Ankle Pain

We're sorry your ankle is bothering you!

Please keep in mind that this guide is not intended to replace a face-to-face evaluation with your doctor. The goal of this guide is to provide information while awaiting evaluation with your doctor or additional information after you have seen him or her.

Certain symptoms suggest a serious cause of ankle pain that requires prompt attention. It's important to ask questions about these symptoms first.

Do you have severe ankle pain with fever, redness, marked swelling, inability to bear weight or recent significant trauma (such as a fall or a car accident)?

Yes, it's pretty bad!

No, my ankle pain is not severe.

Good! That makes fracture, infection or other serious condition less likely.

Next question: Do you have a fever?

Yes, I have a fever.

Nope, no fever.

Good! That makes infection less likely. Now come questions that attempt to sort out how bad the pain is because some causes of pain in the ankle (such as tendonitis or a mild sprain) tend to cause milder pain and do not reduce one's ability to function.

Is the pain mild? That is, are you still able to do everything you usually do, despite the pain?

Yes, my pain is mild.

No, my pain is not mild.

Okay.

Now a question about the duration of the pain.

Has the pain been present for less than three weeks?

Yes, it's been going on for less than three weeks.

Actually, it's been going on for at least three weeks.

Okay, so your ankle pain has not been mild, there's been no fever and it's been going on at least three weeks.

A strain or sprain is the most likely cause, and it may get better on its own. However, some additional possibilities come to mind. Please answer the next few questions to identify other potential causes of your ankle pain.

Yes, other joints are bothering me.

No, right now only my ankle is bothering me.

Okay, to review: you are describing pain that is neither mild nor severe, without fever that started at least than three weeks ago, and no other joints are painful.

Do you have swelling in your painful ankle?

Yes, my painful ankle is swollen.

No, my painful ankle is not swollen.

Okay, just to review: your ankle pain is not mild, there's no associated fever, it's been going on for at least three weeks without swelling and no other joints are painful.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (ankle pain for at least three weeks that is neither mild nor severe, without morning stiffness, fever, pain in other joints or swelling), a number of conditions come to mind.

A sprain or tendonitis could cause ankle pain like yours.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. Ankle pain in this condition is usually worse with walking.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

From your answers (ankle pain for at least three weeks that is neither mild nor severe, with morning stiffness, but without fever, pain in other joints, or swelling), a number of conditions come to mind.

A sprain or tendonitis could cause ankle pain like yours.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. Ankle pain in this condition is usually worse with walking.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis); past psoriasis, diarrhea or a sexually transmitted disease may be of particular importance to you (see arthritis associated with inflammatory bowel disease, psoriatic arthritis or Reiter's syndrome). While morning stiffness is typical of these types of arthritis, swelling is usually present.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

Okay, just to review: your ankle pain is not mild, there's no associated fever, it's been going on for at least three weeks with swelling and no other joints are painful.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (ankle pain for at least three weeks that is neither mild nor severe, without morning stiffness, fever or pain in other joints, but with swelling), a number of conditions come to mind.

A sprain could cause ankle pain but would not explain other joint symptoms.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. Ankle pain in this condition is usually worse with walking.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis); past psoriasis, diarrhea or a sexually transmitted disease may be of particular importance to you (see arthritis associated with inflammatory bowel disease, psoriatic arthritis or Reiter's syndrome). However, morning stiffness and other joint pain are often prominent in these conditions.

Joint infection (including Lyme disease) is a relatively rare cause of ankle pain such as yours.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

From your answers (ankle pain for at least three weeks that is neither mild nor severe, with morning stiffness and swelling, but without other joint pain), a number of conditions come to mind.

A sprain could cause ankle pain like yours, although prominent morning stiffness would be a bit unusual.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. Ankle pain in this condition is usually worse with walking.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis); past psoriasis, diarrhea or a sexually transmitted disease may be of particular importance to you (see arthritis associated with inflammatory bowel disease, psoriatic arthritis or Reiter's syndrome). Joint infection (including Lyme disease) is a relatively rare cause of ankle pain such as yours.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

Okay, to review: you are describing pain that is neither mild nor severe, starting at least three weeks ago, without fever, and other joints are painful.

