Foot & ankle

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

• 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.

• 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.
• It is recommended to try to continue 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.

Self help tips

• Within the first 24 to 48 hours of onset of an ankle problem you should try to:
  • - rest your ankle in an elevated position but avoid long spells of not moving at all

- move your ankle gently for 10 to 20 seconds every hour when you’re awake

• After 48 hours:
  • - Try to use your leg more – exercise really helps your ankle and can relieve pain.

- Do whatever you normally would and stay at, or return to work – this is important and is the best way to get better.

• 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.
• Pain medication can help to reduce the pain and help you move more comfortably, which can help your recovery. Speak to your local pharmacist about medication or other methods of pain relief . It’s important to take medication regularly.
• Keep moving. Regular movement and exercise are safe and helpful for foot and ankle pain. It is important to build up gradually – the exercise or activity you enjoy most. This 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.
• When going upstairs or downstairs , reduce the strain on your foot/ankle by using  a handrail if available.
• Avoid sports or heavy lifting until you have less discomfort and good movement. Remember to warm up before sport.

Please see our condition specific self help guides below, with exercises and management advice for you to try to self manage your condition. 

TBC

• 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 are 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.

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.

• 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.

• 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.

• You can read more information here: Getting a fit note (www.nhs.uk)