Ankle Pain

Is this your symptom?

  • Pain in the ankle
  • If pain is caused by an injury, see Foot and Ankle Injury care guide

Causes of Ankle Pain

  • Muscle Overuse (strained muscles). Ankle pain is often from hard muscle work or sports. Examples are too much walking, running or jumping. This type of pain can last from hours up to 7 days.
  • Sprained Ankles are from over-stretching the ligaments around the ankle joint. Mild sprains can happen from just walking on uneven ground or doing normal activities. Mild sprains often feel better with rest within a few days. Severe sprains can take many weeks to heal.
  • Viral Illness. Mild muscle and joint pain can occur with many viral illnesses such as the flu.
  • Reactive Arthritis. If you have an infection somewhere else in your body (such as bladder or bowel), you may also get inflammation in your joints. The knees and ankles are often affected. Treating the infection will help the joint pain settle down.
  • Septic Arthritis (serious). This is a bacterial infection of a joint space. Main symptoms are fever and severe pain when you move the joint. It may not be possible to move the joint at all. This needs care right away.
  • Tendinitis is inflammation of tendons where they attach to the bone, caused by overuse. An example is Achilles tendinitis which cause pain at the back of the heel. This causes tenderness in the area and pain when the limb is moved or used. Often needs a long period of rest from the activity that caused it. Physical therapy (PT) and/or a steroid shot may be needed to reduce the pain.
  • Bursitis. Many joints are covered by fluid-filled sacs called bursae. They help the joint move smoothly. Bursae can get inflamed or infected, causing pain and swelling. The area may look red and feel warm to touch. See your doctor right away if you have these symptoms.
    • Flat Feet is where the arch of your foot is flattened. You might have inherited this or it could be from injury or wear and tear. It is often painless, but could cause ankle pain.
  • Joint Inflammation. Examples are rheumatoid arthritis, osteoarthritis and gout. Some, like gout, may affect just one joint. Others affect multiple joints at the same time. Osteoarthritis is due to wear and tear on the joints and can cause pain, stiffness and loss of movement. Rheumatoid arthritis usually affects the same joint on both sides of the body. Early treatment may help prevent long-term damage to the joints involved.
  • Trapped Nerves. The nerves in the lower leg can become trapped or squeezed where they pass through narrow spaces as they leave the spine. Sciatica is from pressure on a nerve in the back. It causes tingling, weakness or pain in the leg which may go into the hip (and down to the toes). If symptoms do not go away with rest or treatment, surgery may be needed to release the nerve.

Pain Scale

  • Mild: you feel some pain, but it does not keep you from any normal activities. Work, chores and sleep are not changed.
  • Moderate: the pain keeps you from doing some normal activities. It may wake you up from sleep.
  • Severe: the pain is very bad. It keeps you from doing all normal activities.

When to Call for Ankle Pain

Call Doctor or Seek Care Now

  • Severe pain
  • Ankle is red, warm to touch and painful
  • Loss of feeling lasts more than 1 hour
  • Can't put full weight on the ankle or foot or walk normally
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Red area of skin that is tender to touch
  • Looks infected (spreading redness)
  • Can't move the foot or ankle normally
  • Pain gets worse over several days
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Pain lasts more than 7 days
  • Swollen ankle or foot
  • Can't walk normally, limping
  • Pain keeps you from work or other activities
  • Ankle pains happen often
  • You have diabetes and your feet feel like they are burning, tingling or numb
  • You have other questions or concerns

Self Care at Home

  • Caused by overuse of the foot or ankle
  • Mild ankle pain

Care Advice

  1. What You Should Know About Mild Ankle Pain:
    • Strained muscles, tendons and ligaments are common after using them too much during sports or other activities. They can also happen from a fall.
    • Examples are running, walking or jumping too much. They could be strained from starting a new sport.
    • Weekend warriors who are out of shape get the most muscle pains.
    • Here is some care advice that should help.
  2. Pain Medicine:
    • To help with the pain, take an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
    • Use as needed, but do not take more than the maximum recommended dosage as stated on the package.
    • If you are not sure what to take, ask a pharmacist.
  3. Remove Any Jewelry:
    • Remove any jewelry (toe rings, ankle bracelet) that could become tight if the ankle or foot start to swell.
  4. Cold Pack for Pain:
    • For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth.
    • Put it on the sore muscles for 20 minutes.
    • Repeat 4 times on the first day, then as needed.
    • Caution: avoid frostbite by wrapping the ice pack. Do not put ice directly onto the skin.
  5. Use Heat After 48 Hours:
    • If pain lasts more than 2 days, put heat on the sore muscle.
    • Use a heat pack, heating pad or warm wet washcloth.
    • Do this for 10 minutes, then as needed.
    • Reason: increase blood flow and improve healing.
    • Caution: avoid burns by wrapping the heat pack. Do not put it directly onto the skin.
  6. Rest the Ankle:
    • Rest the painful area as much as possible for 48 hours. Keep the foot and toes moving gently if you can.
    • Keep the ankle raised above the level of your heart, if you can, to help limit swelling. Lying down with your leg raised on pillows or a rolled blanket can help.
  7. What to Expect:
    • A strained muscle hurts for 2 or 3 days.
    • The pain often peaks on day 2.
    • After severe overuse, the pain may last a week or more.
  8. Call Your Doctor If:
    • Fever or a swollen joint occurs
    • Pain lasts more than 7 days
    • Pain gets worse over several days
    • You get swelling and redness over a joint
    • You think you need to be seen

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.