Foot and Ankle pain

Most of us will experience foot and ankle pain at some point. Although it can be painful, it is rarely due to a serious cause. For most people foot and ankle pain normally resolves within 6-12 weeks without any treatment.

Common causes

A number of factors have been associated with foot and ankle pain. These include:

A sprain/strain or fall
A sudden increase or decrease in your normal activity or exercise levels
Muscle weakness
Other conditions such as osteoarthritis, rheumatoid arthritis or fibromyalgia
Following a period of increased stress, worry or low mood
Following a period of poor sleep, fatigue or feeling run down
Other lifestyle factors such as being overweight and smoking
A flare up of longstanding foot and ankle pain

Common symptoms

These include:

Pain
Swelling
Stiffness
Feeling of weakness
Feeling of instability

You may experience constant or intermittent (come and go) symptoms, that are aggravated by certain activities and reduced by others.

What can I do to help it?

In the first few days after an onset of foot and ankle pain, changing or reducing your usual activities may help. However, there is strong evidence that keeping active and gradually returning to all your usual activities and exercise will help you recover.
It is normal to experience some pain during your recovery, but it does not mean you are damaging your foot or ankle.
Try to stay at work or return as soon as you are able. Your employer, GP or health practitioner will be able to advise on how to return to your normal work duties.

Try some of these self-help tips to aid your recovery:

After a foot and ankle sprain a short period of rest (48 hours), foot elevation and using an ice pack (for up to 15 minutes) may be enough to ease your symptoms. Never apply heat or ice directly to the skin.
For foot and ankle pain (without a sprain/strain) apply a heat or icepack to the painful area – for up to 15 minutes.
A short course of simple pain medication as advised by your pharmacist or GP may help reduce pain and allow you to move more comfortably.
Keep moving. Regular movement and exercise is safe and helpful for foot and ankle pain. It is important to build up gradually – the exercise or activity you enjoy most, is likely to help your recovery.
Wearing cushioned footwear e.g., trainers can take some pressure off the foot and ankle.
Try and get a good night’s sleep e.g., place your foot on a pillow.
Good sleep habits and managing stress may help you cope better with your pain.

Facts about foot and ankle pain

Foot and ankle pain is common WITHOUT any damage to your joints, ligaments or tendons.
X-rays and scans often DO NOT show the cause of your pain.
Movement and exercise is NOT harmful for foot and ankle joints.
Your foot and ankle can become stronger and healthier with regular movement and exercise – that is built up gradually.
Creaking and clicking foot and ankle joints are common in people WITHOUT pain. It is a rarely a sign of harm or damage.
If you are overweight - losing weight by getting more active and improving your diet can improve your foot and ankle pain by reducing inflammation in your body and the load on your joints.
Improving your sleep and general health are all also important for your foot and ankle pain.

When should I seek medical advice?

Call your GP surgery if

Your pain is getting worse.
You have tried the self-help tips for 3-4 weeks and the symptoms have not improved.

Seek immediate medical advice if

After a fall, sprain/strain or twisting injury
- your foot or ankle is misshapen and swollen
- you are unable to stand or walk on it
Your calf is red, hot, swollen and tender.
You have a fever and your foot or ankle is hot, red, swollen and painful.
You are a diabetic and have an open wound, ulcer or a hot swollen foot.

Do I need an X-Ray or scan?

X-rays or scans or are NOT usually required to diagnose foot and ankle pain.
X-rays or scans are NOT able to tell us how much pain you are experiencing
X-rays and scans often show joint narrowing and osteoarthritis which are common in people WITHOUT foot and ankle pain. These findings are unlikely to change the way you manage your pain.
X-rays and scans are best used where a serious injury (e.g. a broken bone) or conditions such as cancer or infection are suspected.

Do I need a fit note?

If you’re off work sick for seven days or less, your employer will normally ask you to complete a self-certificate for sick leave as soon as you return to work.
If you're off work sick for more than seven days your employer will normally ask for a fit note (or Statement of Fitness for Work) from your GP or hospital doctor.
You can read more information here https://www.nhs.uk/common-health-questions/caring-carers-and-long-term-conditions/when-do-i-need-a-fit-note/