Are you having a swollen ankle with or without associated pain and wondering what you can do?
I see so many people having this problem every day. Sometimes without any specific cause, sometimes when they have had a fracture, a fall, surgery or circulatory issues.
Most people I see have so many questions and always seem to worry about it.
As a radiographer I will address the most frequently asked questions based on my professional knowledge. I will also rely on medical publications. All references at the end of this article.
Happy reading!😃
Any questions? remarks? Let’s meet in the comments section at the end of this article.🙏
Last updated: Journey 2025. Written by Juliet Semakula, a diagnostic.
Disclaimer: no affiliate links.
Case1️⃣:One swollen and painful ankle with or without injury
Swelling and pain in one ankle can sometimes signify a more serious underlying condition, especially if the swelling is sudden or doesn’t resolve with essential home remedies or self-care.
Or sometimes it may not be serious.
Case study: of a medical case where diagnosis was delayed after an ankle swelling examination.
A 65-year-old presented with pain and swelling in one ankle without any injury, on examination, she could put weight on the ankle.
The doctor found a slightly oedema with erythema, and tenderness on the ankle but there were no abnormal findings even on x-ray apart from degenerative changes
She was sent home with simple analgesics and advised to rest. However, two weeks later she returned with worsening symptoms, repeat x-rays revealed a stress fracture on the ankle (Han et al 1989)
So, it is very possible to have swelling and pain with or without injury. Finding the right diagnosis will depend on the cause and treatment will be on an individual basis.
Here are some of the causes:
🟡Wear and tear can be the main cause for ankle pain without injury. The conditions that are usually associated with this are different types of arthritis such as gout, osteoarthritis of rheumatoid arthritis
🟡Bursitis is usually caused by an injury or infection that can cause inflammation of a bursa in the ankle.
🟡Infection caused by Cellulitis can cause your ankle to swell and feel pain.
🟡Tendinitis is when the ankle gets inflamed between the thick fibrous cords that attach muscle to bone.
Image of Swollen ankle with pain
Case2️⃣: One swollen ankle without pain
Swelling in one ankle without feeling any pain or discomfort is common and can be caused by various reasons.
The cause can be due to anything from circulation issues to an infection or injury.
Here are a few situations in which it is entirely possible to have a swollen ankle or malleoli without pain.
🟣Sometimes standing or sitting in the same position for too long can cause your ankle to swell with no pain.
🟣Also, some pregnant women experience swollen ankles without pain.
🟣Being overweight sometimes causes your ankle to swell.
🟣Taking certain medication such as blood pressure, contraceptives, hormone therapy and pills can cause your ankle to swell without pain
🟣Deep vein thrombosis is a blockage in the blood vessels in the ankle which can lead to a clot in the leg’s deep vein, it may start with swelling only without pain.
🟣Peripheral artery disease is another condition that can cause a blockage in the blood vessels, leading to painless swelling in one ankle.
🟣Lymphedema is caused when the lymphatic system is not working properly, fluid can accumulate in the tissues, causing swelling in one ankle.
🟣Trauma caused by injuries on the ankle such as sprains or strains may lead to swelling with minimal discomfort without pain if the ligaments or tendons around the ankle absorb most of the impact.
🟣Infection of the skin such as cellulitis can lead to localised swelling in the ankle. Although cellulitis usually comes with pain but in the early stages pain may be the sole symptom.
🟣Gout is a form of arthritis that usually comes with swelling and pain but in the early stages you may not feel any pain, but the swelling will be evident.
🟣Septic arthritis is when a joint in your ankle is affected with bacteria or other microorganism, initially you can only have swelling without pain.
🟣Athlete’s foot is a common condition that affects the feet, you may experience itching, redness and stinging, it is cause mainly by fungus. This can cause swelling on the ankle without pain.
🟣Insect bites or stings especially when you are allergic, they can trigger the immune system to release chemicals like histamines, leading to swelling.
🟣Ankle swelling is also common in summer, typically from patients with no obvious cardiovascular disease (Liu et al 2016)
Image of a swollen ankle without pain
▶️ What can you do if your swollen ankle is not painful?
Even when your swollen ankle is not painful, it is important to monitor it closely.
Persistent swelling accompanied by other symptoms like skin colour, warmth or fatigue may require you to see a doctor especially when you have tried rest and elevation, and nothing has worked.
▶️Can a swelling ankle go away on its own.
Yes, absolutely, swelling on your ankle can go away on its own. I have seen examples of conditions such as ligament rupture in the ankle, grades 2 and 3 sprain or water retention.
So, keep the faith if you have ankle swelling, it can go away on its own with time.
▶️Treatment for painless ankle swelling will vary depending on the cause.