Do you have swelling in your painful ankle?

Yes, my painful ankle is swollen.

No, my painful ankle is not swollen.

Okay, just to review: your ankle pain is not mild, there's no associated fever, it's been going on for at least three weeks without swelling and other joints are painful.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (ankle pain for at least three weeks that is neither mild nor severe, without morning stiffness, fever or swelling, but with other joint pain), a number of conditions come to mind.

A sprain could cause ankle pain but would not explain other joint symptoms.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. This type of arthritis often affects the neck, low back, hips, knees, and hands; ankle pain in this condition is usually worse with walking.

Fibromyalgia, an underactive thyroid or too much calcium in the blood (hypercalcemia) can cause pain in multiple joints and/or muscles without swelling.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis); past psoriasis, diarrhea or a sexually transmitted disease may be of particular importance to you (see arthritis associated with inflammatory bowel disease, psoriatic arthritis or Reiter's syndrome). However, morning stiffness and joint swelling are usually prominent in these conditions.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, for evaluation.

From your answers (ankle pain for at least three weeks that is neither mild nor severe, without fever or swelling, but with morning stiffness and other joint pain), a number of conditions come to mind.

A sprain could cause ankle pain but would not explain other joint symptoms.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. This type of arthritis often affects the neck, low back, hips, knees, and hands; ankle pain in this condition is usually worse with walking.

Fibromyalgia, an underactive thyroid or too much calcium in the blood (hypercalcemia) can cause pain in multiple joints and/or muscles without swelling.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis); past psoriasis, diarrhea or a sexually transmitted disease may be of particular importance to you (see arthritis associated with inflammatory bowel disease, psoriatic arthritis or Reiter's syndrome). Morning stiffness is usually prominent in these conditions, but so is swelling.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

Okay, just to review: your ankle pain is not mild, there's no associated fever, it's been going on for at least three weeks with swelling and other joints are painful.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (ankle pain for at least three weeks that is neither mild nor severe, without fever or morning stiffness, but with swelling and other joint pain), a number of conditions come to mind.

A sprain could cause ankle pain but would not explain other joint symptoms.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. This type of arthritis often affects the neck, low back, hips, knees, and hands; ankle pain in this condition is usually worse with walking.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis); past psoriasis, diarrhea or a sexually transmitted disease may be of particular importance to you (see arthritis associated with inflammatory bowel disease, psoriatic arthritis or Reiter's syndrome). Morning stiffness is usually prominent in these conditions.

Joint infection (including Lyme disease) is a relatively rare cause of ankle pain such as yours.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

From your answers (ankle pain for at least three weeks that is neither mild nor severe, without fever but with swelling, other joint pains and morning stiffness), a number of conditions come to mind.

A sprain could cause ankle pain but would not explain other joint symptoms.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. This type of arthritis often affects the neck, low back, hips, knees, and hands; ankle pain in this condition is usually worse with walking.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis); past psoriasis, diarrhea or a sexually transmitted disease may be of particular importance to you (see arthritis associated with inflammatory bowel disease, psoriatic arthritis or Reiter's syndrome). Joint infection (including Lyme disease) is a relatively rare cause of ankle pain such as yours.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

Okay -- so your ankle pain has not been mild, there's been no fever and it's been going on less than three weeks.

A strain or sprain is the most likely cause, and it may get better on its own. However, some additional possibilities come to mind. Please answer the next few questions to identify other potential causes of your ankle pain.

Are other joints bothering you?

Yes, other joints are bothering me.

No, right now only my ankle is bothering me.

Okay, to review: you are describing pain that is neither mild nor severe, without fever that has lasted less than three weeks, and no other joints are painful.

Do you have swelling in your painful ankle?

Yes, my painful ankle is swollen.

No, my painful ankle is not swollen.

