The ankle is the meeting point of leg and foot and is composed of three joints. It is also known as the talocrural region and contains ankle joint, subtalar joint and inferior tibiofibular joint. It is surrounded by several tendons and ligaments that encapsulate it and increase its strength and stability. They also connect the lower muscles of calf with heel of foot and play a role in the weight-bearing process. Thus, it is a strong region that is capable of bearing the body weight and making us mobile.

Ankle pain is a common complaint nowadays. It might be caused by some negligent practice, like wearing tight shoes or overloading with vigorous exercises. In most of the cases, ankle pain is mild and is treated easily by over the counter medications and home-based therapies. Anyhow, it can get severe under certain condition like fracture; rupture of tendon or in case of some systemic disorder. Ranging from local wear and tear to systemic inflammatory disorders, ankle is susceptible to all the local trauma and central disease processes. Below is a list of the most common causes of ankle pain:

• Ankle sprain: Ankle sprain is the most common cause of ankle pain. It accounts for more than 75% of reported cases of ankle pain. This type of ankle pain is commonly seen in athletes and runners. Ankle sprains occur when a person positions their foot incorrectly causing their body weight to center on a single tendon or ligament which in turn gets torn. This tearing of muscles and ligaments causes pain and swelling. Common sprains can be treated at home by resting and applying ice to the injured area. In most cases, a person can take over-the-counter pain killers to help relieve the pain. However, a doctor may prescribe a short-term cast in cases of severe and prolonged ankle pain.
• Rheumatoid arthritis: The most common systemic cause of ankle pain is RA. It starts with toes and gradually leads to the ankle joint. Rheumatoid arthritis causes the ankle joint to become inflamed, stiff, and painful. Hot and cold therapy, exercise, and, in some cases, physiotherapy can help to relieve or lessen the pain caused by RA.
• Gout: Stiffness and pain in the ankle caused by the deposition of uric acid crystals in the ankle is known as gout. In the later stages of gout, it can mimic rheumatoid arthritis pain by causing inflammation and pain in the ankle. Systemic treatment of increase uric acid is done to treat this kind of ankle pain.
• Lupus: This autoimmune disease produces immune complexes that destroy the healthy tissues, and the ankle can become victim to this disorder.
• Ankle fracture: A fracture is one of the worst forms of a local ankle injury. If there is a fracture of any of the three bones (tibia, fibula, and talus) that make up the ankle, it can cause severe pain and immobility. If your doctor discovers that there is a fracture, they may set a cast around the foot and ankle. In the case of a severe fracture, you may need surgery before you can get a cast.

Other possible causes of ankle pain include:

• Achilles tendinitis
• Achilles tendon rupture
• Bursitis
• Flat feet
• Plantar fasciitis
• Osteoarthritis
• Avulsion fracture
• Pseudo-gout
• Psoriatic arthritis
• Reactive arthritis
• Osteochondritis
• Stress fractures
• Septic arthritis
• Carpel tunnel syndrome
• Osteochondral lesions of the talus (OLT)
• Scleroderma
• Infection of heel

Making a Diagnosis for Ankle Pain:

While your doctor makes a diagnosis about your ankles pain, detailed general and medical histories are essential to distinguish between various causes. The points below help doctors to diagnosis foot pain, which include pain in the ankle:

• Determine if the onset of pain is sudden or gradual
• Find the exact location of the pain
• Whether pain radiates in foot or not
• Which factors increase pain and which factors relieve pain
• Find out if there is a specific time of the day pain occurs

◊ General examination of the ankle and heel is made by the doctor to establish any cause of pain. Many foot problems are apparent from a simple foot examination. This includes an inspection for any swelling on the ankle, abnormal skin texture, color change and any other inborn visible deformity in the ankle region. An essential thing in this regard is to check the range of motion at ankle joint. Watching you stand and walk will also help make a diagnosis.

◊ X-rays, although they are not very important in this scenario, can be taken if your doctor suspects a bone fracture due to stress or trauma or if there are any abnormalities related to ankle joint.