When Is Ankle Pain Serious?

The ankle is a hinged joint that enables upward and downward flexion and movement of the foot. It’s made up of three bones: the fibula (lower leg bone), tibia (shinbone) and the talus, the bone that connects the leg and foot. The joint is protected by ligaments, tendons and cartilage that protect, support and stabilize the joint. 

Ankles are mobile, weight bearing joints, which means they’re vulnerable to injuries, damage and pain. Even a minor injury can cause significant pain and discomfort because the ankle is responsible for bearing weight when we move and walk. Ankle pain may stem from multiple causes, including acute injuries or a medical condition. You may have minor pain or stiffness after being physically active or walking for a long period of time. 

But if you’re experiencing persistent or chronic pain, keep reading to learn when you may have a serious injury.  

Signs and Symptoms of Serious Ankle Injuries

Any type of damage or injury to the bones, muscles, ligaments or tendons of the ankle can cause pain and symptoms. Mild injuries with pain, stiffness or swelling usually resolve with a few days of at-home care. However, significant ankle injuries and ankle damage caused by a medical condition require medical care and treatment.     

If you’re experiencing any of the following signs and symptoms of injury, see your doctor as soon as possible for an evaluation.

• Pain and swelling that lasts longer than a few days
• Redness, warmth or tenderness around the joint
• Stiffness and loss of range of motion
• Looseness or instability of the joint
• Inability to walk or put weight on the foot and ankle
• Visible deformity

There are multiple medical conditions and injuries that cause ankle pain and other symptoms. Your doctor will be able to make an accurate diagnosis and help you get the treatment you need for healing.      

5 Injuries and Conditions That Cause Ankle Pain

Because the ankle is a mobile, weight bearing joint, it’s prone to injuries. Ankle pain may have one of the following causes.  

1.) Sprain. A sprain is the most common type of ankle injury. It’s a soft tissue injury that occurs when your foot and ankle roll or twist sideways, causing the ligaments around the joint to tear or overstretch. Sprains usually develop during physical activities like sports or running, or from an accident where you trip and fall. A sprained ankle causes pain and swelling, tenderness and bruising around the joint. You may have difficulty walking or bearing weight on it.    

2.) Tendon injuries. The ankle contains three primary tendons: the achilles tendon and two peroneal tendons that stabilize the joint. Overuse, repetitive use movements and injuries like sprains or strains can cause inflammation, tears, tissue breakdown and degenerative changes to develop in the tendons. Acute tendon injuries cause pain, swelling and difficulty bearing weight around the joint. Chronic injuries that don’t heal properly and long-term degenerative changes cause pain, weakness and joint instability.   

3.) Osteochondral lesions of the talus. Osteochondral lesions damage the talus bone and overlying cartilage that protects it. Injuries like sprains or fractures can lead to cartilage damage and blisters, lesions, cysts or fractures on the underlying talus bone. Initial diagnostic exams like X-rays may not reveal osteochondral defects, which is one reason why this type of injury is over underdiagnosed and undertreated. Osteochondral lesions cause ankle pain with weightbearing, stiffness, swelling, locking or catching of the joint and decreased range of motion.     

4.) Fractures. Sports collisions, falls, car accidents and sudden twisting or rolling of the ankle joint can cause traumatic fractures to develop. Repetitive stress and impact on the joint may cause a stress fracture to develop. Pain, swelling and an inability to bear weight are the most common fracture symptoms.  

5.) Arthritis. Arthritis can cause ankle pain. Osteoarthritis is the most common type of arthritis and impacts millions of people in the U.S. Also known as “wear and tear” arthritis or degenerative arthritis, it’s a condition that develops when the protective cartilage covering the ends of bones begins to wear down and erode. Natural wear and tear on the joint with age, chronic overuse or a history of ankle injuries, genetics and a history of performing high-impact activities with repetitive motions can cause osteoarthritis. It’s a progressive disease that eventually leads to the breakdown and deterioration of joint cartilage, underlying bone and connective tissues. Another common type of arthritis is rheumatoid arthritis, an autoimmune disorder that develops when the body’s immune system begins attacking its own tissues. Rheumatoid arthritis causes inflammation in the ankle joint lining and progressive deterioration of the joint cartilage, underlying bone and connective tissues.  

Treatment Options

The most common course of treatment for ankle pain and injuries is RICE: rest, ice, compression and elevation. You can take over-the-counter anti-inflammatories like ibuprofen to reduce pain, swelling and inflammation. For more severe pain that doesn’t resolve within a few days, your doctor may recommend cortisone injections, assistive devices like orthotics and physical therapy to help improve your strength and range of motion. 

The treatments listed above usually have good results for healing acute or minor ankle injuries. However, a history of multiple injuries that don’t heal properly or a degenerative condition like arthritis may lead to chronic pain, progressive degeneration of the joint and loss of mobility that can’t be treated with conservative measures. Rest, medications and physical therapy can help reduce symptoms of arthritis and chronic joint pain, but they can’t treat the underlying damage and degeneration.

Surgical options are available to treat fractures, severe sprains, damaged or torn ligaments and tendons, cartilage damage and joint degeneration. Two common surgeries to treat arthritic ankles joints are ankle fusion and joint replacement surgery. While both procedures are typically successful at relieving pain, they come with significant downsides.

• Fusion surgery decreases movement and mobility in the ankle and forces nearby joints to overcompensate with increased movement. Over time, increased movement may cause arthritis to develop in the joints.
• Joint replacement surgery allows the ankle to retain a wider range of motion. However, artificial joints may become damaged or loose from high-impact physical activities or stress and pressure placed on the joint.

If you’ve been told you need surgery to treat an ankle injury or condition, there may be another option for you.

iO-Core Treats Arthritis and Joint Pain

If you’re experiencing chronic pain and loss of movement from arthritis or another degenerative condition, then the iO-Core™ procedure may be a viable treatment option for you. iO-Core™ is a minimally invasive procedure that combines orthopedics and biologics to treat degenerating cartilage and underlying bone and tissue damage caused by arthritis. 

Treating the underlying damage and not just the surface layer of cartilage has shown better results over “standard of care” methods in decreasing pain and improving mobility for many patients. Many people who were told they needed a total joint replacement surgery have found long-term pain relief from iO-Core™ instead.  

Contact us today to see if you qualify for the iO-Core™ procedure.