The Most Common Treatments for Ankle Pain… and What to Do If They Don’t Help

The ankle is a complex joint, and there are lots of opportunities for injury and disease at that site that can result in pain. Depending on your unique situation, some treatments may not work for you, or they may not be feasible for your lifestyle or budget. There are also some treatments that, while conventional, have more risk associated with them.

However, there are some innovative new alternatives for the treatment of ankle pain that are safer and longer-lasting. We outline those at the end, so if the most common treatments for ankle pain don’t help, you have other options available. In fact, these new treatments are so effective that you may want to skip the others and start with the latest in pain therapy.

If you have ankle pain, especially if it accompanies an injury, getting off your feet can be essential to healing. Try to sit as much as possible. Elevating your ankle above the level of your heart can help reduce swelling. Rest is also good if you have ankle pain that comes on occasionally, such as pain from an old injury.

Another good way to manage swelling is to apply ice. You can use a towel wrapped around some ice cubes, a reusable gel pack, or even a bag of frozen peas. Apply the ice for 20 minutes or so, and then remove it for a while. Repeat this cycle as needed.

(Note: if you have no swelling but only pain from an old injury, heat may feel better. Use a heating pad or hot soak to loosen the joint and relax soft tissue.)

Compression can help reduce swelling if you need to be up on your feet or as you start to recover from an ankle injury. There are numerous compression socks and wraps on the market today that are easier to use than old-fashioned bandages.

For chronic ankle pain, look to your shoes for assistance. They should have good arch support to help your feet and ankles get through the day, particularly if you stand or walk for long periods. You can improve the arch support of most shoes by adding ready-made or custom orthotic inserts.

Since obesity is linked to joint pain, including ankle pain, losing weight can sometimes get rid of your ankle pain. This can be a catch-22 for some folks, though. When you’re in pain, it’s hard to exercise, and it’s easy to keep gaining weight. As long as you’re pretty sure your weight is to blame, you can break the cycle by doing low-impact exercises like swimming. Combine it with a healthier diet to see faster results.

Sometimes ankle pain comes from poor biomechanics, including how you play certain sports or work out. A physical therapist can analyze your movement and may be able to make adjustments to reduce or eliminate ankle pain. If your pain stems from weakness or tightness, they can suggest strength-building or stretching exercises for you.

Your doctor may suggest steroid injections for certain conditions like bursitis. One well-placed shot should cut pain for a month or two. However, you’ll have to get repeat shots if your pain comes back, which is not an advisable long-term pain management plan.

Over-the-counter drugs like non-steroidal anti-inflammatories (NSAIDs) can help with pain. Common OTC medications include naproxen (Aleve) and ibuprofen (Motrin or Advil). There are topical pain medications as well, such as diclofenac (Voltaren). These don’t penetrate too far under the skin, so they do best on the bonier parts of the ankle.

For really bad pain, your physician may prescribe opioids. For chronic pain, such as with conditions like fibromyalgia, you may get a recommendation for an antidepressant or muscle relaxer.

Surgery is occasionally recommended to fix ankle pain, although this should be a last-ditch solution (see below). It’s more common to see ankle surgery immediately after an injury, like if a break is involved and must be stabilized internally.

Many ankle pain treatments are not long-lasting. These include:

• Ice
• Compression
• Oral medications

Even steroid injections must be repeated every few months, but they can’t be given indefinitely (nor will your insurance likely approve numerous injections, so you’d have to pay out of pocket).

Nearly all of the treatment methods above cover pain, but they do not address the root causes of pain. This doesn’t offer a long-term solution, and you could even do more damage to your ankle if your pain symptoms are masked.

As we said above, some treatments for ankle pain can get pricey. You may have insurance, but it may not cover what your doctor recommends, or you may be saddled with copayments and deductibles to satisfy. Over-the-counter treatments must come out of your own pocket.

Then there’s the issue of time off work. Most people can’t stay off their feet for long because they need to earn a living. Surgery, in particular, is punitive when it comes to lost wages, as you must generally plan for long downtimes to recover.

Medications and surgery can be downright hazardous. Risks associated with these treatments — even over-the-counter drugs you can buy at the drugstore — include:

• Serious side effects (AKA adverse events)
• Sedation that makes you unable to work
• Physical and psychological addiction
• Reactions to anesthesia
• Post-operative complications
• Nerve damage