Ankle Pain

Pain Symptoms· Also known as: sore ankle, painful ankleUpdated Oct 2026

Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026

At a Glance

Ankle pain is a symptom with many possible causes, not a single condition. About 15 per cent of adults aged 45 and over have frequent ankle pain. The commonest cause is a sprain, which is a stretched or torn ligament (a tough band that joins bones), usually on the outer side of the ankle. Other causes include broken bones, overuse problems such as Achilles tendon pain, and arthritis. Most new foot and ankle pain improves within 6 to 8 weeks, and the right care for the cause helps you recover well and lowers the chance of it coming back.

What is it?

Ankle pain is pain in or around the joint where your foot meets your lower leg. It is a symptom, not a diagnosis. Many different problems can cause it, so working out the cause is the first step.

It can be sharp and sudden after a twist or fall, or it can build up slowly over weeks or months. It can be strong, but it is usually not caused by serious damage. Some patterns do need urgent care, and they are listed at the end of this page.

What can cause it?

The commonest cause is an ankle sprain. A sprain is damage to a ligament (a tough band that holds your bones together). More than three-quarters of sprains happen on the outer side of the ankle. Sprains in other spots, such as the ligaments higher up between the two lower leg bones, are less common.

Other causes, roughly from the more to the less common, include:

A broken bone or stress fracture (a small crack from repeated load). A snap, grinding or pop at the time of injury, an odd shape, or not being able to put weight on the foot can all point to a break.
Damage to the ligaments between the two lower leg bones. This can be missed at first, especially when X-rays look normal. If it isn't picked up, it can cause lasting pain and a wobbly ankle.
A wobbly, unstable ankle that keeps giving way. This can follow a first sprain.
A ruptured Achilles tendon (the thick cord at the back of your ankle). There is often a sudden snap or pop, followed by loss of muscle power. Up to 20 per cent are mistaken for a sprain.
Overuse problems, such as Achilles tendon pain and plantar fasciitis (pain under the heel). Doing too much exercise or wearing shoes that are too tight can also bring on ankle pain.
Osteoarthritis (wear and tear of the joint). This is more likely from age 45, with pain that comes on with activity and morning stiffness of no more than 30 minutes.
Infection. A hot, red, swollen, painful ankle with a fever needs urgent attention.
Charcot arthropathy, where the joint suddenly changes shape and becomes red, hot and swollen.
Other causes: bursitis (an irritated cushion of fluid near a joint), pain referred from somewhere else, and nerve pain.

It isn't possible to work out the cause by yourself, so try not to guess. A podiatrist, physiotherapist or GP can sort it out with you.

Who gets it?

Ankle pain can happen at any age. About 15 per cent of adults aged 45 and over have frequent ankle pain. Foot and ankle pain is more common in women, and in women it becomes more common with age.

Sprains are one of the most common injuries of muscles, bones and joints. They make up 16 to 40 per cent of sport-related injuries. Females have a higher risk of an outer ankle sprain than males. Being taller, and having certain ankle joint shapes or foot postures, are also linked to a higher risk.

How is the cause found?

Your practitioner will start by asking how the pain began, where you feel it, what makes it better or worse, and whether you could put weight on the foot straight away. It helps to note down whether there was an injury, a fall, a change in activity or new shoes.

They will then press along the ankle to find the sore spots and test how it moves. After an injury, they use a set of checks called the Ottawa ankle rules to decide whether you need an X-ray to look for a broken bone. You don't need an X-ray or scan for every sprain.

If pain and swelling make the first check difficult, expect to be examined again a few days later. Checking the ligaments is more accurate then. An ultrasound can show damage to the outer ligaments. An MRI scan is kept for injuries that may be more serious, or for symptoms that last.

When the pain didn't start with an injury, the cause is mostly worked out from your story and an examination. Scans are used if the cause is unclear or if surgery is being considered.

Treatment

The right treatment depends on the cause. This section is mainly about a sprain and new ankle pain, which are the most common.

Looking after it at home

If you have no warning signs (see the end of this page), start gentle walking and stretching as soon as you can manage it. Staying active helps you recover better than keeping the ankle still. Cut back or adjust what you do at first rather than stopping completely, and build up gradually.

If you need support, a brace or tape works better than a simple compression bandage or tubigrip. Compression stockings don't help once the first few days have passed.

Anti-inflammatory medicines (NSAIDs), taken by mouth or put on the skin, can ease pain for the first couple of weeks. They can also have side effects and may slow natural healing, so ask your GP or pharmacist before using them.

If you have a plaster cast, keep it dry, don't scratch under it with objects, and don't carry heavy things. If you think your ankle is broken, don't try to treat it yourself.

Treatment from your podiatrist

Starting exercises early after a sprain lowers the chance of hurting the ankle again and is linked to a quicker recovery. Your podiatrist will usually give you a progressive exercise programme and check in on it. This is better than treatments where you stay still and things are done to you.

They may also use tape or a brace, and hands-on treatment to ease pain and swelling. If you have worn a boot or cast, ask what exercises to do when it comes off.

