Where is the pain located?

Pain on the outside of the foot or ankle joint is often caused by overstrain in sports or accidents in everyday life. Mostly the outer ligaments of the ankle joint are affected, which can be stretched, pulled or even torn due to a twist trauma. An ankle joint fracture can also occur, whereby the upper ankle joint is usually affected.

Furthermore, the cause of pain in the ankle joint may be external joint degeneration (arthrosis) or inflammatory diseases of the joint such as arthritis, but also old injuries of the ligaments or bones, as well as congenital malpositions of the ankle or ligaments. A torn or stretched ligament often causes pain over a large area, as it is often accompanied by massive swelling and bruising in and around the joint, which press on the injured ligaments. A characteristic feature of pain in the outer ankle joint is that it increases with movement and load.

Instability in the joint can also become noticeable, leading to more frequent twisting and bending, thus making the ligament stretching even worse. The so-called Os-trigonum syndrome can be another trigger for pain in the outer ankle. The Os trigonum (triangular bone) is a small bone at the rear end of the ankle bone, which is surrounded by various ligaments and when these are put under a lot of strain, irritation occurs, which can lead to persistent pain in the outer ankle joint.

A specialist in orthopedics and trauma surgery should be consulted at an early stage, who can make a reliable diagnosis through specific examination, X-ray diagnostics or magnetic resonance imaging (MRI), in order to prevent consequential damage, such as the development of joint wear and tear or malpositioning. Depending on the cause, treatment ranges from protection and cooling, to immobilisation of the ankle with a plaster cast or splint, to surgical measures. Here, too, accidents or sports injuries are often the cause of pain, although stretching of the ligaments on the inside of the ankle joint occurs much less frequently.

Other causes can be a fracture of the ankle or the lower fibula. Besides the pain, symptoms include swelling, restricted mobility and instability of the joint. Here, too, it is essential to see a doctor, who can differentiate between damage to the ligaments and a fracture and decide on the right therapy.

Morning foot pain can be caused on the one hand by heel spurs, on the other hand by joint wear and tear in the ankle (arthrosis). As with osteoarthritis in other joints, pain in the affected joint often occurs after long periods of rest, often in the morning, so called tarnishing pain, until the joint has “warmed up”. Joint degeneration in the ankle already affects younger patients; often as a result of older injuries or trauma.

Typical symptoms continue to be pulling deep in the ankle, relieving postures, malpositioning and, in the late stages, resting pain. The diagnosis is made by the orthopedic surgeon through targeted questioning and imaging techniques. Therapy includes analgesic medication, physiotherapy, orthopedic footwear and, in cases of advanced wear, surgical measures.

Heel spur, on the other hand, is often caused by an irritated plantar fascia due to constant overloading. The plantar fascia is the tendon that originates at the heel bone and is needed for walking. The constant irritation causes the attachment of this tendon plate to ossify as a countermeasure of the body. Pain in the morning and increasing pain under stress are typical symptoms.The therapy uses orthopedic insoles, heel pads, cooling, stretching, possibly painkilling medication and, if there is no improvement, shock wave therapy.