Ankle pain: what to know

Ankle pain is often dismissed as a simple sprain, especially after a sudden twist or injury. However, not all ankle pain is due to a sprain, and ignoring symptoms can lead to prolonged discomfort or further injury. If your pain persists or worsens, it’s essential to consider other possible causes that might require more specialised treatment.

Ankle fractures

One common condition mistaken for a sprain is a fracture. While both injuries can cause similar symptoms, such as swelling, bruising, and difficulty walking, a fracture involves a break in the bone, which requires immediate medical attention. If you experience intense pain, inability to bear weight, or a visible deformity in your ankle, it’s crucial to seek an evaluation to rule out a fracture. X-rays or advanced imaging may be needed to confirm the diagnosis. A bone can be broken (fractured) but one can still walk/weight bear on it. So, being able to put weight on the foot does not automatically rule out a fracture.

Tendonitis

Another condition that mimics a sprain is tendonitis, the inflammation of tendons that connect muscles to bones. In the ankle, the peroneal tendons, which stabilise the joint, can become irritated or inflamed from overuse, leading to chronic ankle pain and instability.

Tendonitis typically develops gradually and may cause aching or burning sensations on the outside of the ankle. Rest, physical therapy, and anti-inflammatory medications can often relieve tendonitis, but severe cases might require more intensive treatments.

Ankle instability

Ankle pain could also stem from ligament damage, particularly chronic instability following multiple sprains. Over time, ligaments that don’t heal properly can lead to recurring sprains, weakness, and persistent discomfort. In such cases, physical therapy to strengthen the ankle or even surgical intervention may be necessary to restore stability.

Arthritis and gout

Lastly, conditions like arthritis or gout can cause ankle pain without a clear history of injury. Osteoarthritis develops slowly as the cartilage in the joint wears down, while gout causes sudden, severe pain due to uric acid crystal buildup. Both conditions require long-term management strategies.

Can I prevent ankle pain?

While not all ankle pain is preventable, certain strategies can reduce your risk of developing common issues.

Wearing well-fitted, supportive shoes is one of the simplest and most effective measures. Avoid high heels or ill-fitting shoes as this will exacerbate pain. Choose instead footwear with proper arch support and cushioning with adequate room for your toes and support for your foot arches to help distribute pressure evenly.

Maintaining a healthy weight can also reduce stress on your feet and ankles, as excess body weight increases the risk of developing conditions like plantar fasciitis or arthritis. Regular physical activity, combined with stretching exercises, can improve foot strength and flexibility, preventing overuse injuries. Equally, avoid overexertion during physical activities and give your feet time to rest and recover after periods of intense use.

Pay attention to your foot hygiene as well. Keep your feet clean and dry, trim your toenails properly to avoid ingrown nails and inspect your feet regularly for signs of redness, swelling or sores, especially if you have diabetes.

When should I see a specialist for ankle pain?

Ankle pain should never be ignored, especially if it interferes with your daily activities or worsens over time. You should consider consulting a specialist if:

• Your ankle pain is intense or doesn’t improve with self-care.
• Your ankle pain is accompanied by swelling, redness or warmth.
• You have difficulty walking, standing or bearing weight.
• You experience numbness, tingling or a burning sensation in your feet or ankles.
• You notice visible deformities.
• Your ankle pain recurs or persists.