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Tarsal and ankle pain - symptoms, description and treatment

Author MUDr. Peter Bednarčík CSc.

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Ankle pain
Ankle pain

Does your ankle or tarsals hurt and feel swollen or stiff? Pain can be the result of a previous injury, but there can be many causes.

These difficulties can also be related to various diseases. They can affect both men and women and are more common in the over 65 age group. [1]

Find out what the causes of heel and ankle pain are and what treatment options are available. How to suppress pain in the ankles and ankles? Read more here.

Tarsal and ankle pain - symptoms

Ankle:

  • Pain, swelling, bruising – may indicate an ankle sprain.
  • Ankle and heel pain, calf pain when standing on tiptoes – it may be Achilles tendonitis.
  • Dull pain, redness and swelling – possible bursitis (inflammation of the joint capsule).
  • Sudden sharp pain in the ankle with swelling, unusual angle of the ankle, pain in the ankle when stepping on it – it may be a fracture of the ankle.[2]

Instep:

  • Pain, swelling, stiffness and a “popping” sensation when moving the leg – typical of tendonitis, arthrosis.
  • Reddened, warm skin, sudden pain when touched on the foot – a possible cause is gout. [3]
Notice

Only a doctor can make a correct diagnosis. Do not use this or any other article on the internet to make a diagnosis. Don’t put off seeing a doctor and address your condition early.

Tarsal and ankle pain - Description and causes

Ankle pain on the outside of the ankle occurs with ankle sprain
Ankle pain on the outside of the ankle occurs with ankle sprain

What is pain in the tarsals and ankles

Tarsal and ankle pain occur in any part of one or both ankles and insteps. [4] The pain may be sharp, burning or numbing. In some cases the pain comes on suddenly, in others it gradually worsens. [5]

The painful sensations are sometimes accompanied by swelling, reddened skin or bruising. [6 ] It is usually not a serious problem, but it can make life very uncomfortable[7].

Ankle pain on the outside of the ankle occurs when the ankle is sprained – ankle sprain.

Situation 1 in the picture means an ankle sprain with inversion, rolling the foot with the toe up. In which the external ligaments may be stretched.

Situation 2 illustrates an ankle sprain with eversion, an upward rotation of the foot with the malleolus, which may be accompanied by a stretching of the internal ligaments.

Situation 3 shows an ankle injury by torsional movement of the leg, rotation about the axis.

Causes of tarsal and ankle pain

Ankle pain when walking may be related to a fatigue fracture of the humerus
Ankle pain when walking may be related to a fatigue fracture of the humerus

The main causes of  pain of ankle include:

  • Intense physical activity(typical is pain of ankle  during running or sports involving jumping),
  • foot deformities,
  • injuries (for example, fatigue fracture),
  • inappropriate shoe shape and size,
  • unusual shape or size of the arch and toes,
  • being overweight (excessive load on the lower limbs). [8]
Ankle pain when running - flatfoot may be the cause
Ankle pain when running - flatfoot may be the cause

Ankle pain usually has the following origin:

  • Injuries (fractures and sprains),
  • tendonitis,
  • bursitis (inflammation of the joint capsule),
  • arthritis (rheumatoid arthritis or gout),
  • flatfoot. [9]

Diagnostics

The doctor uses X-rays, magnetic resonance imaging (MRI) and computed tomography (CT) to find the cause of the problem . Each of these examination methods has a different significance – X-rays can reveal a fatigue fracture, while CT and MRI show the soft tissues in the ankle area.

Of course, a physical examination of the lower leg in standing and sitting positions and a check for mobility, swelling or tenderness. [10] ,[11]

Did you know?

  • Ankle sprains are one of the most common causes of pain of ankle . Up to 85% of all ankle injuries fall into the “sprain” category. [12]
  • Pain in the lower limb affects up to 87% of all adults during their lifetime. [13]

Complications when left untreated

If  pain with or without swelling limits daily activities and does not improve even after two weeks of home self-treatment, it is advisable to see a doctor. This is especially true for diabetics, where lower limb problems and changes in sensitivity can indicate complications of diabetes. [14]

Unaddressed pain can cause:

  • chronic pain,
  • limitation of mobility.

Relief positions or limping due to pain can cause back and hip pain. [15]

Chronic pain

Chronic pain

Restriction of mobility

Restriction of mobility

Back pain

Back pain

Hip pain

Hip pain

Notice

We recommend not postponing treatment of tarsal and ankle pain

Do not delay treatment for tarsal and ankle pain , and if you have any health problems or doubts about your health, see a specialist. This will prevent unnecessary health complications.

Treatment of tarsal and ankle pain

Conservative treatment of ankle pain
Conservative treatment of ankle pain

Treatment of ankle pain is usually done conservatively in a home setting. The first step is usually:

  1. Rest (especially when internal pain of ankle  occurs after an injury),
  2. cold compresses(will relieve swelling),
  3. compression (elastic bandage is used),
  4. elevated limb (relieves swelling, elevated position is possible even at night).

Ankle pain - what to do next?

Over-the-counter analgesics (painkillers), braces or orthotic shoe inserts can also provide pain relief.

In case of more severe problems, injections with corticosteroids, which have an anti-inflammatory effect, can help. Surgical treatment applies, for example, to patients with torn ligaments or tendons. [16]

Similar precautions apply in the treatment of ankle pain. Wearing appropriate footwear is also an important step – shoes should be reasonably wide, comfortable and without high heels. [17]

Notice

Attention

Treatment for tarsal and ankle pain can only be determined by your doctor after considering your overall health. Therefore, do not use this article as a guide to treatment, which can only be determined by a doctor.

