Pain in the knees, feet and ankles is often caused by strain or overuse — but not always. The specific cause isn’t always obvious. It could be something like repetitive movements or even poorly fitting shoes. Pain in your ankle is usually an important cue to slow down, get some rest and explore what might be happening. At KC Rehab, we treat ankle pain caused by common conditions such as tendinitis, bursitis, arthritis and other musculoskeletal conditions.
Are you only noticing your ankle pain at night? There are a few reasons why this happens. First, you may not notice pain from overuse right away while you’re up and moving around. If you spend a lot of time on your feet, especially if you’re not wearing supportive shoes, sitting down at night can take pressure off your joints. When you relax and your circulation slows down, inflammation and stiffness can flare up. There are also fewer distractions competing for your attention at night, so you may be more likely to notice pain in your body.
So where does sudden ankle pain come from if you haven’t injured yourself? This article describes seven potential causes.
What can cause ankle pain with no injury?
Bursitis and tendinitis are two common conditions that can cause sudden ankle pain with no apparent injury. They occur when the fluid-filled sacs (bursae) inside your joints or the tendons that attach muscles to bones become irritated and inflamed. Bursitis and tendinitis are usually a result of overuse or stress on a specific joint. Osteochondral lesion of the talus (OLT) is another musculoskeletal issue that can develop from an old injury or overuse. It’s a buildup of cartilage or bone at the top of the lower bone in your ankle.
Different forms of arthritis, autoimmune conditions and infections can also cause sudden ankle pain. People typically notice gout in their feet and ankles first. Osteoarthritis happens slowly over time, and people develop it in different places, including the ankles. If bacteria gets into your bloodstream through an open wound, a surgical incision or an ulcer, it can cause an infection in the bones or joint of your ankle. Also, infections in other parts of the body can cause reactive arthritis in your ankle joint.
7 common causes of ankle pain without injury
The current function of your ankle joint, your medical history and your other symptoms will be important clues as to what might be causing your ankle pain. If you go to a physical therapist, they’ll begin with an in-depth assessment to get a clear picture of what’s happening and narrow down some likely causes. From there, they’ll develop a personalized treatment plan to reduce your pain and address any structural problems, help you heal and strengthen the affected tissue.
The following seven conditions can cause sudden ankle pain without injury:
Arthritis — Osteoarthritis is a degenerative joint condition that happens over time. You may notice ankle pain develop suddenly or over time, but it could also be a different kind of arthritis. Gout is the buildup of tiny uric acid crystals in your joints. People often notice it first in their big toe or their ankle, and there are some dietary changes that may help. Finally, reactive arthritis in your ankles can be a result of an infection elsewhere in the body, for instance, your bowel or genitals.
Bursitis — Most joints, including the ankles, have bursae. These are small fluid-filled sacs that cushion the bones where they meet. They can become inflamed from overuse, stress or a traumatic injury. Arthritis and poorly fitting shoes can also cause bursitis in the ankle.
Achilles tendinitis — The Achilles tendon connects your heel to your calf muscle. Like bursitis, overuse, stress or an injury can cause it to become inflamed. Tendons often weaken as people age, so older people who are active may be more likely to develop Achilles tendinitis.
Irregular arches — Fallen arches and flat feet can both cause ankle pain. People with flat feet usually develop the condition during childhood, and it’s called fallen arches when it develops later on. People get fallen arches when their posterior tibial tendon is injured or worn. Arch supports are usually necessary to prevent ankle pain.
Osteochondral lesion of the talus (OLT) — A previous ankle injury, like a sprain or overuse, can cause the lower bone in your ankle joint to build up fragments of cartilage and damaged bone. It’s often asymptomatic, but it can become painful. You may notice pain more when you’re jumping or running, and you may hear a clicking or popping sound.
Autoimmune conditions — Rheumatoid arthritis, scleroderma and lupus are all autoimmune conditions that can cause painful swelling, inflammation and thickening in the ankles without an injury.
Infection — Bacteria such as staphylococcus aureus, streptococcus and enterobacter can all cause painful joint and bone infections. They may enter the bloodstream through an open wound, a surgical incision or an ulcer; other symptoms include warmth, swelling and redness at the site of infection, as well as fever and fatigue.
How can physical therapy help with ankle pain?
The best course of treatment will depend on what’s causing your ankle pain. After an in-depth assessment, your PT will be able to make more specific recommendations. Often, physical therapy for ankle pain begins with some manual techniques designed to break up stiffness, mobilize the ankle joint and increase your range of motion. This improves circulation in the area and helps your body repair damaged tissue faster.
Your physical therapist may use the following treatments for ankle pain:
Manual therapy — Using their hands or stainless steel instruments, your physical therapist will try to break up points of stiffness to get your ankle joint and surrounding tissue moving with less pain. For many patients, manual therapy provides fast results.
Dry needling — Dry needling is another passive technique that’s intended to stimulate blood flow and promote healing. It’s not the same thing as acupuncture — dry needling is more targeted to a specific area. Your PT will use thin needles to stimulate deep layers of tissue to trigger a healing response.
Therapeutic exercise and stretching — Once you can move your ankle with less pain, your physical therapist will likely show you some exercises and stretches that will help strengthen muscles and connective tissue connected to your ankle. They’ll choose specific exercises to maintain circulation and keep tissue healthy, correct imbalances, and strengthen weak areas.
Find out what’s causing your ankle pain and find relief at KC Rehab
To find out what’s causing your ankle pain, you should see a physical therapist for an assessment. At KC Rehab, during your first session, we can perform tests and provide treatments to help reduce your pain. Some people notice results right away. You don’t even need a referral from your doctor, and most insurance plans cover physical therapy treatments.
Wondering what to expect during physical therapy sessions? We love educating our patients about their health and their condition to engage them with their own treatment process. Our treatments are natural and noninvasive, so they support your overall health as you recover. We work with you to make sure your treatment plan makes sense for your life, and we often recommend lifestyle adjustments aimed at long-term healing and wellness. See our FAQs page to learn more and find out how to prepare for your first appointment.
Ready to try physical therapy for your ankle pain? We can help. Contact our team today for more information or to schedule an initial appointment.
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