Tuesday, November 28, 2023

Pain In Back Of Ankle

When Should I Call My Doctor About Ankle Pain

Back of the heel pain (Bone, Tendon & Bursa)
  • Ankle pain is severe or doesnt go away after two to three days of at-home treatment.
  • Pain and swelling come on suddenly.
  • The area is red or warm to the touch, or you have a fever, which could be a sign of infection.
  • You cant put weight on your ankle.

A note from Cleveland Clinic

Ankle pain is a symptom of many injuries and conditions. Swelling, stiffness and pain can make walking difficult or impossible. Most ankle injuries get better with treatments you can do at home, such as elevating your foot and getting plenty of rest. Ankle pain doesnt usually require surgery. If the pain is severe, you have a lot of swelling or the pain doesnt go away after a few days, see your provider. Several noninvasive treatments can help you get back on your feet.

  • American Academy of Orthopaedic Surgeons. Sprained Ankle. Accessed 11/16/2020.
  • American Academy of Orthopaedic Surgeons. Arthritis of the Foot and Ankle. Accessed 11/16/2020.
  • American College of Foot and Ankle Surgeons. Ankle Pain. Accessed 11/16/2020.
  • Merck Manuals. Ankle Fractures. Accessed 11/16/2020.
  • Arthritis Foundation. Ankle Pain. Accessed 11/16/2020.
  • American Orthopaedic Foot & Ankle Society. Chronic Lateral Ankle Pain. Accessed 11/16/2020.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

When Rest Isnt Enough

If physical therapy and avoiding relevé arent cutting it, one option is a cortisone injection to reduce inflammation, as long as there isnt a stress fracture. This may be appropriate as a rare treatment if a dancer has an important performance or audition coming up. However, repeated use of cortisone can have some detrimental side effects, says Shah. Make this decision carefully with your doctor.

For dancers with persistent pain, surgery may be an appropriate option. If youre on a ballet track, and youre getting posterior impingement every few months, youre going to have a hard time making it into a ballet company, says Weiss. Surgical methods, which involve removing extra bone from the back of the ankle, are improving so that surgery is less invasive, which may result in a quicker recovery.

Why Do I Have Pain In My Foot Or Ankle

Most people experience pain in and around their feet or ankles at some point in their lives.

Its one of the most complex, hard-working regions of your body. It has 26 bones and 33 small joints, all held together by a network of soft tissue made up of muscles, tendons, ligaments, nerves, and blood vessels.

Most cases of foot or ankle pain are short term and are caused by soft tissue injuries, such as sprains or strains.

These should gradually heal with the help of simple self-care measures. Though some could take a few months to fully recover, you probably wont need to seek treatment from a healthcare professional.

However, some pain can have no obvious cause or may not improve significantly with self-care.

Pain that seems to be getting worse, does not improve, or lasts longer than a few months could be due to structural changes in the foot or ankle, or an underlying condition.

There can be several explanations for long-term pain in and around the feet or ankles, such as:

  • badly fitting footwear

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Pain In The Back Of The Heel Due To Achilles Tendon Bursitis

When the bursae in the posterior area of the calcaneus become inflamed or irritated, this is known as bursitis, and causes pain in the back of the heel. The bursae are flat, fluid-filled sacs that provide cushioning and reduce friction in areas where muscles, tendons and ligaments run over bones. Retrocalcaneal bursitis is the inflammation of the bursa between the Achilles tendon and the heel bone. Retro Achilles bursitis is the inflammation of the bursa between the Achilles tendon and the skin. Retrocalcaneal bursitis usually occurs from constant irritation and pressure on the bursa, such as lots of uphill running, or in association with Haglunds deformity. Retro Achilles bursitis is almost exclusively caused by footwear that digs into the back of the heel. Sometimes both types of bursitis occur at the same time. Symptoms of bursitis include swelling, redness, and achy pain that becomes worse when the foot is flexed upwards or pointed down.

