Ankle Joint consists of many bones, tendons, ligaments, cartilages and muscles. Injury, infection or inflammation of any of them can cause ankle joint pain. This article explains about the medical conditions that can cause pain in the ankle joints.
7 Major Medical Conditions That Can Cause Ankle Pain:
- Soft Tissue Inflammation– A Cause Of Ankle Joint Pain
- Arthritis of Ankle Joint Resulting In Ankle Joint Pain
- Ankle Joint Rheumatoid Arthritis
- Ankle Joint Osteoarthritis
- Ankle Joint Psoriatic Arthritis
- Ankle Joint Pseudo-Gout
- Ankle Joint Gout
- Ankle Joint Septic Arthritis Causing Pain in the Ankle
- Tarsal-Tunnel Syndrome Resulting in Ankle Joint Pain
- Bone Spurs Causing Ankle Joint Pain
- Ankle Joint Trauma
- Ankle Fracture
- Hairline Fracture
- Stress Fracture
- Avulsion Fracture
Let’s go over all of the above listed medical conditions that can cause ankle joint pain in detail.
Ankle Pain Caused By Ankle Joint Tendinitis
Inflammation of ankle joint tendon is known as tendinitis, which causes severe ankle joint pain. Inflamed tendon is often enlarged and swollen; inflamed tendon is extremely painful on examination.
Causes of Ankle Joint Tendinitis
- Overuse of Calf and Foot Muscle and Tendon-
- Athletes and jobs requiring long distance walk.
- Anatomical Abnormalities-
- Flat foot or high arch foot
- Rheumatoid Arthritis and Osteoarthritis.
- Blunt Trauma
- Penetrating Wound
- Cellulitis of surrounding tissue may spread to tendon.
- Infection of tendon following injury of the tendon.
Inflammation or Injury of Following Tendons Can Cause Ankle Joint Pain:
Pain Around Ankle Can Be Due To:
- Peroneal Tendinitis
- Recurring ankle sprain.
- Achilles Tendinitis –
- Most common sports injury.
- Posterior Tibial Tendinitis –
- Associated with flat foot.
- Flexor Tendonitis
- Pain mostly at the back of the foot.
- Extensor tendonitis
- Mostly occurs secondary to tight shoe.
Ankle Pain Caused By Ankle Bursitis
Inflammation of bursa is known as bursitis. Ankle bursitis causes extremely painful ankle joint pain. Bursas are placed between bone and tendon or ligament. Movements or transmission of weight along ankle joints results in extruciating ankle joint pain. Bursitis is often seen following injury and infection of soft tissue.
Ankle Pain Caused By Rheumatoid Arthritis Of Ankle
Rheumatoid Arthritis (RA) is an autoimmune form of arthritis in which the antibodies and the immune cells attacks joint tissue, causing inflammation, pain, and swelling. Any joint may be affected by rheumatoid arthritis, including the ankle joint resulting in ankle joint pain. Rheumatoid arthritis causes inflammation and thickening of synovial membrane and ligaments causing severe ankle joint pain.
Ankle Pain Caused By Degenerative Ankle Joint Arthritis?
Osteoarthritis is a degenerative arthritis. Untreated or long lasting osteoarthritis causes thinning of bones and ligaments resulting in degenerative arthritis. Ankle joint pain caused by osteoarthritis of ankle joint is associated with degeneration of the bones and joints.1
Is Osteoarthritis Self-Limiting Disease?
Osteoarthritis (OA) is not a self-limiting disease. Joint osteoarthritis if not treated may result in joint dislocation and tendon atrophy. Initial ankle joint pain is secondary to inflammation of synovial membrane and ligaments. During advanced stage of disease ankle joint pain is caused by dislocation or subluxation of the ankle joint.
Ankle Pain Due To Psoriatic Arthritis
Psoriatic ankle joint arthritis causes swelling and pain of the ankle joint resulting in severe sudden ankle joint pain. The ankle joint pain is associated with the psoriatic skin lesions. Many joints including the ankle joint is affected by psoriasis. Joint inflammation is periodic and ankle joint pain is seen during the joint inflammation. Ankle joint pain may be absent if the inflammation is diminished.
Gout- A Cause For Pain Around Ankle
Gout is a form of arthritis in which uric acid or monosodium urate crystals periodically deposit in ankle joints, causing severe ankle joint pain and swelling. Uric acid crystals induce inflammation of synovial membrane and ligament. The ankle may sometimes be affected by gout. Gout is most often seen over the big toe.
Pseudogout- Causing Ankle Joint Pain
Pseudogout means false gout. Pseudogout is caused by calcium pyrophosphate deposition over the cartilage or ligaments of the ankle joint. The term Pseudogout is used to indicate the similarities of the disease like gout. Both the diseases are caused by deposition of inorganic compound followed by inflammation of synovial membrane and ligaments. The ankle joint pain caused by pseudogout depends on crystal deposits inducing inflammation of synovial membrane and ligaments.
Ankle Pain Caused By Septic Ankle Arthritis
Septic ankle joint arthritis is an infection of the ankle joint resulting in ankle joint pain. Most common infection of the ankle joint is caused by bacterial infection. Septic arthritis develops quickly causing severe ankle joint pain, ankle joint swelling and fever. Joint movement and bearing weight on ankle joint causes severe ankle joint pain.
