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Why does my ankle hurt?

A person’s ankle may hurt for many reasons, from minor injuries to chronic medical conditions such as arthritis.

Ankle pain can stem from a variety of injuries to the bones, muscles, and soft tissue structures that support the ankle.

Depending on the cause, the pain can feel like sharp, shooting pain, or a dull ache. People may also notice swelling around the ankle bone.

Minor injuries, such as ankle strains and sprains, are a common cause of ankle pain. People can often treat minor injuries at home, but they should see a doctor about suspected medical conditions or injuries that get in the way of their daily life.

This article discusses some common reasons why a person’s ankle may hurt, as well as how to relieve the pain.

Achilles tendon rupture

Person sitting on sofa holding ankle in pain
Certain antibiotics can increase the risk of an achilles tendon rupture.

The Achilles tendon is a strong band of tissue that connects the heel bone to the calf muscle. The tendon can tear or rupture due to overstretching when running or exercising, or after a fall.

Taking corticosteroids or certain antibiotics, including fluoroquinolones such as Cipro, can also increase the likelihood that a person will experience a tendon rupture.

Symptoms of an Achilles tendon rupture include:

  • a reduced range of motion
  • pain that occurs suddenly in the ankle or calf
  • a popping or snapping sensation in the ankle
  • problems standing on tiptoes or walking up stairs
  • swelling on the back of the leg or ankle

In many cases, an Achilles tendon rupture requires surgery to correct.

Ankle fracture

An ankle fracture is a break of one or more of the bones in the ankle, such as the tibia or fibula. The fracture can be one clean break, or it can break the bone into smaller pieces.

Symptoms of an ankle fracture include:

  • pain that can radiate throughout the lower leg
  • swelling at the ankle and beyond
  • blistering over the injury site
  • difficulty walking and moving the foot a broken bone pushing against the skin

Treatments for an ankle fracture depend upon the injury’s severity and location of the fracture. Surgery is not always necessary.


Ankle sprain or strain

Sprains and strains are both types of soft tissue damage. Both can cause significant pain and discomfort, depending on severity.

A sprain is an overstretching or tearing of a ligament, which is a band of tough tissue that joins bones together. Sprains can range from partial to complete.

A strain is an injury to the muscle or tendon. Tendons are tough cords that attach muscle to bone. Strains can range from a small overstretch to a complete tear.

The ankles are a common area for sprains and strains, as they are a complex joint that endures a lot of daily movement.

Symptoms of an ankle sprain or strain include:

  • a popping or snapping sound
  • instability of the ankle joint
  • swelling
  • tenderness

These types of injury usually occur during physical activity, such as playing a sport or running.


Gout

Gout can cause severe swelling and pain.
Gout can cause severe swelling and pain.

Gout is a form of arthritis that occurs due to a buildup of uric acid crystals in the body. Gout commonly affects the foot and ankle, especially a person’s big toe.

Symptoms of gout include:

  • pain that is usually worse at night or immediately after waking up
  • swelling around the ankle
  • warmth over the ankle joint

People with a family history of gout are more likely to have the condition. Other conditions that increase the risk of gout include diabetes, obesity, and high blood pressure. Taking medicines such as diuretics or niacin can also increase the risk.

Infection

A previous cut, trauma, or surgery can allow bacteria to enter the skin or joint around the ankle and cause an infection.

Symptoms of an ankle infection include:

  • fatigue and feeling generally unwell
  • fever
  • pain
  • redness
  • swelling
  • warmth

A doctor may prescribe oral or intravenous antibiotics depending on the infection’s severity. People should try to seek treatment for the infection as quickly as possible to ensure that it does not get worse.


Osteoarthritis

Arthritis is a wearing down of the protective cartilage in the ankles. This can cause the bones to rub against each other, leading to pain and instability in the ankle joints.

Symptoms of osteoarthritis include:

  • ankle pain
  • growth of bony areas over the ankle joint
  • stiffness
  • swelling
  • trouble walking or bending the ankle

Osteoarthritis gets worse over time, but treatment can slow down or stop the progression of the condition.