But to give you some reassurance most cases, medical, non-medical or surgical treatments for ankle swelling are the same.
Here is an overview of commonly suggested treatments by professionals.
♦Rest your feet and wear wide comfortable shoes with a low heel and a soft sole.
♦Keep your feet clean, dry and well moisturised to avoid any infection.
♦You can also apply ice on the swollen ankle, Ice is most beneficial if your ankle problem is related to an injury.
You can try heat to help your pain levels if there’s no swelling and your symptoms are not related to a recent injury.to ease the swelling.
♦You are encouraged to raise your leg or elevate on a chair whenever you can, it helps to decrease swelling.
♦You can try gentle exercises such as walking to help improve blood supply
♦Avoid standing still for a long time.
♦Wear compression socks, which have been shown to reduce lower limb swelling in some people.
♦Receiving manual lymphatic drainage
♦Wearing an ankle brace, applying strapping or other compressive bandages.
♦Taking anti-inflammatory medications.
♦Receiving injections
♦Applying essential oils or ointments.
♦Considering surgical intervention
♦Reducing salt intake
▶️Has your ankle been swollen for a long time or a short time?
According to Gasparis et al 2020, in their healthcare publications, they recommend considering when the swelling appeared
Getting medical help for your ankle will depend on how long or short you have had the pain or swelling and how it is affecting your daily life.
1️⃣Is the onset recent? Less than 3 days or 3 months?
2️⃣Is the onset long-standing? more than 3 months.
From their publication I retrieved the most common causes of swelling on one side of the ankle, depending on whether the swelling has been present for a long time or not:
The most common causes of unilateral ankle swelling on one side: Gasparis et al 2020
▶️When should you see a doctor for a swollen ankle on one side?
However, if the swelling and pain has not improved after treating it at home for a few days and if you have the following symptoms, you can consult your doctor without urgency.
🟣The swelling is only in one ankle and there’s no obvious cause, such as an injury.
🟣If you have great difficulty walking while bearing weight on the ankle
🟣The swelling is severe, painful or starts very suddenly.
🟣The swollen area is red or feels hot to the touch
🟣Your temperature is very high (38 degrees or higher), or you feel hot and shivery
🟣You have diabetes
🟣It gets worse and destructing your dairy activities.
▶️How can you be sure it’s not something serious?
Even though it’s often impressive and worrying, swelling in one ankle is in most cases, something benign, it is not a sign of a more serious underlying disease in most cases.
It’s always human when you have some condition to always think of the worst situation, for example I see patients every day who come for biopsy samples.
Always their first question is, do you think it is cancer? We tend to seek information that confirms it rather than information that contradicts it.
Always when we are worried about a serious condition, we ignore evidence suggesting otherwise.
So, in my opinion if you are worried instead of being biased, you can always speak to your doctor. Explaining your symptoms will help your doctor to guide you with appropriate treatment.
You can also seek opinions from other people who might have had the same symptoms.
Or you can decide to try the treatment options based on how effective the treatment is, minimum side effects and cost. But do always seek advice from your doctor.
We have come to the end of this article, wishing you a quick recovery!🙋
Any questions let’s meet in the comments section.
📚Source:
Han KH, Maitra AK. Ankle swelling is not always ‘medical’. Arch Emerg Med. 1989 Mar;6(1):56-8. doi: 10.1136/emj.6.1.56. PMID: 2712990; PMCID: PMC1285559.
Lin YH, Chen CY, Cho MH. Effectiveness of leg movement in reducing leg swelling and discomfort in lower extremities. Appl Ergon. 2012 Nov;43(6):1033-7. doi: 10.1016/j.apergo.2012.03.002. Epub 2012 Apr 1. PMID: 22472344.
Herrera-Pérez M, González-Martín D, Vallejo-Márquez M, Godoy-Santos AL, Valderrabano V, Tejero S. Ankle Osteoarthritis Aetiology. J Clin Med. 2021 Sep 29;10(19):4489. doi: 10.3390/jcm10194489. PMID: 34640504; PMCID: PMC8509242.
Gasparis AP, Kim PS, Dean SM, Khilnani NM, Labropoulos N. Diagnostic approach to lower limb edema. Phlebology. 2020 Oct;35(9):650-655. doi: 10.1177/0268355520938283. Epub 2020 Jul 6. PMID: 32631171; PMCID: PMC7536506.
Liu F, Allan GM, Korownyk C, Kolber M, Flook N, Sternberg H, Garrison S. Seasonality of Ankle Swelling: Population Symptom Reporting Using Google Trends. Ann Fam Med. 2016 Jul;14(4):356-8. doi: 10.1370/afm.1953. PMID: 27401424; PMCID: PMC4940466.