Ankle
Ankle pain
Pain, stiffness or swelling in or around the ankle joint that most often comes from a sprain, overuse or wear of the joint, but which occasionally signals a fracture, an inflamed or infected joint, or a blood clot in the leg above it.
Education and reference only. This explains the common causes of ankle pain and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is ankle pain?
The ankle is a hard-working hinge that carries the whole weight of the body and is easy to injure, so ankle pain is extremely common. Most pain follows an obvious cause such as a twist, a roll or a fall, which sprains the ligaments and leaves the joint sore, swollen and bruised.
- Get urgent help: Go to A&E if you cannot put any weight on the ankle or stand on it after a twist or fall, or if the joint looks deformed or out of shape — this may be a fracture. Seek urgent same-day help if the ankle becomes hot, red, very swollen and intensely painful, especially with a fever — this can mean an infected joint or a gout flare.
- Self-care: For an ordinary sprain or a flare of a known joint problem, the simple approach of rest, ice, gentle compression and raising the ankle helps in the first day or two: protect the joint, apply a cold pack wrapped in a cloth for short spells, and keep the foot up to ease swelling.
About ankle pain
The ankle is a hard-working hinge that carries the whole weight of the body and is easy to injure, so ankle pain is extremely common. Most pain follows an obvious cause such as a twist, a roll or a fall, which sprains the ligaments and leaves the joint sore, swollen and bruised. Pain that builds up gradually without injury more often comes from wear of the joint surfaces, from overuse in someone who runs or stands a lot, or from an inflammatory form of arthritis that may also affect other joints. The character and timing of the pain offer clues: stiffness that is worst first thing in the morning and eases with movement points towards an inflammatory cause, whereas pain that worsens through the day and with activity points towards wear. Most ankle pain settles with rest and simple care, but a joint that is hot, red and swollen with fever, or one you cannot stand on after an injury, needs prompt assessment.
When to get help
Call 999 or go to A&E if ankle pain comes with any of these warning signs:
- Go to A&E if you cannot put any weight on the ankle or stand on it after a twist or fall, or if the joint looks deformed or out of shape — this may be a fracture.
- Seek urgent same-day help if the ankle becomes hot, red, very swollen and intensely painful, especially with a fever — this can mean an infected joint or a gout flare.
- Seek urgent help if the calf above the ankle is hot, swollen, tender or painful, as this can signal a clot in a deep vein.
- Seek urgent help for an injury with numbness, pins and needles, a cold or pale foot, or toes you cannot move, which can mean nerve or blood-vessel damage.
- See a doctor promptly if the ankle has been painful and swollen for weeks without injury, particularly if other joints are affected.
When to see a doctor
Most sprains and minor ankle pain settle within a couple of weeks with self-care and do not need a doctor. Seek emergency help if you cannot weight-bear after an injury, the joint looks deformed, or the foot becomes numb, pale or cold, and seek urgent same-day help if the joint is hot, red and swollen with fever. Book a routine appointment if pain is not improving after two to three weeks, keeps coming back, is waking you at night, or comes with stiffness and swelling in several joints, so the cause can be confirmed.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of ankle pain
Ankle pain has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
For an ordinary sprain or a flare of a known joint problem, the simple approach of rest, ice, gentle compression and raising the ankle helps in the first day or two: protect the joint, apply a cold pack wrapped in a cloth for short spells, and keep the foot up to ease swelling. After the initial soreness settles, gentle movement and gradually returning to normal activity help the joint recover better than complete rest. Supportive, well-fitting footwear, avoiding uneven ground while it heals, and keeping to a healthy weight all reduce the load on the joint. If pain follows overuse, ease back on the activity and build it up slowly. None of this replaces assessment for an injury you cannot weight-bear on.
Answers
Ankle pain: frequently asked questions
How do I know if my ankle is sprained or broken?
You often cannot tell from the outside. A useful guide is whether you can put weight on it: being unable to stand on the ankle or take a few steps after a twist or fall, or an ankle that looks misshapen, suggests a possible fracture and should be assessed at A&E.
How long should ankle pain take to settle?
A simple sprain usually improves noticeably within one to two weeks, though full recovery can take longer. Pain that is not settling after two to three weeks, or that keeps returning without injury, should be reviewed by a clinician.
Why is my ankle painful when I have not injured it?
Ankle pain without injury can come from wear of the joint, overuse, or an inflammatory arthritis such as rheumatoid or psoriatic arthritis, or a gout attack. Pain in several joints, morning stiffness, or a hot, red, swollen joint all point towards a cause that needs review.
Should I rest or keep moving a painful ankle?
Rest and raise it for the first day or two while the swelling is worst, then begin gentle movement as it allows. Returning gradually to normal activity usually helps a sprained ankle recover better than staying off it completely.
Sources
Where this is drawn from
- NICE CKS: Sprains and strains.
- Versus Arthritis: ankle pain.
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