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What Causes Sudden Ankle Pain Without Injury?

Ankle pain refers to discomfort, soreness, or inflammation experienced in the ankle joint, which is the joint connecting the tibia bone and the talus bone. The ankle joint also includes the fibula bone and several ligaments, tendons, and muscles that support the joint’s movements.

Although there are many causes of ankle pain, such as sprains or fractures, ankle pain can have causes due to underlying conditions, and can come on suddenly. A study involving over 18,000 participants aged 55 and older found 86% self-reported foot and ankle pain, but sudden ankle pain can strike those of any age.

Learn more about what conditions can cause ankle pain to come on suddenly and how to protect your feet and ankles in the future.

Arthritis Can Cause Joint Pain

What Causes Sudden Ankle Pain Without Injury?

Many types of arthritis may cause sudden ankle pain. Regardless of the type of arthritis, the underlying cause of joint pain is inflammation.

Inflammation is the body’s natural response to injury or infection, but in the case of arthritis, it can become chronic and ongoing. This ongoing inflammation can damage the joint tissues and cause pain, stiffness, and swelling in the affected joint.

In addition to inflammation, arthritis can also cause joint pain by affecting the nerves that transmit pain signals to the brain. As the joint tissues become damaged and inflamed, the nerves in and around the joint can become more sensitive, making even minor movements or pressure on the joint pain.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease that primarily affects the joints, causing inflammation, pain, and stiffness. It is a chronic condition that can affect various joints, including the ankles. The ankle joint is particularly susceptible to rheumatoid arthritis because it is a weight-bearing joint that is constantly in use.

Sudden ankle pain in people with rheumatoid arthritis can be caused by many factors, such as inflammation in the joints, joint damage, nerve compression, or tendinitis.

Reactive Arthritis

Reactive arthritis is another type of arthritis that can cause sudden ankle pain. In addition to inflammation, joint damage, and tendinitis, reactive arthritis can cause enthesitis, inflammation at the site where a tendon or ligament attaches to the bone.

Enthesitis can cause sudden ankle pain, mainly if it affects the Achilles tendon or plantar fascia.

Osteoarthritis

Osteoarthritis is a condition that causes the cartilage that cushions the joints to wear down, resulting in bone-on-bone contact and pain. It is typically a chronic condition that develops gradually over time.

However, in some cases, osteoarthritis can cause sudden ankle pain. This pain can occur when a piece of bone or cartilage breaks loose and gets trapped within the joint, causing irritation and inflammation.

This condition is called osteochondritis dissecans and can occur in any joint, including the ankle. Osteoarthritis can also cause sudden pain if there is a sudden change in the joint, such as a twisting or turning motion, that causes damage to the already weakened cartilage.

Inflammation can also cause sudden pain, as it can put pressure on the nerves in the joint.

Lupus

Lupus is an autoimmune disease that can cause sudden ankle pain in several ways. In lupus, the immune system attacks healthy tissues and organs, leading to inflammation and tissue damage. The joints are a common site of inflammation in lupus, which can cause sudden pain, swelling, and stiffness.

Lupus can cause a type of arthritis called lupus arthritis. In addition to arthritis and tendinitis, lupus can cause secondary conditions, vasculitis, and pericarditis.

Vasculitis is an inflammation of the blood vessels that can cause sudden pain in several joints due to decreased blood flow and tissue damage. Vasculitis can also cause ulcers, skin rashes, and nerve damage.

Lupus can cause inflammation of the pericardium, the sac that surrounds the heart. Pericarditis can cause chest pain that radiates to the neck, shoulders, back, and arms, as well as sudden ankle pain. This pain is caused by inflammation in the pericardium and can lead to fluid accumulation in the legs, causing ankle swelling and pain.

Gout

Gout, a type of arthritis, can cause sudden pain in the ankle joint. Gout is caused by the buildup of uric acid crystals in the joints, particularly in the big toe, ankle, and knee. These crystals, often referred to as tophi, cause inflammation and pain typically described as intense and throbbing.

Other Conditions That May Cause Sudden Ankle Pain

What Causes Sudden Ankle Pain Without Injury?

Although arthritis is a common cause of sudden ankle pain without injury, there are several causes related to other conditions.

Flat Feet/ Fallen Arches

Flat feet, also known as fallen arches, can cause sudden ankle pain due to the altered biomechanics of the foot and ankle. Normally, the arch of the foot provides shock absorption and stability when walking or running.

When the arch collapses, the foot cannot distribute weight evenly, and the ankle joint may be subjected to excess stress, leading to pain and injury. Several factors can cause sudden ankle pain in flat feet:

  1. Overpronation: People with flat feet tend to overpronate, which means that their feet roll inward excessively when walking or running. This can cause the ankle to twist and turn, leading to sudden ankle pain and even ankle sprains.
  2. Stress fractures: The altered biomechanics of the foot and ankle in flat feet can also increase the risk of stress fractures, which are small cracks in the bones of the ankle. Sudden ankle pain can occur when a stress fracture develops.
  3. Plantar fasciitis: Flat feet can cause the plantar fascia, a thick band of tissue that runs along the bottom of the foot, to become stretched and inflamed. This can lead to sudden ankle pain, particularly when standing or walking.