Figure 4. Diagram of the anatomy of the foot, showing the locations of the bursae associated with the Achilles tendon that may become inflamed and cause pain in the back of the heel.

Rare Causes Of Ankle Pain

Achilles Tendon Pain

While your healthcare provider will consider the following potential causes for ankle pain, they are not common.


Gout, a type of inflammatory arthritis, develops as a result of uric acid crystal formation within one or more joints. Since gout is an uncommon cause of ankle pain, it will be primarily considered in people who have already been diagnosed with gout.

Bone Infection

An infection in the bone may rarely occur in the ankle. Besides a tender ankle joint, other signs of an infected bone include warmth and swelling.

Tarsal Tunnel Syndrome

Tarsal tunnel syndrome refers to compression of the tibial nerve within the “tarsal tunnel” of the ankle . This syndrome may cause an aching or burning pain and numb or tingling sensations on the sole of the foot, toes, and sometimes, the heel, ankle, or calf.

Peroneal Neuropathy

The common peroneal nerve runs down the lower leg and branches into both the deep peroneal nerve and the superficial peroneal nerve. If this nerve is compressed, it can cause symptoms that vary depending on where the compression happens.

For instance, compression on the outside of the knee and upper shin, which can occur from prolonged recumbency during hospitalization or from an excessive crossing of the legs, may cause a foot drop.

Deep peroneal nerve compression causes pain on the sides of the ankle along with burning or tingling sensations between the toes. This is a rare condition that can result from wearing a tight-fitting strap from a shoe.


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What Causes Back Of Ankle Pain

Back of ankle pain may be due to a minor injury. If this is the case, in a few days, pain and swelling disappear, and you will feel better. However, if back of foot pain is worsening and you cant move around freely, it is essential to see your doctor. Here are common reasons why the back of your foot hurts

Treating With Ice Or Heat

Heat or ice can be beneficial in the management of musculoskeletal pain.

Ice is most beneficial if your ankle problem is related to an injury. You can try heat to help your pain levels if there’s no swelling and your symptoms are not related to a recent injury.

Never place ice or heat directly on your skin. Use a barrier, like a towel, to protect your skin from a burn.

How long you use ice as a treatment can vary. However, you should generally apply heat or ice for up to 15 minutes. You should also leave a few hours between treatments.

You should stop treating the area with ice or heat and seek advice from a medical professional if you notice an increase in redness, discolouration or blistering of the skin.

If you have any issues with circulation or sensation, you shouldn’t use ice or heat as a treatment for ankle pain.

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Surgery For Ruptured Achilles Tendon

An Achilles tendon rupture may need surgical repair within days of the injury. An orthopedic surgeon will suture the two ends of the tendon back together.

Keep in mind that a partial tendon tear is sometimes treated like Achilles tendinosis. This may depend on your age, medical history, your normal level of activity, and how severe the tear is.

Partial tendon tears tend to be especially painful. If the tear is not treated with surgery, a controlled ankle motion boot with a hell lift may be recommended. It will be used along with physical therapy or home exercises to prevent loss of muscle strength in the foot and ankle.

What Causes Leg Pain

Heel Pain from Plantar Fasciitis and How to Treat It

Typically, folks associate clogging of the arteries with arteries that feed the heart muscle. When the clogging of heart arteries becomes severe, the demand for oxygen outstrips the supply, causing severe pain in the chest .” rel=”nofollow”> angina pectoris). In other words, the same scenario can play out in heart muscle and leg muscles, and the cause is the same.

Why does leg pain go away immediately when you stop walking? When you stop walking you stop muscular contractions in the lower legs. In turn, this reduces the demand for oxygen. Since the demand is greatly reduced, the supply is adequate, and pain vanishes.

The same thing can happen to your heart. If you are out cutting the grass and your heart rate is elevated oxygen demand increases. If arteries that feed blood and oxygen to the heart cannot keep up with demand, it exceeds supply, and you get chest pain. But if you stop to rest, your heart rate decreases back toward resting level. Fewer muscular contractions of the heart mean a decreased oxygen demand and the chest pain stops.