Flatfoot disorder

Acquired flatfoot disorder, also called fallen arches or posterior tibial tendon dysfunction, usually affects one foot only and is a disorder of the tendon that supports the foot’s arch.

Flatfoot disorder causes the arch of the foot to come into contact with the ground.

Symptoms of flatfoot disorder include:

  • flattening of the foot’s arch
  • pain on the outside of the foot
  • pain when doing activities that challenge the tendon, such as hiking, climbing stairs, or running
  • rolling the ankle inward, or overpronation
  • swelling around the foot and ankle

Flatfoot disorder is usually progressive, meaning that it gets worse over time. However, doctors can often correct it using nonsurgical treatments.


Rheumatoid arthritis

A person can take medication to treat rheumatoid arthritis.
A person can take medication to treat rheumatoid arthritis.

Rheumatoid arthritis is an autoimmune disorder that causes the immune system to attack joint linings called synovium.

According to the Arthritis Foundation, an estimated 90 percent of people with rheumatoid arthritis experience problems with their feet and ankles.

Symptoms of rheumatoid arthritis include:

  • difficulty moving the ankle
  • pain
  • swelling

The condition can also affect the hands, wrists, back, and other joints. Rheumatoid arthritis gets worse over time, but people can control their symptoms and prevent the condition from progressing by taking certain medications.


When to see a doctor

If a person has experienced an injury that limits their ability to move their foot and ankle, they should see their doctor. They should seek emergency care if they suspect that the ankle is broken.

People should also see a doctor when ankle pain symptoms worsen instead of improving.

Diagnosis

The doctor will conduct a physical examination of the foot and ankle for any visible deformity, signs of infection, and changes to the skin.

A doctor may also conduct the following tests to determine the cause of the ankle pain:

  • imaging studies, such as X-rays, CT scans, or MRI scans
  • blood tests, which can help diagnose rheumatoid arthritis, gout, and infections
  • skin or fluid samples to test for the presence of bacteria, fungi, and viruses

Treatments and home remedies

Treatments for ankle pain depend upon the underlying cause. For example, a doctor will usually treat an ankle infection with prescription antibiotics. Doctors can also prescribe medications to help control medical conditions such as gout and rheumatoid arthritis.

For injuries, doctors will usually recommend taking over-the-counter (OTC) pain medication, resting, and exercising to improve recovery. However, severe ankle injuries and trauma may require surgery.

Home remedies

One primary treatment for minor injuries is the RICE method. People can use this method at home to reduce pain and swelling around the ankle.

RICE stands for:

  • Rest: Resting the affected ankle joint allows it to heal and lessens the extent of damage.
  • Ice: Applying ice to the affected area can help minimize swelling. Apply a cloth-covered ice pack for 10–15 minutes at a time several times per day.
  • Compression: Wrapping the ankle or applying a compressive brace can help minimize swelling and provide support, which reduces the risk of causing further damage.
  • Elevation: Using several pillows to elevate the ankle can support it and promote blood and fluid flow toward the heart.

Taking OTC pain relievers such as acetaminophen and ibuprofen may also help minimize discomfort. Ibuprofen is available for purchase online.

Changing one’s shoes can often help a person reduce foot and ankle pain. Wearing supportive shoes with a wide toe box can relieve pressure on the ankle and reduce the likelihood of experiencing ankle pain in the future.

Sometimes, a doctor may recommend using a special insert called an orthotic insole. These range in consistency from soft to rigid and help support the feet. Orthotic insoles are available for purchase online.

According to a paper that appears in the journal Seminars in Arthritis and Rheumatism, footwear interventions such as orthotics are clinically proven to help those with rheumatoid arthritis and gout, among other medical conditions.


Outlook

Many types of injury and medical condition can cause a person’s ankle to hurt.

If a person’s ankle pain is affecting their daily activities, they should consider seeing a doctor. Doctors can diagnose and treat potential causes before an injury, condition, or infection worsens.

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