Why Does My Ankle Hurt: Causes, Relief & When to Seek Care

“Why does my ankle hurt?” is a frustrating question with many possible answers. Ankle pain is any discomfort in or around the joint where your leg meets your foot. It can show up after a twist on the field, sneak in from overuse at work, or stem from arthritis, tendon irritation, nerve compression, or even issues higher up the leg. Sometimes there’s swelling or stiffness; other times, there’s no obvious injury at all—just pain that won’t let you move the way you want.

This guide explains what ankle pain can feel like, the most common causes (including pain by location), simple at-home relief, and when it’s time for urgent care. You’ll also learn how podiatrists diagnose ankle pain, treatment options from conservative care to surgery, prevention tips, and who needs special attention. Let’s start with the symptoms to notice.

What ankle pain can feel like (symptoms to notice)

Ankle pain doesn’t feel the same for everyone. It can be a dull ache after a long day, a sharp stab after a misstep, or burning or tingling that points to nerve irritation. Noticing where it hurts, what triggers it, and what other symptoms show up helps answer “why does my ankle hurt?”

• Pain type and location: Dull, sharp, stabbing, or burning; inside, outside, front, or back.
• Swelling or bruising: Around the ankle or foot.
• Stiffness and limited motion: Trouble bending or rotating the ankle.
• Instability or “giving way”: Feeling wobbly on uneven ground.
• Pop or snap at injury: With immediate pain and swelling.
• Numbness, tingling, burning, or weight-bearing pain: Difficulty standing or walking.

Common causes of ankle pain

When patients ask “why does my ankle hurt,” we usually trace it to one of a few categories: a sudden injury, overuse tendon irritation, nerve entrapment, or joint disease. The location and onset help narrow it down. The Cleveland Clinic notes most ankle pain stems from injuries, arthritis, and wear-and-tear. Below are common causes podiatrists see. Other causes include bursitis and, less commonly, infection that needs prompt care.

• Ankle sprain: Ligament stretch or tear after a twist; swelling and bruising.
• Fracture: Broken bone with sharp pain, swelling, and trouble weight-bearing.
• Achilles tendinitis or rupture: Back-of-ankle pain; stiffness or sudden “pop.”
• Peroneal tendinitis or sinus tarsi syndrome: Outer ankle pain, worse on uneven ground.
• Tarsal tunnel syndrome (nerve entrapment): Burning, tingling, or numbness along the inner ankle.
• Arthritis (osteoarthritis or rheumatoid): Stiffness, swelling, and pain with activity or mornings.
• Foot structure (flat feet or high arches): Overload on tendons and ligaments causing chronic ache.

Ankle pain without an obvious injury

If you’re wondering “why does my ankle hurt” when you didn’t twist or fall, think non-traumatic causes. Ankles often ache from joint conditions like osteoarthritis or rheumatoid arthritis, overuse tendinitis, nerve compression (tarsal tunnel syndrome), and foot mechanics (flat feet or high arches) that overload tissues. Less commonly, infections like cellulitis or osteomyelitis cause pain with warmth and swelling and need prompt care. Clues such as morning stiffness, burning or tingling, or pain that builds with activity help narrow the cause.

• Arthritis: Stiffness, swelling; morning or post-activity pain.
• Tendinitis: Achilles, peroneal, posterior tibial overuse ache.
• Nerve entrapment: Inner-ankle burning, tingling, numbness.
• Foot mechanics: Flat/high arches causing chronic strain.
• Infection (urgent): Red, warm, worsening pain; possible fever.

Pain by location: outside, inside, front, and back of the ankle

Where your ankle hurts is a powerful clue. When patients ask “why does my ankle hurt,” mapping pain to the outside, inside, front, or back helps narrow likely causes—from tendon irritation and sprains to nerve entrapment and arthritis—so you can choose the right next step.

Outside (lateral) ankle pain

Lateral pain often follows a twist and points to an ankle sprain, but it can also come from peroneal tendinitis or sinus tarsi irritation, especially if it worsens on uneven ground. Burning or tingling along the outer ankle/foot may indicate sural nerve irritation.

Inside (medial) ankle pain

Pain and fatigue along the arch and inner ankle suggest posterior tibial tendinitis, commonly linked with flat feet. Numbness or burning on the inner ankle can be tarsal tunnel syndrome; warmth, redness, and worsening pain raise concern for infection and need prompt care.

Front (anterior) ankle pain

Aching or stiffness at the front of the joint is frequently due to arthritis (osteoarthritis or rheumatoid arthritis) or irritation after a sprain, especially when bending the ankle. Sudden swelling, warmth, and intense pain could be a gout flare involving the ankle.

Back (posterior) ankle pain

Pain behind the ankle typically points to Achilles tendinitis or retrocalcaneal bursitis, often worse with pushing off or morning steps. A sudden “pop,” sharp pain, and difficulty pointing the foot downward suggest an Achilles rupture and need urgent evaluation.

At-home relief and first aid you can start today

If you’re asking “why does my ankle hurt” after a twist or overuse, start with simple first aid. The Cleveland Clinic recommends the RICE method—rest, ice, compression, and elevation—to calm pain and swelling, paired with over-the-counter pain relief. Protect the joint, let pain be your guide, and avoid “playing through it” while tissues heal.