For non-injury ankle pain, the advice is to keep the foot and ankle moving gently, adjust your activity rather than stopping, and return to normal activities gradually.

Other options

A more complex sprain may need a boot or cast to hold the ankle still. A short time, under 10 days, can ease pain and swelling. Longer than that, at least 4 weeks in a cast gives poorer results than a supportive brace or tape plus exercise for 4 to 6 weeks.

If your ankle keeps giving way, balance training, such as wobble board exercises, has the widest benefits. It improves how the ankle works and feels, your balance, and your sense of where your ankle is in space. Other nerve and muscle training also seems to help in the short term. It isn't yet clear whether this benefit lasts. Check with your practitioner before starting these exercises.

If Achilles tendon pain hasn't improved in 3 months, your podiatrist can offer footwear advice, exercises, changes to your activity, shoe inserts, bracing, or shockwave therapy. An injection into the Achilles tendon isn't advised.

Surgery is kept for the few people who haven't improved after thorough exercise-based treatment. It should be talked through with a specialist.

Will it get better?

Most often, yes. Most new foot and ankle pain improves within 6 to 8 weeks. Soft tissue ankle injuries, such as sprains, usually take 4 to 6 weeks, depending on how severe they are.

Some people have lasting problems after a first outer ankle sprain, such as a wobbly ankle (chronic ankle instability). Estimates vary, from 40 per cent one year after a first sprain to as high as 70 per cent. Long-term instability is linked to lower activity, a lower quality of life, and more wear and tear in the ankle later on. That is a good reason to finish your rehabilitation instead of stopping when the pain eases.

Preventing it

The best ways to avoid repeat sprains are starting exercises early after an injury and wearing a brace or tape. Bracing or taping lowers the chance of a repeat sprain and of a first sprain, especially for people who play sport. Side effects are rare.

After a sprain, don't stop at pain relief. Ask your podiatrist or physiotherapist about an exercise programme that includes balance work. If you play sport and have sprained an ankle before, ask about bracing or taping.

Return to your usual activities gradually as pain allows. If exercise discomfort lasts more than 2 hours afterwards, do fewer repetitions next time.

When to see a podiatrist

When to book

Book an appointment with your podiatrist if your ankle pain is stopping you doing normal activities, is getting worse or keeps coming back, or hasn't improved after about 2 weeks of home care. Book too if you have tingling or loss of feeling in your foot, if your ankle feels unstable or keeps giving way, if it isn't recovering as a sprain should (even if your X-rays were normal), or if Achilles tendon pain hasn't improved in 3 months. If you have diabetes, have any ankle or foot pain checked, because foot problems can be more serious for you.

When to get help sooner

Call your local emergency number if a bone is sticking out through your skin, you have heavy bleeding, or your foot or toes turn blue, white or cold. Call too if you have a wound or infection and feel very unwell, with confusion or slurred speech, severe shivering or muscle pain, severe breathlessness, mottled or discoloured skin, or little or no urine, as this could be sepsis.

These signs need urgent medical assessment: see your GP today, or go to an urgent care clinic or the nearest emergency department. After an injury, go if your ankle is at an odd angle or has changed shape, you have a bad cut or wound, severe pain, or numb toes, if you heard a snap, grinding or pop, or if you can't put weight on the foot straight away or still can't after 48 hours. Go if you suddenly lose muscle power after a snap or pop, because a torn Achilles tendon can be mistaken for a sprain. Go if you have a hot, red, swollen, painful ankle or lower leg with a fever, in an adult or a child, or if your ankle suddenly changes shape. Go too if you have a major injury such as a fall from a height or a direct blow, loss of feeling or movement, or bruising or lumps you can't explain. Also go if you have severe pain that doesn't ease, with a fever, feeling unwell, weight loss, or pain that gets worse at night. If you think your ankle may be broken, don't try to treat it yourself.

Frequently asked questions

Do I need an X-ray for a sore ankle?

Not always. After an injury, your practitioner uses set checks (the Ottawa ankle rules) to decide. An X-ray is usually needed if there is pain around the ankle bones with tenderness over certain bony spots, or if you couldn't take 4 steps straight after the injury and when examined.

Why does my ankle keep giving way?

After a first sprain on the outer side of the ankle, some people are left with an unstable ankle (chronic ankle instability). It is linked to lower activity and, over time, to more wear in the joint. Balance training under guidance from your podiatrist or physiotherapist has the widest benefits.

Can ankle pain be a sign of arthritis?

Yes, particularly from about age 45. Typical signs are pain that comes on with activity and morning stiffness that eases within 30 minutes. Osteoarthritis can often be recognised from your story and an examination, without a scan. Your practitioner can talk you through the options.

Is it better to rest a sprained ankle completely?

Usually not. Starting gentle walking and stretching as soon as you can manage it helps you recover better than staying still. Reduce or adjust what you do at first, then build back up. A complex sprain may need a boot or cast, so follow your practitioner's advice.