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Pain In The Back Of The Heel Due To Calcaneal Apophysitis

Severs disease is a common cause of heel pain in the back of the heel in children and adolescents aged between 8 and 14 years old2. This condition occurs when excessive tension and stress are placed on the calcaneal apophysis , causing inflammation and irritation in this area. Young patients with this condition may complain of pain in one or both heels. The pain in the back of the heel is often described as a constant bruise, which feels more painful with exercise. Whilst any child may become affected, Severs disease is most common in those who participate in sports where lots of jumping is required, such as basketball, volleyball or gymnastics.

Figure 1. Diagram of the anatomy of the foot, showing the location of the growth plate at the heel bone. The red area shows the typical area where a patient with Severs disease may feel pain and tenderness.

What Makes Up The Ankle

The ankle is a “hinged” joint capable of moving the foot in two primary directions:

  • away from the body , and
  • toward the body .

The ankle’s anatomy is formed by the meeting of three bones.

  • The end of the shinbone of the leg and a small bone in the leg meet a large bone in the foot, called the talus, to form the ankle.
  • The end of the shinbone forms the inner portion of the ankle, while the end of the fibula forms the outer portion of the ankle.

The hard, bony knobs on each side of the ankle are called the malleoli. These provide stability to the ankle joints, which function as weight-bearing joints for the body during standing and walking.

Ligaments on each side of the ankle also provide stability by tightly strapping the outside of the ankle with the lateral collateral ligaments and the inner portion of the ankle with the medial collateral ligaments. The ankle joint is surrounded by a fibrous joint capsule.

Tendons that attach the large muscles of the leg to the foot wrap around the ankle both from the front and behind. The large tendon of the calf muscle passes behind the ankle and attaches at the back of the heel. A large tendon of the leg muscle passes behind the medial malleolus. The peroneal tendon passes behind the lateral malleolus to attach to the foot.

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Achilles Tendon Pain: Symptoms Causes And Treatments

Understanding Achilles tendonitis, tendinosis, and tendon ruptures

Achilles tendon pain stems from the fact that, like all tendons, the Achilles tendon is strong, but not very flexible. The Achilles tendon connects muscles in your calf and lower leg to your heel bone, and it can only stretch so far. When it goes beyond its limits, it becomes inflamed or tears .

Stress or injury to the Achilles tendon can cause discomfort that can range from a slight ache and stiffness to severe Achilles tendon pain.

In this article, you’ll learn more about Achilles tendonitis, tendinosis, and rupture and how they can cause Achilles tendon pain. You’ll also leave this article knowing when to see a healthcare provider, how they will diagnose you, and how Achilles tendon pain can be treated.

Verywell / Alexandra Gordon

What Causes Foot And Ankle Pain

Heel Pain Treatment East Longmeadow

A number of different things can cause foot and ankle pain. Around 1 in 5 middle-aged or older people suffer from it, and women are particularly affected. The most common causes involve the soft tissues of the foot and ankle:

  • Plantar fasciitis: this usually causes pain in your heel and along the arch of the foot. Plantar fasciitis occurs when the soft tissue on the underside of the foot becomes inflamed. The pain is often worse after being inactive or first thing in the morning
  • Achilles tendonitis: this causes pain at the back of the ankle when the Achilles tendon, which connects the calf muscles to the heel bone, becomes irritated. It can be caused by overuse, often when you start a new type of exercise or if the amount you exercise is increased
  • Ankle sprains: these occur when the ligaments are damaged due to an injury. There will often be pain around the ankle and bruising or swelling, as well as reduced movement

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What Is An Os Trigonum

Os Trigonum forms when one area of bone fails to fuse with the rest of the bone. During growth. In the ankle, this extra bone forms behind the talus bone. Approximately 1 in 4 of the general population has this extra bone. This extra bone is like an appendix in most people it doesnt cause a problem. However, similar to the appendix, it can cause pain after an ankle twist or in certain sports such as ballet, running, or football.