Bursitis

Bursitis is a condition that can cause sudden pain in many areas of the body, including ankle pain. Bursae are small, fluid-filled sacs that cushion and lubricate joints, muscles, and tendons. When bursae become inflamed, it can lead to bursitis, which can cause pain, swelling, and stiffness.

The most common type of bursitis in the ankle is retrocalcaneal bursitis, which occurs when the bursa between the heel bone and Achilles tendon becomes inflamed. This can cause sudden ankle pain, particularly when walking or running.

Scleroderma

Scleroderma is an autoimmune disease that can cause sudden ankle pain in several ways. Scleroderma causes the body to produce too much collagen, which can lead to skin thickening and hardening, as well as damage to internal organs, blood vessels, and joints.

Additionally, Raynaud’s phenomenon is a common symptom of scleroderma, which causes the blood vessels in the hands and feet to narrow and spasm in response to cold or stress. Raynaud’s can cause sudden ankle pain, particularly if the blood vessels in the ankle are affected, leading to decreased blood flow and tissue damage.

Scleroderma can also cause calcinosis, which is the formation of calcium deposits in the skin and subcutaneous tissue. It is also associated with lupus. Calcinosis can cause sudden ankle pain if the calcium deposits become inflamed or infected.

Achilles Tendinitis

Achilles tendinitis is a condition that occurs when the Achilles tendon, which connects the calf muscles to the heel bone, becomes inflamed. This can cause sudden ankle pain that is typically located just above the heel.

The Achilles tendon is one of the largest and strongest tendons in the body, and it is responsible for supporting the body’s weight during activities such as running, jumping, and walking. When the tendon becomes overused or overstretched, small tears can develop, leading to inflammation and pain.

The Best Treatments for Sudden Ankle Pain

Fortunately, there are many treatment options for sudden ankle pain. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help relieve pain and reduce inflammation. Another easy way to ease ankle pain is by practicing “RICE.” RICE stands for Rest, Ice, Compression, and Elevation.

  • Rest: Resting is an important part of treating sudden ankle pain because it allows the injured tissues to heal. When you rest, you avoid putting any additional stress on the affected area, which can further aggravate the injury and delay healing.
By limiting activity and movement, you can also reduce inflammation and pain in the ankle. Resting can mean different things depending on the severity of the ankle injury.
For minor ankle injuries, such as a sprain or strain, resting may involve avoiding any activities that put weight or pressure on the ankle, and keeping the foot elevated to reduce swelling. For more severe injuries, such as a fracture, immobilization with a cast or brace may be necessary to allow the bone to heal properly.
  • Ice: Icing is also a common treatment for sudden ankle pain because it can help reduce pain and inflammation in the affected area. When you apply ice to the ankle, the cold temperature causes blood vessels in the area to constrict, which reduces blood flow and slows down the inflammatory response. This can help reduce swelling, pain, and stiffness in the ankle.
  • Compression: Compression can be helpful for sudden ankle pain, especially if it is caused by a sprain or strain. Compression works by applying pressure to the affected area, which can help to reduce swelling, inflammation, and pain.

Wrap the ankle with a compression bandage or elastic wrap to reduce swelling and provide support. Be sure not to wrap it too tightly, restricting blood flow.

  • Elevation: Elevation is a useful technique to treat sudden ankle pain, especially if an injury or inflammation causes it. Elevating the affected ankle can help to reduce swelling and relieve pain by reducing the amount of blood flow to the area.

To use elevation for sudden ankle pain, you should lie down with the affected ankle elevated above the level of your heart, ideally for 20-30 minutes at a time, a few times a day. This can help to reduce swelling by allowing gravity to pull fluids away from the affected area.

Protect Yourself with Custom Orthotics

Resting and medication can help, but custom orthotics are one of the most beneficial treatment options to alleviate ankle pain. Custom orthotics can be used to treat sudden ankle pain by providing support and cushioning to the foot and ankle, which can help to improve alignment and reduce pressure on the affected area.

Custom orthotics are designed to fit the unique shape of your foot and address any specific issues that may be contributing to your ankle pain. Take the first step by taking our free quiz, and see what kind of orthotic is best for you!

Frequently Asked Questions

  • What does it mean when your ankle started hurting out of nowhere? Common causes include arthritis, injury, or normal wear and tear.
  • What do you do when your ankle hurts out of nowhere? When your ankle hurts it is recommended to rest, ice, compress, and elevate.
  • What causes sharp pain in ankle with no swelling? The most likely cause is an high ankle sprain.
  • What does gout in the ankle feel like? Gout in the ankle feels very tender and hot, often to the point of touching it feels unbearable.