• Rest and protect: Pause running/jumping; consider a supportive ankle brace to limit strain.
• Ice: 15 minutes at a time, a few times daily, with a thin towel barrier.
• Compression: Wrap with an elastic bandage—snug, not tight—to control swelling.
• Elevation: Prop the ankle above heart level whenever possible.
• OTC pain relief: NSAIDs like ibuprofen or naproxen can reduce pain and swelling; acetaminophen helps pain if NSAIDs aren’t right for you.
• Supportive footwear/orthotics: Stable shoes and cushioned inserts can offload irritated tissues.
• Gentle motion: When pain allows, start easy range-of-motion work to reduce stiffness.

When to see a doctor, urgent care, or the ER

If you’re still wondering “why does my ankle hurt” after a few days of rest and RICE, it’s time to get it checked. Early evaluation can prevent small problems from becoming long layoffs or surgery. Use these cues to choose where to go.

• See a podiatrist soon (24–72 hours) if: Pain lasts more than a few days or is getting worse; swelling/bruising with trouble walking; recurring instability; numbness, tingling, or burning; pain that changes your daily routine.
• Same-day/urgent care if: You felt or heard a “pop” with immediate swelling; signs of infection (spreading redness, warmth, worsening pain, possible fever); you have diabetes and any new ankle pain or a wound.
• ER now if: You had major trauma (car accident or severe fall), you can’t move your ankle or leg, or you think you have a broken bone.

How a podiatrist diagnoses ankle pain

To answer “why does my ankle hurt,” a podiatrist starts with your story—how the pain began, where it sits, and what worsens or relieves it—followed by a focused exam to check swelling, bruising, motion, and tenderness. From there, targeted tests help confirm the cause and rule out serious injury.

• History and hands-on exam: Pinpoints pain location, checks swelling and motion, and reproduces symptoms safely.
• Imaging when needed: X‑rays for suspected fractures; ultrasound or MRI to assess tendons, ligaments, and soft tissue.
• Joint aspiration (when appropriate): Removing excess fluid can relieve pressure and help clarify the source of swelling.
• Trial supports: Bracing or taping may be used to see if stabilizing the joint eases symptoms.

Treatment options: from conservative care to surgery

The best treatment depends on why your ankle hurts, how long it’s bothered you, and what the exam and imaging show. Most people start with conservative care to calm pain, control swelling, and restore motion and stability. If symptoms persist or there’s structural damage (like a fracture or torn tendon/ligament), procedures and surgery can provide lasting relief.

• Activity modification + RICE: Rest, ice, compression, and elevation to settle pain and swelling.
• Medications: Over-the-counter NSAIDs (ibuprofen, naproxen) or acetaminophen; providers may use corticosteroids (including injections when appropriate) for inflammation.
• Orthotics/footwear changes: Supportive shoes and inserts to offload irritated tissues and improve mechanics.
• Physical therapy: Targeted exercises to restore strength, flexibility, and balance.
• Immobilization: Splint, brace, or cast to protect sprains, fractures, or tendon issues while they heal.
• Joint aspiration: Removing excess joint fluid to reduce pressure and help you move more comfortably.

When needed, surgery addresses the underlying problem:

• Arthroscopy (minimally invasive): To treat many tendon/ligament injuries and some joint issues.
• Fracture repair: Stabilizing broken bones for proper alignment and healing.
• Advanced procedures for severe arthritis: Options can include ankle fusion to relieve pain and improve stability.

Prevention tips to keep your ankles healthy

Healthy ankles start with consistent habits. If you keep asking “why does my ankle hurt” after activity, tighten the basics—warm-ups, supportive shoes, and recovery. Small home safety tweaks also prevent twists and falls so you can keep moving confidently.

• Protective gear: Wear sport-appropriate braces or supports.
• Warm up and stretch: Then cool down and stretch again.
• Don’t play through pain: Build in rest and recovery.
• Supportive footwear: Choose stable shoes; consider orthotics.
• Home safety and falls: Clear tripping hazards; use a cane or walker if needed.

Special considerations for athletes, older adults, and people with diabetes

Some groups face unique ankle risks and need a smarter plan. Athletes push tissues to the limit; older adults deal with balance, bone, and joint changes; people with diabetes can miss warning signs and heal more slowly. Tailoring care helps you stay active and safe.

• Athletes: Don’t play through pain. Get sprains and “pops” assessed, then follow structured rehab (strength, flexibility, balance). Brace or tape during return to sport.
• Older adults: Arthritis and fractures are more common. Seek prompt care for swelling or trouble weight-bearing. Choose supportive shoes; use a cane or walker to reduce falls.
• Diabetes: New pain, redness, warmth, or any wound deserves same-day evaluation. Check feet daily, protect skin, and avoid walking on injuries—cellulitis or deeper infection can develop quickly.

Care at Achilles Foot and Ankle Center in Central Virginia

If you’re still asking “why does my ankle hurt,” our specialists can help. Across thirteen convenient locations, we offer same-day appointments, on-site digital X‑ray and ultrasound, fluoroscopy‑guided injections, custom bracing and orthotics, and Central Virginia’s only Foot & Ankle Ambulatory Surgery Center for arthroscopy, fracture care, and complex reconstruction when needed. We accept all major insurance plans (including Medicare and Medicaid), provide concierge-style service with no extra fees, and make scheduling and records easy through our Healow Patient Portal.

The bottom line

Ankle pain has many causes—from sprains and tendinitis to arthritis and nerve entrapment—but you don’t have to guess or “play through it.” Start with RICE and supportive shoes; if pain persists, affects walking, or follows a pop, get evaluated. Our foot and ankle specialists can pinpoint the cause and get you moving again. Ready for answers? Schedule care with the Achilles Foot and Ankle Center.