The importance of physiotherapy and exercise

Physiotherapy has its place in the treatment of tarsal and ankle pain pain for several reasons: appropriate exercises will strengthen the muscles, improve mobility and reduce the risk of injury.

  • Your physiotherapist will recommend the right stretching and strengthening exercises .
  • Exercise regularly.
  • Take time to warm up the soft tissues before exercising to prevent injury. [18]

Prevention of tarsal and ankle pain

Preventive measures relate to both an active lifestyle (regular physical activity, maintaining the right weight) and foot care.

  • Healthy orthopedic shoes should be roomy enough, comfortable and without high heels.
  • Hammer toes and flat feet can also be a risk, so it is worth seeking podiatric care (a specialty that deals with foot care) for these problems. [19],[20]
Notice

Important infromation when dealing with tarsal and ankle pain

  • Tarsal and ankle pain can be related to injuries, long-term overuse or certain diseases (e.g. arthritis).
  • Conservative treatment includes rest, cold compresses and exercises to strengthen the muscles.
  • For pain of tarsal and ankle, don’t forget comfortable shoes and relief positions for the lower limbs.

Summary and recommendations for the management of tarsal and ankle pain

1.

See a doctor

The treatment of tarsal and ankle pain is always determined by a doctor based on a general examination, an assessment of your health and an accurate diagnosis.

2.

Causal treatment of tarsal and ankle pain

After a general examination, your doctor will recommend treatment for the cause of your tarsal and ankle pain. They will also advise you on possible lifestyle adjustments and the next course of action.

3.

Relieving pain, swelling and inflammation

Symptomatic treatment focuses on the symptoms of the disease. Such treatment can significantly improve your quality of life and support comprehensive treatment during the course of the disease.

Sources, references and literature

[1] Ankle Pain. Cleveland Clinic, 26. 12. 2020. Available at: https://my.clevelandclinic.org/health/symptoms/15295-ankle-pain

[2] Ankle pain. NHS, 22. February 2022. Available at: https://www.nhs.uk/conditions/foot-pain/ankle-pain/

[3] Pain in the top of the foot. NHS, 15. February 2022. Available at: https://www.nhs.uk/conditions/foot-pain/pain-in-the-top-of-the-foot/

[4] Benjamin C. Ankle Pain. Medline Plus, 24. April 2023. Available at: https://medlineplus.gov/ency/article/003167.htm

[5] Metatarsalgia. Mayo Clinic, 3. November 2021. Available at: https://www.mayoclinic.org/diseases-conditions/metatarsalgia/symptoms-causes/syc-20354790

[6] Pain in the top of the foot. NHS, 15. February 2022. Available at: https://www.nhs.uk/conditions/foot-pain/pain-in-the-top-of-the-foot/

[7] Metatarsalgia. Mayo Clinic, 3. November 2021. Available at: https://www.mayoclinic.org/diseases-conditions/metatarsalgia/symptoms-causes/syc-20354790

[8] Metatarsalgia. Mayo Clinic, 3. November 2021. Available at: https://www.mayoclinic.org/diseases-conditions/metatarsalgia/symptoms-causes/syc-20354790

[9] Ankle Pain. Cleveland Clinic, 26. 12. 2020. Available at: https://my.clevelandclinic.org/health/symptoms/15295-ankle-pain

[10] Metatarsalgia. Mayo Clinic, 3. November 2021. Available at: https://www.mayoclinic.org/diseases-conditions/metatarsalgia/symptoms-causes/syc-20354790

[11] Ankle Pain. Cleveland Clinic, 26. 12. 2020. Available at: https://my.clevelandclinic.org/health/symptoms/15295-ankle-pain

[12] Phillips N. What to Know About Ankle Pain. Healthline, 9. November 2019. Available at: https://www.healthline.com/health/ankle-pain#TOC_TITLE_HDR_1

[13] Foot Problems. Health In Aging, February 2023. Available at: https://www.healthinaging.org/a-z-topic/foot-problems/basic-facts

[14] Ankle pain. NHS, 22. February 2022. Available at: https://www.nhs.uk/conditions/foot-pain/ankle-pain/

[15] Metatarsalgia. Mayo Clinic, 3. November 2021. Available at: https://www.mayoclinic.org/diseases-conditions/metatarsalgia/symptoms-causes/syc-20354790

[16] Ankle Pain. Cleveland Clinic, 26. 12. 2020. Available at: https://my.clevelandclinic.org/health/symptoms/15295-ankle-pain

[17] Metatarsalgia. Mayo Clinic, 3. November 2021. Available at: https://www.mayoclinic.org/diseases-conditions/metatarsalgia/symptoms-causes/syc-20354790

[18] Ankle Pain. Cleveland Clinic, 26. 12. 2020. Available at: https://my.clevelandclinic.org/health/symptoms/15295-ankle-pain

[19] Ankle Pain. Cleveland Clinic, 26. 12. 2020. Available at: https://my.clevelandclinic.org/health/symptoms/15295-ankle-pain

[20] Pain in the top of the foot. NHS, 15. February 2022. Available at: https://www.nhs.uk/conditions/foot-pain/pain-in-the-top-of-the-foot/

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