Common Causes of Pain in the Back of the Ankles

If pain in your ankles is making it difficult for you to walk, run, or affecting your ability to stand, it is a cause for concern and needs medical attention. At Pain Management NYC, Dr. Leon Reyfman focuses on determining why you are having pain in the back of your ankles and recommends the best treatment to cure your pain and its symptoms. Dr. Reyfman understands how ankle pain can affect your life and movement and uses the safest and most effective techniques and therapies to ease your discomfort.

The ankle is the joint that connects your foot to your lower leg. It is a significant part of the musculoskeletal system as it helps the body move, and enables you to walk, run, turn from side to side, jump, and land safely. Made up of bones, ligaments, muscles, tendons, nerves as well as joints, ankles are complicated structures that keep you stable and maintain your balance.

Occasional discomfort at the back of the ankle is not unusual and may be related to a minor injury or accident. However, ankle pain in the back that does not go away, worsens, or makes it difficult for you to walk or move indicates a bigger problem.

Read on to learn more about the common causes of pain in the back of the ankles and when you should see a pain doctor for your discomfort.

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What Causes Pain in the Back of the Ankles?

Here are some reasons you may be experiencing soreness in this part of the foot.

Arthritis

Arthritis is one of the reasons behind pain in the back of your ankles. The ankle consists of three joints. The true ankle joint called the talocrural joint, allows the foot to move up and down, the subtalar joint allows the ankle to turn in and out, and the inferior tibiofibular joint allows the ankle to do both movements.

Arthritis causes the cartilage that cushions the ends in the joints of your body to wear down, which can affect your ankles. When the cartilage in your ankles is damaged, it becomes painful to put weight on them and they become stiff.

Osteoarthritis and rheumatoid arthritis are two more common types of arthritis that often affect ankle joints. Osteoarthritis is the wear and tear form of arthritis that causes the cartilage at the end of the bones to break down. Without the protective padding, the bones rub together, resulting in stiffness, mobility issues, and pain around the ankle.

Rheumatoid arthritis (RA) is an autoimmune condition in which the body’s immune system overreacts and attacks the healthy tissues. It occurs in the joints on both sides of your body. It can result in pain, swelling, and joint stiffness.

Bursitis

Bursitis is a painful swelling, around the ankle joints. Bursae are small, fluid-filled sacs that cushion the bones, tendons, and muscles near the joints and keep your tendons from rubbing against the bones and other soft tissue. Bursitis is inflammation of these sacs, typically caused by repetitive motion of the ankles due to physically demanding activities. Bursitis is painful and limits your range of motion.

The retrocalcaneal bursa is located by the heel in the back of the ankle, where the Achilles tendon connects the heel bone to the calf muscles. Overuse of the ankle joint, such as frequent jumping, walking, or running can irritate the bursae and lead to pain at the back of the ankle. Ankle pain caused by bursitis can worsen with activities and feel sore to the touch. You may also notice a bump on the back of the ankle when this bursa is irritated.

Ankle Sprain

Ankle sprains are common injuries that result when the foot is turned inwards, creating pain on the outside of the ankle. Fibrous ligaments support and stabilize the ankle overstretch and tear, but when a ligament is torn or over-stretched, it can lead to a strain. While walking, running, or jumping, you may twist or roll your ankle too far, which may cause its ligaments to sprain. This can be extremely painful and limit your range of motion.

Pain, bruising, and swelling at the back of the ankle are common symptoms of a sprain. Sprains vary in severity depending on which ligaments are involved and how severely they are damaged. While minor sprains can heal with resting for a week or two, severe sprains may require more comprehensive, professional treatment.

Posterior ankle impingement is a complication that occurs when the soft tissues or bone structures within the ankle get compressed or pinched during certain movements, such as overtraining in sports or injury that has not healed properly. This can lead to discomfort and inflammation in the joint.

Ankle Strain

Ankle strains can result from sudden movements where the ankle turns inwards or outward naturally. Strains are similar to sprains, but they affect the muscles and tendons. Acute strains can occur following a single trauma, such as slipping and falling on a patch of ice or running and jumping during sports. Chronic strains usually occur due to longer-term overuse of the ankle muscles, and frequently affect long-distance runners, soccer and football players, gymnasts, and dancers.

Signs of a strain include swelling, pain, and tenderness around the ankle joint. Some people also experience muscle spasms, cramps, and muscle weakness in the ankle. Pain may either appear immediately at the onset of acute strain or gradually in case of a chronic strain that develops over time due to overuse of ankle muscle.