What Is The Fastest Way To Heal Tendonitis In The Ankle

The majority of ankle pains will heal by themselves using at-home remedies. The fastest way to heal tendonitis depends on the reason for the pain in the ankle. Typical treatments include:

  • Orthotic Inserts Orthotics are specialized inserts that conform to the inside of the individuals shoes. One option is to purchase them over the counter or from the manufacturer who custom-makes a pair unique to your feet. Stabilizing and supporting the feet while guaranteeing appropriate alignment is the purpose of orthotics.
  • Splints and Braces Using an ankle brace or splint might provide alleviation of pain and stabilize the ankle. Specific splints and braces are more suited for particular activities. Consult your health care provider to advise on the most ideal for your lifestyle.
  • Medications Some forms of medications reduce ankle pain and decrease inflammation. Medication geared toward treating gout and arthritis relieves pain and reduces swelling.
  • Joint Aspiration Joint aspiration or Arthrocentesis is a technique used to extract fluid from a joint using a needle. The procedure reduces swelling and pain.
  • Steroid Injections Health care providers use needles to directly inject anti-inflammatory medicine into the joints. At times the health care professional uses Cortisone to help ease the swelling and pain.
Medical Disclaimer

It would be best to get medical assistance from your doctor to ensure that the problem you are experiencing is correctly diagnosed.

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Pain At The Back Of The Heel

  • Sarah Morton, academic primary care F2 doctor1,
  • Aisha Newth, primary care teacher development lead1,
  • Azeem Majeed, professor of primary care1
  • 1Department of Primary Care and Public Health, School of Public Health, Imperial College London, London W6 8RP, UK
  • Correspondence to: S Morton sarah.mortondoctors.org.uk
    • Accepted 7 January 2016

    What you need to know

    • Achilles tendinopathy is the most common cause of chronic posterior heel pain

    • Achilles tendinopathy is a clinical diagnosis and imaging is not needed unless there is diagnostic uncertainty

    • Eccentric calf muscle exercises are the traditional means of strengthening the Achilles tendon

    A 41 year old man complains of longstanding pain at the back of his left heel and stiffness when he gets up. The pain is worse when he plays tennis. He asks for advice on what it is and what can be done.

    Pain at the back of the heel arises from a limited number of anatomical structures: the Achilles tendon, the calcaneal bursa, or the surrounding soft tissues . This limits the likely differential diagnoses. Achilles tendinopathy is the most common cause of posterior heel pain.1 Its incidence is estimated at 1.85 per 1000.2 It is also important to note that Achilles tendinopathy may underlie other pathologies, particularly partial tears of the Achilles tendon.3

    Fig 1 Anatomy of the heel

    When To Consult A Doctor

    Peroneal Tendonitis (Side of Foot Pain), Causes & Self-Treatment.

    While most ankle sprains heal with a little TLC and at-home care, its important to know when the injury has progressed past that point.

    Those who experience extreme swelling or bruising, along with the inability to put weight or pressure on the area without significant pain, should consult a doctor.

    Another general rule is to seek medication attention if theres been no improvement during the course of the first few days.

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    Physical Therapy For Pain In The Ankle And Heel

    If you have been experiencing the pain in the back of your ankle and above your heel for a week or two now with no relief from at-home stretching, you should schedule an appointment with a physical therapist for more targeted treatment. Physical therapy is one of the most common treatments for Achilles tendinitis because it focuses on strengthening and stretching the damaged Achilles tendon, helping it to heal and reduce the inflammation that is responsible for your symptoms.

    If your injury is related to a sport, your physical therapist may also recommend sports therapy to work with you on your form and movement to help prevent future injuries. Sports therapy also uses a treatment called Active Release Technique to massage around the damaged muscle in order to improve circulation, promote healing and improve functionality.

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