Causes of Septic Ankle Arthritis Are As Follows
- Blunt Trauma To The Ankle
- Penetrating Injury In The Ankle
- Impaired immune system- AIDS
Ankle Pain Caused By Tarsal Tunnel Syndrome
Tarsal tunnel syndrome (TTS) is a very painful disease resulting in severe ankle joint pain spread over ankle joint and bottom of the foot. Tarsal tunnel is covered by tibiocalcaneal ligament. Ligament is known as tarsal ligament and spread in oblique direction on the medial side of ankle joint. Tarsal ligament is attached to medial malleolus of tibia and calcaneus bone. Posterior tibial nerve along with artery, vein, and tendons passes through the tunnel under the tarsal ligament. The ankle joint pain is caused by irritation or pinch of the posterior tibial nerve within tarsal tunnel. Initial symptoms are pain and tingling. Later if disease is not treated symptoms could be permanent numbness and weakness.
Ankle Pain Due To Bone Spurs
Bone spurs are abnormal spiking outgrowth of the bone around the edge or border of the bone. Spurs may be observed over shaft or end of the bone involved in joint formation. Spur causes ankle joint pain when located within ankle joint or causes friction with tendon. Spurs may discharge bone fragments in the ankle joint and may cause ankle joint pain with joint movements.
Ankle Joint Sprain
Several bones forming the joint are held together by ligaments. Ankle joint sprain is caused by turn and twist of the ankle joint resulting in tear or injury of the joint ligaments. Damage to any one of the ligaments in the ankle can cause severe ankle joint pain with joint movement or weight bearing in standing position. Pain is less severe when foot is elevated in lying position. Restriction of joint movement also reduces pain.
High Ankle Joint Sprain Causing Ankle Joint Pain
High ankle joint is ligamental binding between tibia and fibula above talus bone. The ligament, which binds tibia and fibula is known as syndesmotic ligament. High ankle sprain resulting in ankle joint pain is caused by injury, tear or scratch of the syndesmotic ligament. A high ankle sprain causes less ankle joint pain than ankle sprain. Swelling and tenderness is often not noticeable. The ankle joint pain lasts for long time and healing is often prolonged.
Pain Around Ankle Due To Tendon Tear or Tendon Rupture
Rupture or tear of tendons supporting ankle joint is a common injury among average individuals, which results in ankle joint pain. Twisting or tripping of lower leg or foot often occurs while ambulating on uneven or icy surface. Such injury results in rupture of one of the tendon of ankle joint. Tendon is non-elastic tight band attached to hard surface of bone and muscle fibers. During fall or twist, tendon is stretched to maximum length. In addition to being stretched, tendon is pulled by vigorously contracting muscles. Muscle contraction is a protective reflex during any painful events. Stretched tendon may result in tear when pulled by contracting muscles while opposite end is anchored to bone.
Pain In The Ankle Due To Dislocation
Ankle dislocation is a separation of joint link resulting from forceful sliding of one of the bone. True ankle joint dislocation involves dislocation between tibia and talus, or fibula and talus. Ankle joint dislocation is often associated with fracture of medial malleolus bone. Ankle dislocation without fracture is very rare. Subtalar dislocation occurs between talus and calcaneus bone. Ankle joint dislocation causes severe and continuous ankle joint pain.
Causes of Ankle Joint Dislocations Are As Follows:
- Fall on uneven surface, ice or slope.
- Automobile or Work accident.
- Disabling Joint Disease- Advanced osteoarthritis.
Risk Factors for Ankle Joint Dislocation
- Old age
- Musculoskeletal Disorder- Muscle weakness and polio.
- Neurological Diseases- Peripheral neuropathy, numbness, and paresthesia.
- Frequent Fall- Epilepsy, dizziness, vertigo.
- Pre-Existing Advanced Arthritis- Osteoarthritis and Rheumatoid Arthritis.
- Slip and Fall- On slippery surface.
- Direct Impact
- Contact Sports- Like Wrestling, Football or Ice Hockey.
Ankle Joint Fracture
Ankle joint fracture involves break in any of the four bones in the ankle. Fracture of ankle joint mostly involves tibia and fibula. Most common fracture is medial malleolus and lateral malleolus bone, followed by lower end of tibia above medial malleolus. Fracture of talus and calcaneus is rare. Ankle joint fracture results in severe and continuous ankle joint pain.
Classification of Ankle Fracture
Types of Ankle Fracture-
- Hairline Fracture of Ankle– Bone pieces or segments are not displaced.
- Partial Separating Fracture of Ankle– Partial separation or shift is detected.
- Complete Separation Fracture of Ankle-Divided in several groups as follows-
- Comminuted Fracture of Ankle- Broken into several pieces
- Impacted Fracture of Ankle- Bone fragments are impacted into adjacent fragments of fracture bone.
- Avulsion Fractures of Ankle- Fragments of the bone are displaced at adjacent position.
Causes of Ankle Fracture
- Injury– Fall, direct impact caused by auto or work accident.
- Degenerative Joint Disease– Osteoarthritis.
- Sport Injury– Fall, stress on impact over outstretched upper extremity.
Watch Video Of Causes of Ankle Joint Pain
Ankle osteoarthritis: etiology, diagnostics, and classification.
Barg A, Pagenstert GI, Hugle T, Gloyer M, Wiewiorski M, Henninger HB, Valderrabano V.FootAnkle Clin.2013 Sep;18(3):411-26. doi: 10.1016/j.fcl.2013.06.001.Orthopaedic Department, Osteoarthritis Research Center Basel, University Hospital of Basel, University of Basel, Spitalstrasse 21, Basel CH-4031, Switzerland; Harold K. Dunn Orthopaedic Research Laboratory, University Orthopaedic Center, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA. Electronic address: [email protected]
- Ankle dislocation without fracture.
Wroble RR, Nepola JV, Malvitz TA.
Foot Ankle.1988 Oct;9(2):64-74.
University of Iowa Hospitals and Clinics, Department of Orthopaedic Surgery, Iowa City.