Achilles Tendinitis and Tendinopathy

The Achilles tendon is the largest tendon in the body. It runs down the back of the lower leg and connects the calf muscles to the heel bone. It is used for walking, running, jumping, climbing, and standing on tiptoes. Achilles tendinopathy is a painful condition that results from degeneration of the collagen that forms the tendon. Repetitive use of the ankles can cause inflammation in the tendons that leads to pain in the back of the ankle and limited range of motion.

Achilles tendinopathy is more common in younger people, particularly professional and weekend athletes, and occurs due to overuse injury or during intense activity. Pain and swelling at the back of the ankles that worsens with activity are common signs of a condition affecting the Achilles tendon.

Ankle Fracture

A broken ankle is one of the most common causes of ankle pain. A fracture is a partial or complete break of one or more bones that form the ankle joint. Accidents like falls from heights or twisting or rolling one’s ankle while walking or running can potentially cause a fracture. Impact with an object, like during a car accident, can also cause the bones of the ankle to break. The more bones you break, the more serious the injury.

Pain, swelling, and bruising are signs of an ankle fracture. In some cases, a broken ankle seems visibly deformed. Types of treatment of ankle fractures vary, depending on the nature and severity of the injury. A simple fracture in a single bone may not affect walking and other activities. Multiple or complex fractures may require surgical intervention. It can take anywhere from several weeks to several months to repair a broken ankle.

Ankle pain is often a result of simple overexertion from a long day of physical activity and usually goes away after a few days of rest and gentle stretches. However, ankle pain that is more intense than usual or lasts longer than a week may be related to any of the conditions discussed above and needs medical attention.

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What Causes Back of Ankle Pain When You Walk?

Our ankle is a complex collection of bones, cartilage, ligaments, and tendons. Damage or disease within these structures can cause ankle pain and other symptoms when you walk, put weight on the ankle joint, or move your feet. Ankle pain when walking can make just about any part of your daily routine more challenging and needs medical attention.

Learning more about what might be causing your ankles to hurt when you walk can reduce your discomfort and get you back to doing what you love.

Physical Therapy for Pain in the Back of the Ankles

Nonsurgical treatments can help to manage and reduce pain at the back of the ankles. Physical therapy can increase your ankle’s strength, flexibility, and range of motion. Your therapist will assess your symptoms, create a treatment plan specific to the injury or problem, and lead you through the recovery process.

Treatment may include:

• Taping
• Stretches
• Gait training
• Dry needling
• Manual therapy
• Posture guidance
• Therapeutic exercise
• Strength and endurance training
• Neuromuscular and balance training

They focus on therapeutic exercises, gentle stretches, joint mobilization, and soft tissue mobilization that strengthen your foot and ankle muscles and prevent the risk of future injuries.

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When to See a Doctor for Your Ankle Pain?

Most ankle pain usually gets better with rest, ice, and over-the-counter pain medications. If there is no improvement during the course of the first few days, or you have extreme ankle pain when walking or cannot move the joint, don’t delay seeing a doctor.

Seek immediate medical attention if you are unsure of the causes behind your ankle pain or if you are having the following symptoms:

• An inability to walk on the affected ankle
• A deformity around the ankle joint
• Ankle pain that occurs at night or while resting
• Ankle pain that persists beyond several days
• An inability to bend the ankle
• Progressive swelling of the joint into the foot or the calf area
• Signs of an infection, including fever, redness, and/or warm skin
• Any other unusual symptoms

The doctor will examine your joint and may ask for X-rays or other imaging tests to make an accurate diagnosis of your condition. Ankle injuries and arthritis can be treated with medication, physical therapy, and home care. However, severe ankle injuries, especially broken bones, may require surgery. You may also need surgery if you have severe ankle pain that does not get better after trying other nonsurgical treatments.

Do not let ankle pain restrict your movement or keep you from activities you love – Call Pain Management NYC today and schedule an appointment with Dr. Leon Reyfman for the best treatment and care. Dr. Reyfman is a highly rated pain management specialist in NYC and specializes in addressing pain-related issues. He focuses on finding out the causes of pain in the back of your ankles and comes up with personalized treatment plans that ensure quick and lasting relief.

Boleslav Kosharskyy, MD, is a top-rated, best-in-class interventional pain management doctor. He is board-certified in Anesthesiology, Interventional Pain Medicine, and Palliative Care.

Dr. Kosharskyy is an Associate Professor of Anesthesiology and Rehabilitation Medicine at Albert Einstein Medical College. He’s also the Associate Medical Director of Pain Medicine and Director of Anesthesia for the Joint Replacement Center at Montefiore Medical Center and Albert Einstein Medical College.

He is an active member of the American Society of Anesthesiology (ASA), the American Society of Regional Anesthesia and Pain Medicine (ASRA), and the New York State Society of Anesthesiologists (NYSSA)