Rare and unusual ankle pain causes
Rare and unusual causes that may lead to severe ankle pain include:
- Loss of blood supply to the bone: This can follow trauma, blood vessel blockage, or certain diseases, and causes bone damage and pain.
- Tumors: These can form in and around the ankle joint, causing pain and swelling.
Whether you're incredibly active or spend most nights on the couch, an ankle injury can happen to anyone. If you find yourself with an ankle that's not cooperating, it's time to look into treatments.
Posterior tibialis tendinopathy
Posterior tibialis tendinopathy
The posterior tibialis tendon attaches the calf muscle to the bones on the underside of the foot. It provides stability and arch support. If this tendon is damaged, the result may be a flat, unstable foot.
Posterior tibialis tendinopathy is most often a sports injury, where the tendon becomes inflamed or torn through overuse or high impact.
Symptoms include pain down the ankle and into the foot, sometimes with swelling. The pain becomes worse with any activity, even standing or walking. When standing, the patient's arch will be collapsed and flat and the front of the foot will point outward. The patient will be unable to stand on the injured foot and raise the heel.
Diagnosis is made through patient history, physical examination, and imaging such as x-ray, CT scan, or MRI.
Treatment involves rest, over-the-counter pain relievers, orthotics (shoe pads,) braces, and sometimes steroid injections into the damaged tendon. Surgery can be tried, but tends to be complex and cannot always restore the tendon completely.
Rarity: Ultra rare
Top Symptoms: swollen foot, pain in one foot, limping, pain in one ankle, spontaneous ankle pain
Symptoms that never occur with posterior tibialis tendinopathy: recent cutting accident
Urgency: Primary care doctor
Osteochondritis dissecans
Osteochondritis dissecans, also called OCD, is a joint condition. It occurs when there is not enough blood flow within the end of a bone, under the protective cartilage. These bone layers begin to die and separate from the main bone, taking the cartilage with them.
The exact cause is not known. It may be due to overtraining a young person before the bone is entirely mature, which can interfere with blood supply.
Most susceptible are children and teenagers. The condition is found most often in only one joint, usually the ankle, knee, or elbow. However, any joint can be affected and there may be more than one.
Symptoms include swelling and pain in the joint during exercise, and sometimes "locking" of the joint. Osteochondritis dissecans may lead to osteoarthritis if not treated.
Diagnosis is made through patient history, physical examination, and imaging.
Treatment first involves rest because in children who are still growing, the bone and cartilage may heal spontaneously. If there are loose pieces of bone within a joint, surgery may be necessary.
Rarity: Rare
Top Symptoms: pain in one knee, knee stiffness, knee instability, knee pain that gets worse during a run, pop in the knee
Urgency: Primary care doctor
Gout
Gout is a form of arthritis that causes sudden pain, stiffness, and swelling in a joint. The big toe is often affected, but it can also happen in other joints. Sometimes, the joint gets hot and red. Gout is caused by uric acid crystals. Risk factors for gout include obesity, eating a lot of meat, drinking beer, age (older), sex (male), and family history.
You should see a healthcare professional to see if uric acid crystals have accumulated in the joint. Gout can be diagnosed based on symptoms, but it's also common to take a sample of joint fluid for testing. A physician can give you a prescription for anti-inflammatory medications and/ or pain medications. There are also medications to stop your body from making too much uric acid. Sometimes, a shot in the joint can help with symptoms also.
Rarity: Common
Top Symptoms: swollen toes
Urgency: Primary care doctor
Fibromyalgia
Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.
The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.
Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.
Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.
There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.
Fibromyalgia does not go away on its own but does not get worse, either.
Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.
Rarity: Common
Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache
Symptoms that always occur with fibromyalgia: arthralgias or myalgias
Urgency: Primary care doctor
Cellulitis
Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.
The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.
Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.
Symptoms arise somewhat gradually and include sore, reddened skin.
If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.
Symptoms of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.
Diagnosis is made through physical examination.
Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.
Rarity: Uncommon
Top Symptoms: fever, chills, facial redness, swollen face, face pain
Symptoms that always occur with cellulitis: facial redness, area of skin redness
Urgency: Primary care doctor
Broken ankle
An ankle fracture is a break in 1 or more ankle bones.
You should seek immediate medical care. The ankle will likely be splinted, but in severe cases, surgery may be necessary.
