The Most Common Causes of Ankle Pain and the Problem with Conventional Treatments

Ankle pain is a frequent complaint among people of all ages but especially in older adults. It’s also a concern for serious athletes and people who work on their feet all day.

Below is a list of the most common causes of ankle pain. If you suffer from ankle pain and have tried to treat it using traditional measures, you may have found yourself frustrated, with little to no relief. We’ll tell you why conventional treatments usually fail and what you should try instead.

If your feet are naturally built a certain way, you may be predisposed to ankle pain. At the top of this list is having flat feet, meaning you have very little (if any) arch to help provide support for your weight and the transfer of motion as you move. Sometimes flat feet and other foot anatomy problems are a developmental issue, but more often, they are genetic.

If you have poor foot anatomy, you definitely want good support in your shoes. Even people with high arches can experience ankle pain if their footwear doesn’t give them the base they need. In addition to buying high-quality shoes and avoiding footwear with no arch support, you may need orthotics, either ready-made or custom tailored for your feet.

Being overweight puts more stress on all your lower extremity parts, but it’s especially hard on your feet and ankles, which carry the most weight. If you have anatomical problems, excess weight will only exacerbate them. Still, simply being obese can cause ankle pain. The solution is to lose weight and see if that eliminates your pain.

There are many types of arthritis that can cause ankle pain, including psoriatic arthritis, rheumatoid arthritis, and osteoarthritis, the most common kind. Lupus, an autoimmune disease, can also cause arthritis, which is inflammation of the joint characterized by pain, swelling, redness, stiffness, and joint anatomy changes. There are many different treatments for arthritis based on the type, but the ones for the most serious forms of arthritis typically carry significant health risks, such as increased vulnerability to infection.

Bursae are small, fluid-filled sacs in your joints that facilitate smooth joint movement. They can become irritated and swollen (bursitis), causing pain. There are three major bursae in the ankle, leaving lots of room for potential bursitis.

Treating bursitis usually involves finding the cause of the irritation and eliminating it, such as changing footwear or modifying athletic training. It may also include steroid injections and oral pain medications to reduce inflammation.

You’re probably familiar with the Achilles tendon, which attaches your calf muscle to your heel. Irritation and tiny tears in this tendon can result in tendinitis, which may necessitate rest, ice, heat, and stretching.

With Achilles tendinosis, the tissue breaks down from overuse. You may notice pain in the tendon and a bump near your heel when this happens. Rest, medication, different footwear, and braces may be recommended, along with physical therapy.

Your plantar fascia is a thick sheet of tissue that runs along the bottom of your foot. Because it covers the heel, if it gets inflamed, as with plantar fasciitis, it can result in ankle pain. You may feel a stabbing pain when you put weight on your foot, especially first thing in the morning.

It’s not uncommon to have plantar fasciitis in both feet, and it’s a frequent malady of runners, folks who stand all day, and people who are overweight. You may need rest, new shoes or orthotics, physical therapy, and other measures to eliminate plantar fasciitis permanently.

Uric acid, a waste product, can form into crystals and accumulate in your joints, resulting in gout. Gout usually produces extreme pain, sensitivity, and swelling. Rest and medication may be suggested, but for long-term relief, you may need to change your diet, exercise more, and consume less alcohol.

Your ankle pain may be caused by a recent trauma, such as a sprain or similar sports injury. In most cases, people know when ankle trauma happens because they go from feeling fine to experiencing sharp pain, swelling, and the inability to bear weight. Sudden ankle trauma (AKA acute injury) should prompt a visit to the doctor or ER to make sure nothing is broken or torn.

Old ankle trauma can also resurface as ankle pain years later. You may have bone spurs, scar tissue, or torn cartilage that brings pain when you overdo it physically or when the weather turns cold and wet.

Unfortunately, many of the treatments for ankle pain, such as those described above, fail for users. That’s because most of these treatments for ankle pain:

• require a major impractical lifestyle change (e.g., quitting a sport or no longer working on your feet)
• are expensive, even with insurance
• have short-term efficacy (masking pain vs. resolving it)
• can be risky due to side effects (including both over-the-counter and prescription medications)

Even more potentially dangerous than OTC anti-inflammatory drugs and sedating painkillers, surgery may be encouraged for stubborn cases of ankle pain. In addition to being costly and requiring extensive recuperative downtime, surgery has risks with anesthesia and even the post-op period, like blood clots. There is no guarantee of success with surgery, and in some cases, you may be left with worse pain.