Sudden pain in the ankle without injury can have many possible causes, including autoimmune conditions, different types of arthritis, and foot alignment issues.

Conditions such as lupus and arthritis can be serious if not treated.

There are a number of potential causes for sudden ankle pain without injury. In this article, we will discuss those possible causes, treatments that are available, and when a person should seek medical attention.

A person holding their ankle. Some causes of ankle pain without injury include osteoarthritis and bursitis.Share on Pinterest
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Osteoarthritis (OA) is the most common form of arthritis, and it can occur in the ankle joint. OA in the ankles occurs through wear and tear of the joint that causes the cartilage and bone to break down and change.

Causes of OA in the ankles can include:

  • Age: OA in the ankles is more common in older adults.
  • Previous injury: Any former ankle injury can lead to OA in the ankles, although symptoms may not show for years after the injury.
  • Weight: If a person is overweight it may put more stress on the ankles.

Symptoms

Common symptoms of OA in the ankle joints can include:

  • pain, aching, or swelling in the ankles
  • stiffness in the ankles, especially in the morning or after periods of rest
  • lack of flexibility, range of motion, instability, or looseness in the ankle joints

Treatment

There are several treatments that may help relieve symptoms of OA in the ankles, including:

Reactive arthritis is an inflammatory disease that occurs as a reaction to an infection in the digestive tract, urinary tract, or genitals.

It can cause symptoms such as pain and inflammation that come on suddenly, with joints such as the ankles affected.

Symptoms

Symptoms of reactive arthritis typically start 2–4 weeks after the infection. Once symptoms start, they typically develop over the course of a few days.

Some people experience mild symptoms, while others have more severe symptoms that affect daily activities. The most common symptoms of reactive arthritis that affect the ankles are inflammation and pain.

Other symptoms include:

Treatment

Some treatment options available to help alleviate symptoms of reactive arthritis in the ankles include:

Lupus is a chronic autoimmune disease that can affect the ankles.

Autoimmune diseases occur when a person’s immune system attacks itself because it mistakes healthy tissue for viruses or bacteria. This can cause inflammation in joints such as the ankles, along with other symptoms.

Symptoms

If a person has Lupus in the ankles they may experience some of the following symptoms:

  • pain or tenderness
  • swelling
  • stiffness

Other symptoms include:

  • extreme fatigue
  • skin rashes
  • fever
  • sun sensitivity
  • numb or discolored fingers or toes

A person may experience times when their symptoms flare and times in remission when they feel well.

Treatment

Some treatment options to help manage symptoms of lupus include:

Posterior tibial tendon dysfunction (PTTD), also known as fallen arches or flat feet, occurs when the tendon supporting the main arch of the foot weakens. This causes the arch of a person’s foot to gradually flatten.

PTTD can lead to pain in the ankles and is often caused by overuse of the posterior tibial tendon.

Symptoms

Symptoms of PTTD may include:

Treatment

A podiatrist may recommend the following treatments for PTTD:

  • shoe modifications, such as wearing inserts
  • physical therapy, such as exercises and stretches
  • pain medications such as NSAIDs
  • ankle braces
  • surgery

Rheumatoid arthritis (RA) is an autoimmune, inflammatory disease that affects the lining of the joints. RA typically affects both ankles at the same time and can cause pain.

Symptoms

A person with RA in the ankles may experience flares of symptoms that last for a number of days or months, followed by periods of remission.

Symptoms of RA in the ankles can include:

  • pain
  • stiffness
  • tenderness and swelling, often in more than one joint
  • the same symptoms on both sides of the body, such as both ankles

Other symptoms include:

  • fever
  • fatigue
  • weight loss
  • weakness

Treatment

A doctor may recommend strategies to try to reduce symptoms of RA in the ankles, including:

Achilles tendonitis occurs when the Achilles tendon, which is located in a person’s ankle, becomes painful and inflamed.

It often occurs due to overuse, although it is not typically related to a specific injury. Other factors may also put a person at risk of Achilles tendonitis, including:

  • older age
  • a sudden increase in the amount or intensity of exercise
  • tight calf muscles
  • Haglund’s deformity (an enlargement of the bone on the back of a person’s heel)

Symptoms

Some symptoms of Achilles tendonitis can include:

  • pain in the heel or Achilles tendon when exercising or applying pressure
  • pain and stiffness in the heel and tendon in the morning
  • continuous swelling that gets worse through the day or with activity
  • thickening of the tendon
  • severe pain the day after exercising
  • pain on the back of the heel when wearing shoes
  • bone spur formation

Treatment

A person with ankle pain due to Achilles tendonitis may benefit from the following treatments:

  • rest and reducing physical activity impacting the ankles
  • NSAIDs
  • supportive footwear
  • physiotherapy and stretching
  • surgery

Gout is an inflammatory form of arthritis that can cause pain in the ankles. It is caused by a condition called hyperuricemia, which is when there is too much uric acid in a person’s body.

Gout usually affects one joint at a time, and often starts in a person’s big toe.

Symptoms

Symptoms of gout can start suddenly and last for days or weeks, known as flares. Symptoms may then not reappear for weeks, months, or years.

The main symptom of gout in the ankles is intense pain, often at night time. The pain may be so severe it causes a person to wake up.

Other symptoms of gout in affected joints can include:

  • swelling
  • redness
  • warmth

Treatment

A healthcare professional may recommend the following treatments for gout in the ankle joints:

  • NSAIDs
  • colchicine
  • corticosteroids
  • maintaining a healthy lifestyle

Bursitis describes inflammation of a bursa. Bursas are fluid-filled sacks located between the bones, muscles, tendons, and ligaments.

Bursitis typically affects the shoulders, knees, elbows, hips, or feet, although it can occur in any joint including the ankles.

Symptoms

A person with bursitis in the ankles may experience the following in the ankle joints, especially during movement or when applying pressure:

  • swelling
  • pain
  • warmth
  • redness

Treatment

The following treatments may help alleviate symptoms of bursitis in the ankles:

Some other causes that may lead to sudden ankle pain without injury include:

A person should seek medical attention if they experience sudden ankle pain without injury and experience any of the following:

  • pain that affects daily activities, or makes a person feel faint or nauseous
  • pain that has not improved after 2 weeks
  • tingling or loss of sensation in the foot
  • the ankle has changed shape and appears to be at an odd angle

There are multiple reasons why a person may experience sudden ankle pain without injury, from auto-immune conditions to wear and tear.

A person should consult a healthcare professional if symptoms are causing severe pain or have lasted for over 2 weeks.

There are a number of treatments available for sudden ankle pain without injury. A healthcare professional will need to perform a full examination before recommending appropriate treatments.