Okay, just to review: your ankle pain is not mild, there's no associated fever, it's been going on for less than three weeks without swelling and no other joints are painful.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (ankle pain for less than three weeks that is neither mild nor severe, without fever and without other joint pains, swelling or morning stiffness), a number of conditions come to mind.

A sprain could cause these symptoms.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. Pain is usually worse with walking.

Gout usually causes swelling so that is a bit less likely, but sometimes gout affects the tendon more than the joint and swelling is hard to appreciate.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

From your answers (ankle pain for less than three weeks that is neither mild nor severe, without fever and without other joint pains or swelling but with morning stiffness), a number of conditions come to mind.

A sprain or tendonitis could cause these symptoms.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. Pain is usually worse with walking.

Fibromyalgia, an underactive thyroid or too much calcium in the blood (hypercalcemia) can cause pain in multiple joints and/or muscles without swelling.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis) but there is usually pain in other joints and swelling; past psoriasis, diarrhea or a sexually transmitted disease may be of particular importance to you (see arthritis associated with inflammatory bowel disease, psoriatic arthritis or Reiter's syndrome).

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

Okay, just to review: your ankle pain is not mild, there's no associated fever, it's been going on for less than three weeks with swelling and no other joints are painful.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (ankle pain for less than three weeks that is neither mild nor severe, without fever and without other joint pains or morning stiffness, but with swelling), a number of conditions come to mind.

A sprain or tendonitis could cause these symptoms.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. Pain is usually worse with walking.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis) but there is usually pain in other joints and morning stiffness is usually prominent; past psoriasis, diarrhea or a sexually transmitted disease may be of particular importance to you (see arthritis associated with inflammatory bowel disease, psoriatic arthritis or Reiter's syndrome). Joint infection (including Lyme disease) is a relatively rare cause of ankle pain such as yours.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

From your answers (ankle pain for less than three weeks that is neither mild nor severe, without fever and without other joint pains, but with swelling and morning stiffness), a number of conditions come to mind.

A sprain or tendonitis could cause these symptoms.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. Pain is usually worse with walking.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis) but there is usually pain in other joints; past psoriasis, diarrhea or a sexually transmitted disease may be of particular importance to you (see arthritis associated with inflammatory bowel disease, psoriatic arthritis or Reiter's syndrome). Joint infection (including Lyme disease) is a relatively rare cause of ankle pain such as yours.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

Okay, to review: you are describing pain that is neither mild nor severe, for less than three weeks, without fever, and other joints are painful.

Do you have swelling in your painful ankle?

Yes, my painful ankle is swollen.

No, my painful ankle is not swollen.

Okay, just to review: your ankle pain is not mild, there's no associated fever, it's been going on for less than three weeks without swelling and other joints are painful.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (ankle pain for less than three weeks that is neither mild nor severe, without fever, swelling or morning stiffness, but with other painful joints), a number of conditions come to mind.

A sprain or tendonitis could cause these symptoms, but would not explain pain in the other joints.

Fibromyalgia, an underactive thyroid or too much calcium in the blood (hypercalcemia) can cause pain in multiple joints and/or muscles without swelling.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. This type of arthritis often affects the neck, low back, hips, knees, and hands.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis) but there is usually swelling and prominent morning stiffness.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

From your answers (ankle pain for less than three weeks that is neither mild nor severe, without fever or swelling, but with morning stiffness and other painful joints), a number of conditions come to mind.

A sprain or tendonitis could cause these symptoms, but would not explain pain in the other joints.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. This type of arthritis often affects the neck, low back, hips, knees, and hands.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis) though there is often prominent joint swelling.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

Okay, just to review: your ankle pain is not mild, there's no associated fever, it's been going on for less than three weeks with swelling and other joints are painful.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (ankle pain for less than three weeks that is neither mild nor severe, without fever or morning stiffness, but with swelling and other painful joints), a number of conditions come to mind.

