Painful Ankles in the Morning? Causes & How to Treat Them

If you're suffering from early morning ankle pain, here are some of the main symptoms to look out for:

• Pain
• Stiffness
• Swelling and redness

The severity of symptoms can differ from person to person, and some may experience a combination of these symptoms together at once.

Many people deal with joint pain and stiffness after middle age, though it's possible to experience ankle pain in the morning at any age. The ankles are the most common joints that people find can become painful or stiff in the morning, some of the possible reasons for this can include:

• Arthritis - Osteoarthritis is the most common form which causes pain and inflammation affecting a joint caused by breakdown of the smooth cartilage layer. Another type of arthritis that can cause stiff ankles in the morning is Rheumatoid Arthritis (RA), which causes similar longer lasting pain symptoms.
• Tendonitis - a painful condition that affects the tendons around a joint.
• Plantar Fasciitis - A condition that causes discomfort under your heel when walking which typically affects people in middle age. The plantar fascia is a band of tissue (fascia) that connects your heel bone to the base of your toes. Plantar Fasciitis occurs when it's stretched out too much leading to irritation and inflammation resulting in discomfort in foot and ankle pain.
• Bad fitting shoes - Shoes that are too small or too large can hurt your ankles. A small fitting shoe will start hurting very quickly. If the shoe is oversized, the muscles in the bottom of your foot will constantly tighten to stop it from sliding around which can also result in Plantar Fasciitis.
• Previous injury - if you have a previous ankle injury such as a sprained ankle, potentially from sports or an accident.
• Flat Feet - If you have flat feet, they will be flat on the surface without an arch. They usually don't lead to any serious issues but can cause pain around your ankle.
• Overuse - exercise or a strenuous activity for an extended period.

Early morning ankle stiffness can be very painful, but usually only lasts around 30 minutes. For some people, the ankle pain can alleviate as they start their day and begin moving around.

Getting out of bed to discomfort in your ankles is a terrible way to start the day. Luckily, there are a few different home remedies, exercises and medicinal treatments that can help alleviate ankle pain in the morning. Let's take a look.

Home remedies

There are various things you can do at home to help ease ankle pain when you wake up, depending on the cause:

• Ice - using ice packs on your ankle to reduce swelling. You can also wrap frozen peas in a towel. Icing should be applied for up to 20 minutes every 2-3 hours.
• Rest - resting your ankle by keeping weight off it.
• Elevating your ankle - lifting your ankle while lying down by placing a pillow or cushion under it.
• Compression wraps - used to help alleviate pain and swelling faster.
• Following a physical therapy regime - your doctor may recommend a physiotherapy regime to carry out at home, which aims to strengthen the muscles around your ankle.

The best method to help with arthritic ankle stiffness is movement. It helps with stiffness in the morning in Rheumatoid arthritis, especially the ankle and hands.

You should avoid walking or standing for extended periods. High heels or tight footwear should also be avoided. If it's caused by an injury, do not take ibuprofen for the first 48 hours, as this can slow down the healing process.

Treatments

If the pain is persisting, or is getting in the way of your morning routine, it's a good idea to consider using pain relief treatments to reduce symptoms. There are also a range of anti-inflammatory treatments out there that can help reduce and prevent joint pain.

• Paracetamol- a common over the counter painkiller used to treat mild to moderate pain.
• Ibuprofen / Nurofen- a pain relief medication with anti-inflammatory properties.
• Diclofenac gel (Voltarol) - Diclofenac sodium is an anti-inflammatory pain reliever that can be rubbed directly onto the ankle. It can reduce swelling within 20-30 minutes however the full anti-inflammatory effects can take up to 2 days if applied regularly.
• Flexiseq gel - A drug-free medicine available without a prescription that targets joint pain and stiffness helping to improve joint mobility. Available in 2 gels, Flexiseq (for Joint Wear & Tear) and Flexiseq Max Strength (for Osteoarthritis).

Exercises for ankle pain in the morning

If you experience painful ankles in the morning, here are some light exercises that can help alleviate the pain:

Ankle circles

1. Sit in a solid chair and place your leg in a crossed position over your lap.
2. Gently rotate your ankle in a circular motion.
3. Maintain a comfortable range of motion and avoid forcing the movement.
4. Do the exercise until the swelling or stiffness in your ankle alleviates.
5. Repeat the exercise on your other ankle.

Remember to focus on your breathing while stretching. You should take a slow and controlled breath in through your nose and then breath out through your mouth, and repeat until you have finished stretching.

Achilles stretches

1. While standing, place your hands in front of you on a wall for balance.
2. Place the leg you are stretching one step behind your other leg.
3. Carefully bend the knee closest to the wall while keeping the soles of your feet planted. You should be able to feel your Achilles tendon that is furthest from the wall stretching.
4. Repeat the exercise by swapping the position of your legs.

Towel stretches

1. Sit on the floor with your legs positioned flat in front of you while keeping your back straight.
2. Wrap a towel or a suitable piece of fabric around the toes of the foot that has a stiff ankle.
3. While keeping your shoulders down and away from your ears, gently pull the towel towards you until you can feel a slight stretch in your ankle.
4. Repeat the exercise on the other foot.

Doing stretching exercises each morning can help reduce stiffness by improving your ankle's flexibility.

Most cases of early morning ankle stiffness will pass within 30 minutes. The advice in this guide should help reduce the pain and duration of discomfort if followed regularly; however, if you don't notice any improvement or the pain is severely impacting your morning routine, you should contact your doctor or health care provider to discuss your symptoms.

If you have severe symptoms such as numbness, unusual shape under the skin, weakness, fevers, or a break to the skin and have diabetes you should seek urgent medical advice from your doctor.

We're here to help so if you have any questions about painful ankles in the morning, please get in touch with our caring team of medical experts.