Pain on the inside of the ankle when walking can significantly disrupt daily routines and physical activity. This discomfort often presents as a dull ache or sharp pain, making simple movements like stepping or standing challenging. Understanding the various factors that contribute to this type of ankle pain is a first step toward finding relief and resuming normal activities. This article explores the common reasons behind inner ankle pain and outlines steps for managing it effectively.
Common Reasons for Inner Ankle Pain
Posterior Tibial Tendon Dysfunction (PTTD) is a common cause of pain along the inner ankle and arch. This condition occurs when the posterior tibial tendon, which supports the foot’s arch, becomes inflamed or torn. PTTD can lead to a gradual flattening of the arch, causing discomfort that worsens with activity. Pain and swelling are often experienced along the inside of the ankle and foot, especially when walking or standing for extended periods.
Tarsal Tunnel Syndrome involves the compression of the tibial nerve as it passes through a narrow space inside the ankle, known as the tarsal tunnel. This compression can result from factors like ankle sprains, flat feet, or swelling. Symptoms include numbness, tingling, or burning sensations that can extend into the arch, heel, and toes, often intensifying with prolonged standing or walking. Pain is also felt on the inside of the ankle and along the bottom of the foot.
Ankle sprains, particularly severe inversion sprains, can cause inner ankle pain, even though they are more commonly associated with the outer ankle. While the primary injury might be to outer ligaments, significant force can strain inner ankle structures. This includes the deltoid ligament or the posterior tibial tendon, leading to pain and swelling in the inner ankle region. The pain might be immediate following an injury or develop as a secondary issue.
Stress fractures are tiny cracks in a bone, often occurring in the navicular or talus bones of the foot due to repetitive stress. Athletes, especially runners, are susceptible when training intensity increases too rapidly. The pain starts as a mild ache that worsens with activity and improves with rest, often localized to the inner ankle or top of the foot. Swelling and tenderness over the affected bone may be present.
Arthritis, which involves inflammation of a joint, can cause inner ankle pain. Osteoarthritis, a degenerative condition, can affect the ankle joint, causing cartilage to wear down over time. Rheumatoid arthritis, an autoimmune disease, can target the ankle joint, leading to inflammation, stiffness, and pain. Both conditions result in joint stiffness and pain that intensifies with movement, affecting the inner ankle.
Immediate Steps for Relief
Resting the affected ankle is a key step to alleviate inner ankle pain. Reducing weight-bearing activities helps decrease strain on injured or inflamed tissues. Avoid activities that aggravate the pain, allowing the ankle time to recover.
Ice packs can help reduce inflammation and numb the painful area. Apply an ice pack wrapped in a cloth to the inner ankle for 15 to 20 minutes at a time, several times a day. This helps constrict blood vessels, minimizing swelling and discomfort.
Compression with an elastic bandage or brace provides support and controls swelling. Wrap the bandage snugly around the ankle, ensuring it is not too tight to cut off circulation. This support can stabilize the joint and reduce fluid buildup.
Elevating the ankle above heart level helps reduce swelling. When lying down, prop the ankle up on pillows to facilitate fluid drainage away from the injured area. This can diminish discomfort.
Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, can manage pain and inflammation. These medications work by reducing the body’s inflammatory response. Always follow dosage instructions carefully.
Wearing supportive footwear or using shoe inserts reduces stress on the inner ankle. Shoes with good arch support help stabilize the foot and ankle, especially if the pain is related to arch issues. Custom or over-the-counter orthotics can provide additional support and cushioning.
When to See a Doctor
Seeking medical attention is important if inner ankle pain is severe or prevents you from bearing weight. An inability to put pressure on the foot or ankle suggests a serious injury requiring professional evaluation. This could indicate a fracture or a severe ligament tear.
Consult a doctor if the pain worsens or does not improve after a few days of consistent home care. Persistent discomfort despite rest, ice, and elevation signals a need for medical intervention. Prolonged pain can also lead to compensatory movements that affect other joints.
Numbness, tingling, or weakness in the foot are concerning symptoms requiring immediate medical assessment. These sensations can indicate nerve involvement, such as tarsal tunnel syndrome, which benefits from early diagnosis and treatment. Nerve damage can worsen if left unaddressed.
Visible deformity of the ankle or significant swelling that does not subside with home treatment requires professional evaluation. A noticeable change in the ankle’s appearance or excessive swelling may indicate a dislocation, fracture, or severe soft tissue injury. Prompt assessment helps prevent further complications.
Signs of infection, including redness, warmth, or fever accompanying ankle pain, require urgent medical attention. An infection can spread rapidly and cause damage if not treated promptly. These symptoms indicate a systemic issue.
Pain resulting from a direct injury or trauma, such as a fall or impact, should prompt a visit to a healthcare provider. Even if the initial pain seems manageable, a thorough examination can rule out fractures or other hidden injuries that are not immediately apparent.
Medical Diagnosis and Treatment
A medical professional begins the diagnostic process with a comprehensive physical examination of the ankle. This involves palpating the area to pinpoint tenderness, assessing the range of motion, and observing the foot’s structure, including the arch. The examination helps identify potential sources of pain, such as tendon inflammation or nerve compression.
Imaging tests are used to view the ankle’s internal structures. X-rays can detect fractures or signs of arthritis within the bones. Magnetic resonance imaging (MRI) provides detailed images of soft tissues, identifying tendon tears, ligament damage, or nerve entrapment. Ultrasound imaging can visualize tendons and fluid collections around the ankle.
If nerve entrapment, such as tarsal tunnel syndrome, is suspected, nerve conduction studies or electromyography (EMG) may be used. These tests measure the electrical activity of nerves and muscles, confirming nerve compression and assessing its severity. They provide objective data about nerve function.
Conservative treatment approaches are often the first approach. Physical therapy is significant, involving specific exercises and stretches to strengthen ankle muscles, improve flexibility, and enhance stability. Therapists may use modalities like ultrasound or electrical stimulation to reduce pain and inflammation.
Custom orthotics or ankle braces provide external support, stabilizing the ankle and foot, especially in conditions like PTTD. Orthotics correct foot mechanics and reduce stress on affected structures, promoting healing. Braces offer additional stability during activity.
Corticosteroid injections may be used to reduce localized inflammation and pain, particularly in cases of tendonitis or nerve irritation. These injections provide temporary relief by directly delivering anti-inflammatory medication to the affected area. Surgical intervention is considered a last resort when conservative treatments have not improved symptoms. Procedures can involve repairing torn tendons, releasing compressed nerves, or correcting significant structural deformities.