Ankle pain is a common symptom, with many possible causes. In this article we’ve listed some of the most common causes of ankle pain, with links to more detailed information that may assist in understanding the source of your ankle pain.

Ankle injuries

A specific traumatic injury or event is one of the most common causes of ankle pain. This can be the result of a fall, an awkward twisting movement or an impact injury to the ankle. This sort of ankle injury will typically cause an ankle sprain or an ankle fracture. You may have swelling and pain in the ankle, and you may also have difficulty weight bearing on the affected foot. Investigations such as an x-ray, ultrasound and/or MRI may be recommended to confirm the diagnosis, and ensure the most appropriate treatment.

Another type of ankle injury is due to overuse or repetition. For example, peroneal tendonitis is associated with overuse and inflammation of the peroneal tendons which run along the outside of the lower leg, behind the ankle and onto the foot. In this condition, the pain is usually felt mostly on the outside of the foot and ankle, and there is often also ankle instability.

Ankle arthritis

Arthritis in the ankle is another cause of ankle pain, and may be due to either osteoarthritis or rheumatoid arthritis. Osteoarthritis is a degenerative condition that can cause pain and stiffness, which is usually worse after resting or a period of not using the joint. Rheumatoid arthritis commonly affects both sides of the body and may cause intermittent pain and stiffness in both ankles.

Biomechanical dysfunction

Posterior tibial tendon dysfunction is a common cause of adult-acquired flat feet, which can cause pain along the medial (or inside) of the ankle. The posterior tibial tendon plays a role in supporting the arch of the foot. Therefore, when this tendon becomes inflamed or injured, the arch of the foot can collapse over time, resulting in a flat foot position. This type of ankle pain tends to be worse with activity.

Gout

If your ankle pain has come on suddenly, it could be due to gout. In gout there is a build-up of uric acid forming crystals that can cause joint destruction. Gout can occur in ankle joints, causing redness, swelling and pain and the joint may be very tender to touch.

Infection

If your ankle pain is accompanied by other signs of infection such as a fever, with swelling and redness of the joint, you may have an infection. Infections vary in severity and in some instances can progress rapidly. If you have signs of a possible infection it is always best to see a doctor as soon as possible to confirm what treatment may be required to prevent deterioration.

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