A sprain or tendonitis could cause these symptoms, but would not explain pain in the other joints.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. This type of arthritis often affects the neck, low back, hips, knees, and hands.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis) though there is often prominent morning stiffness.

Gout can cause pain and swelling in one ankle, though it's usually very painful; gout occasionally affects more than one joint but even then it's only a few joints. Joint infection (including Lyme disease) is a relatively rare cause of ankle pain such as yours.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

From your answers (ankle pain for less than three weeks that is neither mild nor severe, without fever, but with swelling, other painful joints, and morning stiffness), a number of conditions come to mind.

A sprain could cause these symptoms, but would not explain pain in the other joints.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. This type of arthritis often affects the neck, low back, hips, knees, and hands.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis), and there is typically swelling in these other joints as well.

Gout can cause pain and swelling in one ankle, though it's usually very painful; gout occasionally affects more than one joint but even then it's only a few joints. Joint infection (including Lyme disease) is a relatively rare cause of ankle pain such as yours.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

Next, a question about the duration of pain because certain conditions, such as sprains, tend to last a short time, while others, such as some forms of arthritis, tend to last much longer.

Have you had ankle pain for less than three weeks?

Yes, it's been going on for less than three weeks.

No, my ankle has been painful for at least three weeks.

Okay -- so your ankle pain has been mild, there's been no fever but it's been going on at least three weeks.

A strain or sprain is still the most likely cause, and it may get better on its own. However, since it seems to be dragging on, some additional possibilities come to mind. Please answer the next few questions to identify other potential causes of your ankle pain.

Are other joints bothering you?

Yes, other joints are bothering me.

No, right now only my ankle is bothering me.

Okay, to review: you are describing mild pain, without fever that has lasted at least three weeks, and no other joints are painful.

Do you have swelling in your painful ankle?

Yes, my painful ankle is swollen.

No, my painful ankle is not swollen.

Okay, just to review: your ankle pain is mild, there's no associated fever, it's been going on at least three weeks without swelling and no other joints are hurting now.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (mild ankle pain without fever or swelling, lasting at least three weeks, no other painful joints, without morning stiffness), a number of conditions come to mind.

A sprain could cause these symptoms.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle.

Gout can cause pain and swelling in one ankle, though it's usually very painful.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

From your answers (mild ankle pain without fever or swelling, lasting at least three weeks, no other painful joints, with morning stiffness), a number of conditions come to mind.

A sprain could cause these symptoms.

Ankle arthritis may accompany conditions causing arthritis in other parts of the body (such as rheumatoid arthritis) though there is usually swelling and other joints are usually painful.

Osteoarthritis could do this, especially if you are over the age of 50 or have had previous injuries to that ankle. Another possibility is sarcoidosis, which may cause inflammation near the joint (including tendonitis) rather than actual arthritis.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

Okay, got it -- your ankle pain is mild, there's no associated fever, it's been going on at least three weeks with swelling and other joints are not painful.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (mild ankle pain, no fever, for at least three weeks, with swelling, no other joint pain, no morning stiffness), a number of conditions could explain your pain:

Osteoarthritis is a common cause of joint pain in persons over age 50 or if there has been previous injury or arthritis. Other forms of arthritis are also possible.

A sprain or tendonitis could cause pain and swelling without other symptoms; sometimes people do not recall any specific injury.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

From your answers, (mild ankle pain, no fever, for at least three weeks, with swelling and morning stiffness, but no other joint pain), a number of conditions come to mind.

An ankle sprain or tendonitis can cause pain and swelling, though prominent stiffness in the morning would be a bit unusual.

Ankle arthritis could cause this, and a number of specific disorders that commonly cause ankle arthritis are listed on the next page. If you have psoriasis, Crohn's disease, ulcerative colitis, or prominent low back pain, for example, conditions on the next page may be of particular importance to you.

