Gout in ankle: symptoms, causes, treatments

If you’re experiencing intense ankle pain along with burning, tingling, and swelling, gout may be a possible cause. Gout is a type of inflammatory arthritis that often affects the ankles, big toes, feet, and knees. It occurs when uric acid (a substance your body normally gets rid of) builds up and crystallizes in the joints. 

Pain from gout in the ankle can be intense. “Your ankle may feel hot, swollen, and inflamed for a few days during a gout flare,” says Mary Kimbrough, PT, DPT, a physical therapist with Hinge Health. “It may be difficult or painful to walk, stand, or climb up and down stairs, and sleep comfortably.”

While a gout flare can feel very painful, it’s often manageable. More often than not, rest is the key to getting through an acute gout episode. But engaging in gentle, targeted mobility movements may ease gout pain following a flare. Easing back into exercise after a gout flare with low-impact activity can help increase blood to the area and promote healing. Everyone is different, so it’s important to talk to a healthcare provider about the best approach for your needs. 

Read on to learn more about how to help prevent and manage gout in the ankle, including exercises recommended by our Hinge Health physical therapists.

Gout in ankle symptoms 

The most common symptom of gout in the ankle is sudden, sharp pain, says Dr. Kimbrough. It tends to come on suddenly, with the most intense symptoms occurring within the first 12 to 24 hours after it begins. Other gout symptoms in your ankle include:

• Warmth 

• Tenderness

• Swelling

• A shiny, redness appearance to your skin (usually from swelling)

• Stiffness that limits your range of motion

Gout can sometimes affect both ankles, but it’s usually more pronounced in one ankle. This is often the ankle where you may already have another condition, such as osteoarthritis.

What causes gout in the ankle?

Gout in the ankle is a result of uric acid buildup. It tends to develop earlier in men — usually between the ages of 30 and 45 — than in women, who often get it after age 55. Other factors that can increase your risk of gout include:

• A diet high in purines. Eating a lot of meat or seafood and drinking sugary beverages like soft drinks and alcohol (especially beer or cider) can all increase your risk for gout. “These foods and drinks are high in purines, which are natural compounds that break down into uric acid during digestion,” says Dr. Kimbrough.

• Being overweight. Carrying extra weight increases the risk of gout because it raises uric acid production and makes it harder for your kidneys to eliminate uric acid effectively. Taking small steps to support your overall well-being — like staying active and eating a balanced diet — can help lower your risk and support your joint health.

• Underlying health conditions. Conditions such as obesity, insulin resistance, high cholesterol, heart disease, and kidney disease are all linked to a higher risk of gout.

• Medications. Some medications, such as diuretics for blood pressure, daily aspirin, and certain cholesterol-lowering drugs, may also increase gout risk because they can lead to higher uric acid levels in your body. If you have questions about your medications or overall risk, talk to your healthcare provider.

• Previous ankle injuries. A past ankle injury, like an ankle sprain, can increase your risk of gout in the ankle. Injuries can lead to changes such as inflammation and cartilage loss, making the joint more susceptible to uric acid crystal deposits.

• Genetics. Family history plays a significant role — if gout runs in your family, your risk is higher.

How can exercise help gout in the ankle?

When you’re in the thick of a gout flare, you may be in too much pain or discomfort for vigorous physical activity. That said, you may find relief from simple ankle movements that help to increase mobility and ease inflammation in the area. “Light movement can improve blood flow to the area, which in turn can reduce pain,” says Dr. Kimbrough.

Once the gout flare begins to subside, and the redness and swelling ease up, try low-impact cardio like walking, swimming, water aerobics, or cycling. 

Aerobic exercises can also help manage other conditions that increase the risk of gout in the ankle, like high blood pressure, chronic kidney disease, or obesity. Once you get the okay from your physical therapist or healthcare provider, you can return to high-impact activity, like running. The key is to stay consistent: Research shows that staying active not only reduces your risk of future gout flares but can also help make them less painful if they do occur.

Gout flares can be very painful, which is why it’s essential to listen to your body. During a flare, you may not be able to exercise like you’re used to. If movement feels okay, consider performing the gentle, targeted exercises above. These moves can enhance ankle mobility, increase strength in supporting muscles, and alleviate pain. These exercises can help you move better by breaking up stiffness and rigidity from inflammation linked to gout. “The goal is to increase your ankle’s range of motion so you can get back to everyday activities with minimal discomfort,” says Dr. Kimbrough. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for gout in ankle

Gout flares can feel overwhelming, but early treatment can help you get relief and lower the risk of future episodes. While symptoms often improve on their own with time and conservative treatments, addressing them early can ease discomfort and support your ankle health.

• Try physical therapy and targeted exercises. During a gout flare, a physical therapist can help you protect your ankle using a supportive device such as a brace or cane as you heal. “As your symptoms start to improve, your physical therapist can guide you through gentle movements and strengthening exercises to reduce lingering inflammation and help you return to your usual activities,” says Dr. Kimbrough. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Apply heat and cold therapy. Ice can help tame inflammation, which is why Dr. Kimbrough recommends using this method within the first 10 days of a gout flare. Once swelling and redness dissipates, taking a warm bath or using a heating pad can help promote blood flow to the affected ankle. If one method feels better for you, stick to that one. 

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for managing pain from gout in the ankle. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Dietary changes. Making changes to your diet can help manage gout symptoms. “Try to limit foods like red meat, seafood, alcohol, and sugary drinks, which are all rich in purines and can raise uric acid levels in your body,” says Dr. Kimbrough. Instead, focus on enjoying more fruits, vegetables, whole grains, and lean proteins to support your overall health — and keep gout at bay.

How to prevent gout in the ankle

There are a few things that you can do to help prevent a future flare. These include:

• Stay hydrated. Drinking enough water can help keep uric acid levels low, which can reduce the risk of gout flares. “Staying hydrated is especially important if you take medications, like certain blood pressure drugs, that have a diuretic effect on your body,” says Dr. Kimbrough.

• Watch your diet. Choosing more plant-based foods, including fruits, vegetables, whole grains, nuts, and seeds can help lower your risk of gout and improve your overall health. 

• Exercise regularly. Gout episodes happen when uric acid builds up in your joints, leading to intense discomfort. Physical activity (outside of a flare) can help reduce these levels in the body, which may prevent painful gout flares. It can also help lower other risk factors you may have that raise risk of gout, such as high blood pressure.

When to see a doctor

Gout is a medical condition that typically requires care from a healthcare provider — often an internal medicine, family medicine, or rheumatology doctor. Prescription medications are usually needed to prevent future flares and help treat symptoms during a flare.

If you’re not already under a doctor’s care for gout, it’s important to get connected with one. And even if you are, reach out if your symptoms persist or worsen despite self-care steps like gentle movement, hydration, or dietary changes.

Contact a healthcare provider if you’re experiencing the following:

• Severe or unrelenting pain

• Frequent gout flares

• Significant swelling, redness, or warmth in your ankle

• Difficulty moving your ankle

• Fever or drainage from the painful area

PT tip: Make opportunities for your ankle to move  

It’s fine to use an ankle brace or boot for support during a gout flare, says Dr. Kimbrough. “Once the redness and swelling go down, try to rely on the brace less so you don’t end up with extra stiffness that can make getting back to your usual activities more challenging,” Dr. Kimbrough says. Gradually returning to movement helps your ankle stay flexible and strong.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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