other underlying injuries to the ankle and the structures around it. For example, ankle pain can result from ankle sprains, arthritis, trauma, fractures, improper footwear, etc.

Like pain in any location, ankle pain is often self-reported but can also be elicited by foot movement, either actively or passively. It could also present with other symptoms like swelling, redness, warmth, and loss of function.



Summary of Important Points

• Ankle pain is any form of pain or discomfort in any part of the ankle.
• It can occur because of an ankle injury, arthritis, trauma, or overuse.
• Depending on the cause, the pain can be a dull, aching, burning, or stabbing sensation.
• Other possible symptoms include swelling, stiffness, and loss of function.
• Pain management involves using conservative methods like rest, ice, activity modification, NSAIDs, exercise, and massage.
• Where the injury is severe, surgery may be necessary. Consider seeing a doctor if ankle pain persists despite home treatment or the use of non-conservative approaches.

Symptoms of Ankle Pain

Ankle pain can have a debilitating effect and influence your ability to perform regular daily activities. This makes it a cause for concern that must be addressed promptly. Depending on the cause, ankle pain can be a dull, aching, burning, or stabbing sensation that occurs either at rest, constantly, or with movement.

The frequency and type of pain can suggest its possible cause. For example, the source of sharp pain that occurs during movement is likely muscular, while the source of a dull, aching pain that occurs even at rest is likely skeletal.

Ankle pain can have a diurnal presentation, worsening at specific times of the day. Ankle pain is generally progressive. As such, you must treat any form of discomfort or pain in the ankle promptly before it worsens.



Causes and Risk Factors of Ankle Pain

While there are direct causes of ankle pain, there are also certain risk factors that can lead to ankle pain, including obesity, improper footwear, advancing age, and sports.

Direct causes of ankle pain include:

• Achilles tendonitis The inflammation of the Achilles tendon can cause severe ankle pain.
• Ankle sprains An ankle sprain occurs when ligaments are overstretched and tear. It occurs when the ankle forcefully rolls out of its normal anatomical position.
• Arthritis Pain and stiffness in the ankle joint can be a result of ankle arthritis. Ankle arthritis can occur due to damage to the tibiotalar joint.
• Bursitis The fluid-filled sacs, called bursae, around the ankle can become irritated and inflamed due to trauma, overuse, repetitive stress, infection, or different kinds of arthritis (rheumatoid arthritis, osteoarthritis, gout).
• Foot mechanics The shape of the foot can cause ankle pain, e.g. flat feet or high arches.
• Fracture An ankle fracture can occur because of an accident and cause ankle swelling and pain.
• Infection Any infection that affects the bone around the ankle can cause swelling and pain in the joint, e.g. cellulitis or osteomyelitis.

Without management, ankle pain can become worse and lead to an inability to perform your favorite activities. Therefore, you should manage ankle pain promptly.



Conservative Treatments for Ankle Pain

When it comes to managing ankle pain, conservative treatment is the first approach. This involves the use of NSAIDs, RICE (Rest, Ice, Compression, Elevation), correct footwear, physical therapy, and orthosis.



Use of NSAIDs

Over-the-counter pain medication like non-steroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation.



RICE (Rest, Ice, Compression, and Elevation)

This method works when there is inflammation along with pain. Rest involves getting off the ankle and is especially important in the acute phase of an ankle injury. Ice provides pain relief directly, while compression and elevation help reduce swelling and ankle pain.



Correct Footwear

Always go for footwear that provides sufficient heel and arch support when you have ankle pain. Avoid ill-fitting shoes and shoes with high heels.



Physical Therapy

A physiotherapist will use a series of physical methods to bring pain relief. These methods include using ice, heat, massage techniques, exercise, shockwave therapy, ultrasound therapy, TENS, etc.

While most modalities bring pain relief directly, exercise does so indirectly. Exercise strengthens the ankle, stretches the muscles around it, and promotes circulation and healing.



Orthotics

Orthotics are specialized heel or shoe inserts deployed for corrective or supportive purposes. They can be either over-the-counter orthotics or custom-designed for your foot.

A podiatrist prescribes an orthotic in line with the cause and progression of injury. So, you should consult a podiatrist to assess your foot and prescribe the ideal orthotic for your ankle pain.



Can Ankle Pain Be Treated or Prevented Without Surgery?

Ankle pain is not entirely preventable. However, you can greatly reduce the risk for ankle pain by taking care of your ankle and immediately addressing any problems once observed.

You can treat ankle pain without surgery, provided you address it early enough. However, in some instances, surgery may be necessary. For example, certain fractures around the ankle or a complete tear of the Achilles tendon can only be treated with surgery.



Should You See a Doctor for Ankle Pain?

It is always safe to try home remedies and conservative treatment first. However, if pain persists despite treatment for a few weeks, consider seeing your doctor.

Alternatively, you should seek immediate medical advice if the pain or swelling is severe and you cannot put weight on your ankle. Also, immediately consult a doctor if there is an open wound, deformity, or a sign of infection.

In that case, please book an immediate appointment with your doctor, who will first try to identify the cause and then address it.