Infection in the joint, including Lyme disease, is a possibility, though not as common as other possibilities.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

If your ankle pain is already improving, you may just need to give it a bit more time; over-the-counter anti-inflammatory medicines (such as acetaminophen or ibuprofen) are reasonable to try unless you are already taking them or your doctor has told you to avoid these. If symptoms persist, see your doctor for evaluation.

Okay, to review: you are describing mild pain, without fever that has lasted at least three weeks, and other joints are painful.

Do you have swelling in your painful ankle?

Yes, my painful ankle is swollen.

No, my painful ankle is not swollen.

Okay, just to review: your ankle pain is mild, there's no associated fever, it's been going on at least three weeks without swelling; other joints are hurting also.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

From your answers (mild pain, no fever, pain for at least three weeks, no swelling or morning stiffness, but with pain in other joints), a number of conditions could explain your pain:

Osteoarthritis is a common cause of joint pain in persons over age 50 or if there has been previous injury or arthritis.

Fibromyalgia, an underactive thyroid or a problem with calcium levels can cause pain in multiple joints and/or muscles without swelling.

If there is swelling in the other painful joints, rheumatoid arthritis, or a related condition, comes to mind, although there is usually morning stiffness in these disorders.

There are other possibilities (if you can believe it!) and you could have more than one cause of joint pain; early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

Although your symptoms could be related to a sprain or other minor injury, this would not explain your other joint pains. Morning stiffness and swelling are common signs of joint inflammation (arthritis). If you have other similarly swollen and painful joints that are particularly stiff in the morning, rheumatoid arthritis is a possible cause of your symptoms. However, symptoms should be present for at least six weeks before this diagnosis can be made with confidence. Other possible causes include sarcoidosis, ankylosing spondylitis (especially if you have prominent back pain), or a related condition.

If you have had past episodes of swelling that came up suddenly and resolved quickly, gout would be a consideration (especially if you are male or a woman over age 55).

Finally, a joint infection, such as Lyme disease, could be the cause.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation.

Got it, that's helpful information: your ankle pain is mild, there's no associated fever, it's been going on at least three weeks with swelling and other joints are hurting also.

Just one more question:

Is your ankle pain worse in the morning for at least 30 minutes? Another way to ask this is: Does it take at least 30 minutes for your ankle to get as good as it's going to get for the rest of the day?

Yes, I have morning stiffness.

No, I don't have prominent morning stiffness.

Although your symptoms could be related to a sprain or other minor injury, this would not explain your other joint pains. The absence of prominent morning stiffness argues against significant inflammation in the ankle. Swelling without much inflammation may be a sign of osteoarthritis, sprain or fracture. If you have other swollen and painful joints that are particularly stiff in the morning, rheumatoid arthritis or a related condition are possible causes of your symptoms. However, symptoms should be present for at least six weeks before this diagnosis can be made with confidence. Sarcoidosis is another cause of ankle pain, though there is often swelling in or near the joint and a rash (called erythema nodosum) commonly accompanies the ankle pain.

Finally, a joint infection, such as Lyme disease, could be the cause.

There are other possibilities (if you can believe it!) and early treatment is important for many of these, so it is important that you see your doctor soon for evaluation. See the next page for more information about specific causes of ankle pain.

So, your pain is not severe (at least it is not affecting your function), you have no fever, and it's been going on for less than three weeks.

Your ankle pain is probably due to a mild strain or sprain, even if you cannot recall a specific trigger or injury.

Unless you have been instructed to avoid these medicines, it would be reasonable to take acetaminophen (Tylenol) or ibuprofen (Advil) or naproxen (Aleve), rest the ankle, keep it elevated and wrapped and it may get better on its own. If it is not getting better, or if it gets worse, contact your doctor for evaluation.

Although most people with ankle pain have no serious illness, ankle pain associated with fever could be due to an infection in the joint -- and that's a serious problem that requires prompt treatment. Contact your doctor right away for evaluation!

Based on your symptoms, you could have an infection, fracture or other serious cause of ankle pain. Contact your doctor or go to a local emergency room right away for evaluation! It may be helpful to return to this Decision Guide after your evaluation.