Experiencing a burning sensation in the ankle can be alarming and uncomfortable. While ankle pain is common after injuries like an ankle sprain, a persistent burning feeling often points to nerve involvement or a deeper chronic condition.
Dr. James C. Anderson, DPM, a nerve decompression surgeon, emphasizes that patients should not dismiss burning ankle pain as “just inflammation.” In his surgical practice and published research on nerve-related conditions such as restless legs syndrome and diabetic neuropathy, he has demonstrated that chronic burning pain is frequently a sign of nerve compression or irritation that, if left untreated, can progress to long-term nerve damage.
This article explores the leading causes, how specialists like Dr. Anderson diagnose the problem, and the treatment options available.
Common Causes of Burning Sensation in the Ankle
Several underlying issues may lead to nerve irritation or damage around the foot and ankle:
1. Tarsal Tunnel Syndrome
One of the most frequent causes is tarsal tunnel syndrome. This condition occurs when there is pressure on the tibial nerve, which runs along the inside of the ankle. Much like carpal tunnel in the wrist, compression here can trigger nerve pain, tingling, and burning sensations. Patients may also report pain and swelling that worsens with standing or putting pressure on the foot.
Dr. Anderson notes that in his studies of peripheral nerve compression, releasing trapped nerves often led to immediate improvement in burning pain. Similar mechanisms apply in the ankle, where decompression of the tibial nerve can restore function and sensation.
2. Tibial Nerve Dysfunction and Nerve Damage
The posterior tibial nerve may become injured from trauma, repetitive stress, or chronic compression. Over time, this leads to tibial nerve dysfunction. In severe cases, untreated compression causes nerve damage, which alters sensation and restricts range of motion in the ankle.
Dr. Anderson’s research on surgical decompression has shown that addressing nerve entrapments early can reverse symptoms and even restore sensation in cases previously thought to be permanent nerve loss. These findings, published in peer-reviewed studies on neuropathy and restless legs syndrome, support the role of nerve decompression in ankle-related burning pain as well.
3. Structural Foot Problems
Flat feet or abnormal arch positions may put extra strain on the tibial nerve. Similarly, a bone spur or swelling from arthritis can narrow the space where the nerve travels, further increasing irritation.
4. Injuries and Overuse
A prior ankle sprain or fracture can leave behind scar tissue or chronic inflammation. These changes sometimes trap or irritate nearby nerves, leading to a lingering burning sensation. Athletes who repeatedly stress their ankles are especially prone to this problem.
Symptoms to Watch For
Beyond the burning sensation, patients often notice:
- Tingling, numbness, or “pins and needles” in the ankle or foot
- Weakness when pushing off the toes
- Pain and swelling that worsen at night or after activity
- Stiffness and limited range of motion
Dr. Anderson stresses that these signs should not be ignored. “When nerve compression goes unchecked, it can transition from a reversible irritation to a chronic condition with permanent nerve injury,” he explains.
Diagnosis: How Specialists Identify the Cause
Because nerve pain can mimic other ankle problems, proper diagnosis is critical. Specialists may use:
- Physical examination – Testing tenderness, mobility, and sensitivity along the tibial nerve
- Electromyography (EMG) – A study that measures electrical activity in muscles to detect nerve dysfunction
- Imaging (X-ray or MRI) – To identify structural causes such as bone spurs or arthritis
In Dr. Anderson’s practice, he emphasizes the role of detailed nerve testing and patient history. His clinical findings often show that patients misdiagnosed with “arthritis” or “tendonitis” actually have nerve entrapment syndromes.
Treatment Options for Burning Ankle Pain
The right treatment depends on the cause and severity of the condition. Most patients benefit from a combination of conservative care and targeted therapies.
1. Rest and Activity Modification
Reducing activities that aggravate the nerve, such as prolonged standing or putting pressure on the inside of the ankle, allows healing time.
2. Medications
- Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce swelling and pain.
- Steroid injections may be recommended around the tibial nerve to calm inflammation in persistent cases.
3. Physical Therapy
Physical therapy improves flexibility, strengthens support muscles, and helps correct gait problems. Therapy also restores range of motion while reducing stress on the nerve.
4. Orthotics and Bracing
Custom inserts can correct flat feet and reduce nerve strain. Ankle braces help stabilize joints weakened by injury.
5. Surgical Options
If conservative measures fail, surgery may be needed to release the tibial nerve from compression. This procedure, called nerve decompression, is an area of Dr. Anderson’s surgical expertise. In his studies on restless legs syndrome and diabetic neuropathy, patients experienced reversal of nerve-related burning and tingling symptoms following decompression. These outcomes illustrate how similar principles can restore ankle function when nerve pain is caused by entrapment.
Living With a Chronic Condition
For some patients, the burning sensation in the ankle becomes a chronic condition. Ongoing management may involve:
- Regular follow-up with a nerve or foot and ankle specialist
- Long-term use of orthotics to reduce strain
- Continued physical therapy to protect nerve function
- Monitoring for progression of nerve damage
Dr. Anderson emphasizes that catching the condition early gives the best chance for full recovery. “We’ve seen in our research that timely nerve decompression can not only stop worsening symptoms but actually restore lost function,” he notes.
When to Seek Medical Help
Seek medical care if:
- The burning sensation lasts more than a few days
- Pain worsens at night or interrupts sleep
- You notice weakness, imbalance, or difficulty walking
- NSAIDs and steroid injections no longer provide relief
Prompt evaluation can prevent progression to long-term tibial nerve dysfunction.
Conclusion
A burning sensation in the ankle is often more than a minor ache. It may result from tarsal tunnel syndrome, posterior tibial nerve compression, or lingering damage from an ankle sprain. Left untreated, the condition can progress to permanent nerve damage.
Drawing from his surgical work and published research, Dr. James C. Anderson, DPM, stresses that identifying and treating nerve compression early offers the best outcomes. With diagnostic tools such as electromyography (EMG) and treatments ranging from physical therapy to surgical nerve decompression, patients can find real relief and restore mobility.
If you are experiencing persistent ankle burning or ankle pain, it is important to seek care from a specialist who understands the role of nerves. Addressing the issue early offers the best chance at recovery and a return to full activity.
