Ankle pain
Pain - ankleAnkle pain involves any discomfort in one or both ankles.
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Causes
Ankle pain is often due to an ankle sprain.
- An ankle sprain is an injury to the ligaments, which connect bones to one another.
- In most cases, the ankle is twisted inward, causing small tears in the ligaments. The tearing leads to swelling and bruising, making it difficult to bear weight on the joint.
- The ligament injuries are more common on the outside of your ankle but the inside ligaments can tear also.
In addition to ankle sprains, ankle pain can be caused by:
- Damage or swelling of tendons (which join muscles to bone) or cartilage (which cushions joints)
- Infection in the ankle joint
- Osteoarthritis, gout, rheumatoid arthritis, Reiter syndrome, and other types of arthritis
Problems in areas near the ankle that can cause you to feel pain in the ankle include:
- Blockage of blood vessels in the leg
- Heel pain or injuries
- Tendinitis around the ankle joint
- Nerve injuries (such as tarsal tunnel syndrome or sciatica)
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Home Care
Home care for ankle pain depends on the cause and what other treatment or surgery has taken place. You may be asked to:
- Rest your ankle for several days. Try to NOT put much weight on your ankle.
- Put on an ACE bandage. You also can buy a brace that supports your ankle.
- Use crutches or a cane to help take the weight off a sore or unsteady ankle.
- Keep your foot raised above the level of your heart. When you are sitting or sleeping, place two pillows under your ankle.
- Ice the area right away. Apply ice for 10 to 15 minutes every hour for the first day. Then, apply ice every 3 to 4 hours for 2 more days.
- Try acetaminophen, ibuprofen, or other pain relievers made by the store.
- You may need a brace to support the ankle or a boot to rest your ankle.
As the swelling and pain improve, you may still need to keep extra weight and stress off your ankle for a period of time.
The injury may take a few weeks to many months to fully heal. Once the pain and swelling are mostly gone, the injured ankle will still be a little weaker and less stable than the uninjured ankle.
- You will need to start exercises to strengthen your ankle and avoid injury in the future.
- DO NOT begin these exercises until a health care professional tells you it is safe to start.
- You will also need to work on your balance and agility to avoid another injury or sprain.
Other advice your health care provider may give you include:
- Avoid putting on extra weight since this could increase strain on your ankles.
- Warm up before exercising. Stretch the muscles and tendons that support the ankle.
- Avoid sports and activities for which you are not properly conditioned.
- Make sure that shoes fit you properly. Avoid high-heeled shoes.
- If you are prone to ankle pain or twisting your ankle during certain activities, use ankle support braces. These include air casts, ACE bandages, or lace-up ankle supports.
- Work on your balance and do agility exercises.
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When to Contact a Medical Professional
Go to the hospital if:
- You have severe pain even when you are NOT bearing weight.
- You suspect a broken bone (the joint looks deformed or you cannot put any weight on the leg).
- You can hear a popping sound and have immediate pain in the joint.
- You can't move your ankle back and forth.
Contact your provider if:
- Swelling does not go down within 2 to 3 days.
- You have symptoms of infection. The area becomes red, more painful, or warm, or you have a fever over 100°F (37.7°C).
- The pain does not go away after several weeks.
- Other joints are also involved.
- You have a history of arthritis and are having new symptoms.
References
Chiodo CP, Price MD, Sangeorzan AP. Foot and ankle pain. In: Firestein GS, Budd RC, Gabriel SE, Koretzsky GA, McInnes IB, O'Dell JR, eds. Firestein and Kelly's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 52.
Irwin TA. Tendon injuries of the foot and ankle. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 118.
Osborne MD, Esser SM. Chronic ankle instability. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 85.
Rose NGW, Green TJ. Ankle and foot injuries. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 49.
Rothenburg P, Swanton E, Molloy A, Aiyer AA, Kaplan AR. Ligamentous injuries of the foot and ankle. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 117.