Where Does Nerve Pain in the Ankles Come From?
As an average person, you take 5,000 to 7,000 steps every day. So it's not surprising that ankle pain is one of the most common medical complaints. Since your ankles are subject to so much stress, ligaments, joints, and tendons will all have problems that lead to pain.
Sprains and fractures
Ankle sprains are one of the most common injuries. Sprains are injuries to the ligaments of the ankle, causing them to tear from sudden stretching. A sprain can happen on either or both of the inner and outer portions of the ankle. The typical injury occurs when the ankle is suddenly "twisted" in a sports activity or by stepping off an uneven surface. The pain is initially severe and can be associated with a "popping" feeling. Immediate swelling happens as the injured blood vessels leak fluids. You will feel severe pain when the ankle is moved. Sprains are commonly evaluated with an X-ray. X-rays can determine whether there is an accompanying fracture of the bone. Ankle fractures can occur without significant trauma in people with weak bones, such as from osteoporosis. Sometimes these fractures are tiny stress fractures along the bone. These are typically associated with pain and tenderness.
Severe ankle sprains are treated with ice, rest, and limiting the amount of walking and weight put on the injured ankle. You can elevate your ankle to reduce swelling, and crutches are recommended to keep weight off the injured ligaments. Anti-inflammatory medications can be used and ice packs help decrease swelling of the area and reduce pain. Broken ankles can go along with ankle sprains or can happen without a sprain. Fractures are mended by wearing a cast to immobilize the bone for healing. Depending on how bad the break is, surgery may be needed.
If you have tendonitis, you have an inflammation of the tendon. Ankle tendinitis is usually the result of a sudden injury or from overuse. All forms of tendonitis cause pain, swelling, and tenderness in the area involved. Initial treatment for tendinitis includes immobilizing the ankle, limiting weight-bearing, applying ice, elevating the ankle and using anti-inflammatory drugs. More severe tendinitis may require wearing a casting. Physical activity should be limited while the tendon is inflamed, because there is a considerable risk of rupturing or tearing the tendon.
Inflammatory types of arthritis that can be found in your ankle area include rheumatoid arthritis, reactive arthritis, gouty arthritis, and psoriatic arthritis. They are not caused by traumatic injury, but develop over time. You will have to have a complete evaluation by a doctor, along with blood tests, for a definite diagnosis. The various types of arthritis produce ankle nerve pain, stiffness, swelling, redness, and warmth in the ankle.
Infections in the ankle joint are uncommon. They usually happen as a result of bacteria getting into the joint as the result of puncture wounds or other injuries that break the skin. Patients with impaired immune systems such as those with AIDS, or other immune diseases, are at an increased risk of infections in the joints, including the ankle. Also, patients with diabetes or those who take cortisone medications have an increased risk for bacterial infections of the joints. Bacterial joint infections are serious and require drainage and antibiotics, usually intravenously.
The peroneal tendons are found on the outside of the ankle, just behind the fibula bone. Tendons connect muscle to bone. Tendinosis means there is enlargement and thickening with swelling of the tendon. This usually occurs from overuse, when you do a repetitive activity that irritates the tendon over a long period of time.
If there is stabbing pain in the ankle during an exam on the peroneal tendons,you may also have weakness in the ankle. An ultrasound is a very effective way to assess the tendons and can show abnormalities. An MRI is also equally important and can also show a tear.
Most cases of peroneal tendinosis get better without surgery. It can usually heal with rest. If there is significant pain, an orthopedic boot might be necessary for several weeks. An ankle brace may be the next best step. You should limit how much you are walking or on your feet until the pain subsides. This may take several weeks. It is important to talk to your doctor about changing your training. This includes getting new shoes with more support for running and cross-training. This also means alternating your physical activities each day. Physical therapy is also very important to strengthen the tendons.
You will fully recover, but it can take a fair amount time. You have to be patient and allow the tendon to completely heal before becoming active again. If you have to have surgery, your recovery time will increase substantially. The doctor may instruct you not to put weight on your foot for about six weeks.
If you do as the doctor instructs, the outcome is usually good. It will just take time. It will vary from person to person, however, before you can get back to your previous level of activity. If the tendinosis is not seen to, it may lead to the tearing of the tendon. It can also lead to a sprained ankle. If you have to have surgery, infection can develop. Ankle nerve pain and damage is also a possibility if the nerves along the side of the foot,which provide feeling in the foot,are cut or stretched.