Rarity: Common
Top Symptoms: difficulty walking, constant ankle pain, swollen ankle, pain in one ankle, ankle pain from an injury
Symptoms that always occur with broken ankle: pain in one ankle, swollen ankle, ankle pain from an injury, constant ankle pain
Urgency: Hospital emergency room
Ankle sprain
A foot sprain means there is damage to ligaments within the foot. The term "sprain" specifically refers to overstretching or tearing of ligaments – the strong, fibrous bands of tissue that hold the bones together within the joints.
Foot sprains are usually sports or dance injuries. Any sort of running movement that involves sudden stops, starts, and twisting can lead to a foot sprain. Suddenly getting the foot caught while walking or running can wrench the ligaments and cause a sprain.
Symptoms include swelling, bruising, and pain in the affected foot, especially with weight bearing.
If symptoms do not resolve quickly, or seem to get worse instead of better, a medical provider should be seen to make sure no fracture is involved.
Diagnosis is made through physical examination and imaging such as x-ray, CT scan, ultrasound, or MRI.
Treatment is usually conservative and involves rest to allow healing; nonsteroidal anti-inflammatory drugs for pain; elevating the foot to improve circulation; and wrapping the foot with an Ace bandage or wearing a special boot for support.
Rarity: Common
Top Symptoms: pain in one ankle, ankle pain from an injury, swollen ankle, bruised ankle, ankle twisting
Symptoms that always occur with ankle sprain: pain in one ankle, ankle pain from an injury
Urgency: Phone call or in-person visit
Ankle bruise
A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the ankle are common, often due to minor injury.
You can treat this at home with R.I.C.E - rest (exercise as tolerated), ice (10-20 minutes at a time), compression (with tape or bandage), and elevation (putting your feet up helps blood drain and return to the heart).
Rarity: Rare
Top Symptoms: constant ankle pain, pain in one ankle, ankle pain from an injury, recent ankle injury, swollen ankle
Symptoms that always occur with ankle bruise: ankle pain from an injury, recent ankle injury, constant ankle pain
Urgency: Self-treatment
Ankle arthritis
Arthritis simply means inflammation of the joints. Because the feet and ankles have many small joints and carry the weight of the body, they are often the first place that arthritis appears.
Ankle arthritis is caused by a breakdown in the protective cartilage at the end of each joint, so that the bones begin to wear against each other and the joint becomes stiff and painful. This breakdown may be due to simple wear and tear; an injury; or from rheumatoid arthritis, an autoimmune condition which causes the body to break down its own cartilage.
Symptoms include swelling, warmth, and redness in the joint, and pain with movement or with pressure on the joint.
Diagnosis is made through patient history, physical examination, and imaging such as x-rays, CT scan, or MRI.
There is no cure for arthritis, but treatment is important because the symptoms can be managed to prevent further damage, ease pain, and improve quality of life. Treatment involves physical therapy, pain-relieving medications, and sometimes surgery to help repair damaged joints.
Rarity: Uncommon
Top Symptoms: swollen ankle, swollen foot, joint stiffness, pain in one ankle, ankle stiffness
Urgency: Self-treatment
At-home ankle pain treatments
You can begin addressing your ankle pain symptoms at home while you recover or wait for an appointment.
- RICE Method: If the pain is due to an injury, provide first aid to control the swelling and pain. Rest the ankle. Put ice on for about 20 minutes and repeat three times daily. Compress the ankle, but not too tightly, by putting on an elastic bandage. Elevate the ankle above the heart level.
- Medications: Ankle pain can be treated with non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, analgesics, and other OTC pain relievers.
- Devices: Crutches and walkers are helpful for mobility and rest.
- Therapy: Exercises facilitated by a physical therapist can help restore the ankle's strength and flexibility.
- Surgery: In severe cases, surgery can be necessary for the reconstruction of damaged ligaments and fractured bones.
Preventive measures for ankle pain
Try the following methods to help prevent ankle pain and injury.
- Watch your step closely when walking, particularly on uneven surfaces
- Warm up before doing any strenuous exercises or sports
- Avoid wearing high-heeled shoes
- Exercise and stretch regularly
- Watch your weight
- Eat a balanced diet
Free yourself from ankle pain by knowing its symptoms, causes, and treatment. You'll be back on two healthy feet in no time.
Questions your doctor may ask about ankle pain
- How would you explain your ankle pain?
- Have you ever been diagnosed with diabetes?
- What is your body mass?
- Any fever today or during the last week?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
