Ankle Pain: Causes, Symptoms, and Treatment

Ankle pain refers to any pain in the ankle joint area, which comprises three main bones. These are the shin bone (or tibia), the fibula, and the talus¹. Pain in your ankle could be because of injuries to any one of these bones, or the components between them. Certain health conditions like osteoarthritis may also cause flare-up symptoms leading to ankle pain².

In this guide, we cover common ankle pain causes, frequent symptoms experienced with ankle pain, and various treatment options available.

The most common ankle pain causes fall under three categories: 1) injury, 2) arthritis, and 3) wear and tear³.

If you're feeling pain it may be due to:

• Ankle Sprain: Sprains usually result from an awkward turning, twisting, or rolling of the ankle. The ligaments that hold your ankle bones in place can become overstretched or torn from such movements. This can cause bruising, ankle pain and swelling³, and it may reduce your ankle's range of motion. Ankle sprains are a common injury among athletes.
• Ankle Strain: Much like a sprain, an ankle strain involves subjecting the ankle to movements that overstretch the ankle. The difference between a strain and a sprain³ is the parts of the ankle they affect. A strains affect the muscles or tendons surrounding the ankle, while a sprain affects the connecting tissues, or ligaments. Ankle strains may cause ankle pain and swelling, reduced range of motion, and muscle spasm³. It may cause bruising.
• Osteoarthritis of the Ankle: Osteoarthritis is a degenerative disease² that affects the body's joints (including the ankle) through the breakdown of cartilage between bones that form a joint. This can cause sharp pain in the ankle⁴ when walking, running, or partaking in other activities where pressure is applied to the ankle.

Learn more about arthritis joint pain in our guide here.

Learn more about the common causes of joint and muscle pain here.

• Overuse of Ankle: If you're suffering from aching ankles, you may due to overuse. Running excessively, like when training for a marathon, can cause an overuse injury¹.

Ankles are important joints that facilitate walking movement¹ and balance, so naturally, ankle pain can be a real drag.

Other ankle pain symptoms¹ that can impact quality of life

• Weakness or instability: a feeling that your ankle might give out or an inability to bear weight⁵
• Ankle Swelling: swollen and puffy ankles caused by excess fluid around the joint⁵
• Ankle Bruising: visible bruising on the exterior skin, commonly indicative of a sprained ankle⁵
• Ankle Stiffness or Limited Range of Motion: a feeling of "tightness" that prevents you from having a full range of motion in your ankle⁵

Most mild cases of ankle pain can be treated with over-the-counter options, rehabilitation, and at-home remedies⁵.

However, if your ankle pain is severe, especially following an injury that causes you to be unable to bear weight⁵, consult your healthcare provider to see whether you require a different form of ankle pain treatment.

Over-the-counter options for ankle pain include oral pain relievers and topical analgesics that provide soothing pain relief.

Oral pain relievers that may provide short-term pain relief for aching ankles⁶ include but are not limited to acetaminophen or a Non-Steroidal Anti-Inflammatories like Ibuprofen. Before use, check with your healthcare provider to see if over-the-counter options are suitable for the type of pain that you have.

Topical analgesics like Biofreeze topical products^* provide pain relief via external application. Biofreeze^* products are menthol-based, providing cooling sensations and pain relief for joint pain⁷. For a unique area like the ankle, Biofreeze Spray^* and Biofreeze Roll-On^* are perfect for targeted pain relief.

Those who are recently injured may have been prescribed the RICE method. RICE stands for rest, ice, compression, and elevation⁸. One of the main components of RICE is of course the ice, or cold therapy.

Ice can decrease inflammation⁹ at the site of injury and help reduce or control pain. Ice application has been proven to decelerate nerve activity¹⁰. This means it may slow the rate at which your pain signals fire, leading to a decrease in pain perception, and an increase in pain tolerance.

Cold therapy should be avoided¹⁰ if you have:

• poor circulation
• impaired sensory perception (not being able to tell if the cold application is too cold)
• cardiovascular or heart disease
• an open wound

Find out more about cold therapy in our guide, here.

Learn more about whether you should use heat or ice on muscle pain in our guide, here.

Heat therapy can also be useful in providing pain relief¹⁰. Heat therapy helps dilate blood vessels and increase blood flow¹¹, encouraging relaxation and recovery in stiff and sore muscles.

However, heat therapy should not be used if there is visible bruising, swelling, and/or inflammation¹⁰. Heat therapy should also be avoided if you have impaired sensory perception (not being able to tell if the heat application is too hot) and/or an open wound.

If you suffer from exercise-induced¹² pain, alternating between cold therapy and heat therapy may be an effective ankle pain treatment for pain relief, compared to just resting.

Physical therapy is a common pain treatment, particularly following an injury¹³. It can help restore strength, range of motion, and stability. If you've recently sprained or injured your ankle, you can expect to practice different ankle stretches and ankle strengthening exercises that promote recovery from injury and prevent future ones.

It is also not uncommon to have multiple physical therapy sessions per week when undergoing a physical therapy program¹⁴. While it may require more time and commitment upfront, physical therapy may be useful for longer-term preventative care.

In addition to the ankle pain treatments above, certain lifestyle changes can help to reduce the daily impact and stress on your ankles, minimizing the occurrence of pain.

Try the following:

• Take up biking or swimming as a cardiovascular exercise, (lessens the impact on your ankles while continuing to exercise and stay healthy)¹⁵
• Keep within a healthy weight (minimizes the stress on your joints, including your ankles)²
• Take it slow or stop completely if a movement or physical activity causes you ankle pain⁵
• Avoid running or walking on uneven surfaces, which can risk injury³
• Strengthen surrounding leg muscles to increase the flexibility and range of motion of your ankle⁵
• Choose proper and supportive footwear (this reduces fatigue and sore muscles in the foot and ankle area)³

While many cases of ankle pain may improve on their own with at-home pain treatments, there are instances where you should consult your healthcare provider about your ankle pain.

These include:

• After an injury that impacts your ability to bear weight on the ankle or that results in an open wound or deformity
• If your pain or swelling is severe and hasn't improved within two to three days of at-home pain treatment⁵
• If you experience pain and swelling that comes on suddenly

Even if you are not completely sure whether your ankle pain is serious, a healthcare provider can help you determine the cause of your pain, so you can treat it appropriately.

^{*Ensure this product is right for you. Always read and follow the product label.}