Ankle Pain: Causes and Treatments

ankle pain
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Ankle pain is an extremely common complaint that has many different causes. It is important to see a doctor—such as a podiatrist or an orthopedic specialist—to get an accurate diagnosis and an appropriate treatment plan.

Causes of Ankle Pain

  • Arthritis: Arthritis is less likely to occur in the ankle than it is in other joints, but it can cause ankle pain. Ankle cartilage can wear away and that is often painful. Ankle arthritis is most common in patients who have rheumatoid arthritis or in patients who have had a previous injury to the ankle joint. Anterior impingement is a specific area of the joint that becomes damaged as a result of bone spur formation.
  • Ankle Sprains: Ankle sprains injure the ligaments around the ankle. Sprains can cause significant ankle pain, as well as swelling and a feeling that the joint may give out. A high ankle sprain is a specific type of ligament injury to the ankle. In a high ankle sprain, the ligaments on top of the joint are injured. The treatment for a high ankle sprain is different from a usual ankle sprain.
  • Tendonitis: Tendonitis can occur in any of the tendons around the joint and cause ankle pain. Tendonitis occurs when the tendons, the attachments of muscles to the bone, become irritated and inflamed. Posterior tibial tendonitis causes ankle pain on the inside part of the joint and, if left untreated, can lead to significant walking problems. Achilles tendonitis causes ankle pain in the back of the joint. It's the most common type of tendonitis around the ankle joint.
  • Ankle Fractures: An ankle fracture is a common type of broken bone. There are many different types of ankle fractures and each of these must be treated individually. Some ankle fractures can be treated like sprains, while others require surgery.
  • Cartilage Damage: The cartilage of the ankle joint is susceptible to injury if you sustain an ankle sprain, fracture, or ​another type of traumatic injury. Cartilage injuries can run the spectrum from a limited area of damage to more widespread ankle arthritis.
  • Gout: Gout is an uncommon cause of ankle pain. However, in patients who have a diagnosis of gout, it must be considered as a cause for new ankle pain.

    Symptoms

    If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, seek medical attention. Treatment of ankle pain must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

    • Inability to walk comfortably on the affected side
    • Injury that causes deformity around the joint
    • Ankle pain that occurs at night or while resting
    • Ankle pain that persists beyond a few days
    • Inability to bend the ankle
    • Swelling of the joint or the calf area
    • Signs of an infection, including fever, redness, and/or warm skin
    • Any other unusual symptoms

    Treatment Overview

    Treatment depends entirely on the cause of the problem. Therefore, it's important that you understand the cause of your symptoms before beginning treatment. If you are unsure of your diagnosis, or of the severity of your condition, seek medical advice before beginning any treatment plan. Some common treatments for ankle pain are listed here. Not all of these treatments are appropriate for every condition, but they may be helpful in your situation.

    Conservative

    • Rest: The first type of treatment for most common conditions that cause ankle pain is to simply rest the joint and allow the acute inflammation to subside. Often this is the only step needed to relieve ankle pain. If the symptoms are severe, crutches may be helpful.
    • StretchingStretching the muscles, tendons, and ligaments that surround the joint can help with some causes of ankle pain. A good routine should be established.
    • Ice and Heat Application: Ice packs and heating pads are among the most common treatments for ankle pain. So which one is the right one to use: ice or heat? And how long should the ice or heat treatments last? Learn more about ice and heat treatment.
    • Footwear Modifications, Orthotics, and Braces: Depending on the type of injury, footwear modifications, braces, or orthotics may all be potentially helpful. The specific injury and its cause will determine which of these may be helpful.​

      Moderate

      • Physical Therapy: Physical therapy is an important aspect of treatment of almost all orthopedic conditions. Physical therapists use different modalities to help you increase strength, regain mobility, and return to your pre-injury level of activity.
      • Anti-Inflammatory Medication: Nonsteroidal anti-inflammatory medications, which are commonly referred to as NSAIDs, are some of the most commonly prescribed medications, especially for patients who have ankle pain caused by problems such as arthritis and tendonitis.

      More Invasive

      • Cortisone Injections: Cortisone is a powerful medication that treats inflammation, and inflammation is a common problem in patients with ankle pain. Discuss the possible benefits of a cortisone injection for your condition with your doctor.
      • Arthroscopic Surgery: Arthroscopic ankle surgery may be a treatment option for certain types of ankle pain. Arthroscopic surgery is a procedure that involves inserting a small camera inside the joint. Through other small incisions, instruments can be inserted to repair or remove damaged structures.

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