Pain in the ankle can make walking difficult and can severely limit your mobility. The ankle is a hinge joint that allows the foot to move in two directions – either toward the body or away from the body. The ankle joint is the cross-section of three bones; the shinbone or tibia, the small bone of the leg or fibula and a large bone in the foot called the talus.

Working together, these three bones and the ankle joint are responsible for providing stability to the ankle, and function to bear the weight of the body while you walk or stand. Simply put, the ankle is a hard-working joint.

 

What Causes Ankle Pain?

Pain in the ankle can make walking difficult and can severely limit your mobility.  The ankle is a hinge joint that allows the foot to move in two directions – either toward the body or away from the body.  The ankle joint is the cross-section of three bones; the shinbone or tibia, the small bone of the leg or fibula and a large bone in the foot called the talus.

Working together, these three bones and the ankle joint are responsible for providing stability to the ankle, and function to bear the weight of the body while you walk or stand.  Simply put, the ankle is a hard-working joint.   Injuries and tendonitis are the common causes of swelling and pain in the ankle.

Sprains and Fractures

Of all the possible strains that your musculoskeletal system can endure, ankle sprains are among the most common and are due to injuries to the ligaments of the ankle – typically tears that occur with sudden stretching motions to the inner or outer ankle.  Such is the case when you twist your ankle accidentally when playing basketball or other sports, or when you step off an uneven surface unexpectedly.

Ankle pain in these instances is usually severe initially and may be accompanied by a sensation of the ankle popping, as well as by immediate swelling from injured blood vessels that may leak fluid locally into tissues of the ankle.  The degree to which the ligaments of the ankle are injured is best evaluated by x-ray tests which can also reveal any fracture to the bones of the ankle as well.  With minor ankle sprains, the only treatment needed is the application of ice, rest, and limitation on putting weight on the ankle until it has healed sufficiently.

Acute ankle sprains may thus require the use of crutches during recuperation in order to avoid further damaging the ligaments and elevation of the leg to reduce swelling.  Anti-inflammatory pain medications are also often recommended for minor sprains to relieve ankle pain and promote healing by reducing inflammation.

For patients with severe injuries and fractures to the ankle, immobilizing casts may be needed and may be required until the injury has healed sufficiently. In worst case scenarios, surgical repair may be required followed by physical therapy.

Tendinitis

Inflammation of the tendon is called tendinitis (sometimes spelled tendonitis).  When tendinitis occurs in the ankle, it usually involves the Achilles tendon but can affect the peroneal tendon or tibial tendon.  Tendinitis usually results from traumatic injury but may be the result of underlying illnesses or diseases like rheumatoid arthritis or reactive arthritis.

Tendinitis in the ankle can cause ankle pain as well as tenderness and swelling in the tendons of the ankle.  Tendinitis of the ankle can have a paid onset or may come on more slowly.  Treatment for ankle pain caused by tendinitis involves immobilizing the area, elevating the legs, limiting the weight placed on the ankle, application of ice, and administration of NSAID (nonsteroidal anti-inflammatory drugs) in order to reduce inflammation.  The most severe cases of tendonitis may require orthopedic casting.

Arthritis

Arthritis can affect any area of the body, including the ankle.  Ankle pain caused by arthritis is usually the result of rheumatoid, reactive, gouty, spondylitis, psoriatic or ankylosing arthritis, although other types of arthritis can cause problems with the ankles as well.  Ankle pain from arthritis usually develops slowly and is accompanied by swelling, stiffness, warmth, and redness in the ankle area.  Treatment for ankle pain due to arthritis generally involves staying off of the ankle as much as possible, application of ice, and anti-inflammatory medication.

Tarsal Tunnel Syndrome

Nerve compressions of the ankle can cause ankle pain and the development of tarsal tunnel syndrome.  Pressure on the median nerve in the ankle can bring on tarsal tunnel syndrome – often from work-related activities that are repetitive, or from sports injuries.  Diagnosis of tarsal tunnel syndrome involves nerve conduction studies.

Tarsal tunnel syndrome is treated in much the same manner as its sister syndrome of the wrist – carpal tunnel syndrome (the anatomy of the wrist and ankle are similar).  Tarsal tunnel syndrome can cause pain, swelling, numbness and tingly in the ankle.  While ice, rest, elevation, and NSAID pain relievers are recommended, surgical intervention is sometimes required.

The Main 4 Causes of Pain in Ankle, Last Update: 9/5/2017