Although the ankle joint is strong enough to bear full body weight, it is designed for mobility and is prone to instability and injury. Most ankle injuries occur to the outside or lateral part of the ankle, due to its skeletal design, so pain on the outside bone of the ankle is not uncommon 1. However, according to the Mayo Clinic, because ankle pain can sometimes indicate a serious problem, severe ankle pain should be evaluated by your doctor, especially if it follows an injury 1.

Lateral Ankle Sprain

A sprain is a tearing, partial or complete, of the bands of tissue that connect bone to bone, called ligaments. Most ankle sprains occur when the ankle rolls inward, in part, because the outer ankle bone is longer than the inner ankle bone. According to the Mayo Clinic, signs and symptoms of an ankle sprain include pain--especially with weight bearing--swelling and bruising around the bone and restricted range of motion 1. While most ankle sprains can be treated at home with ice, compression, elevation and rest, the only way to rule out an ankle fracture is a visit to a physician.

Ankle Fracture

A fracture of the outer bone of the ankle, or fibula, can occur during an ankle sprain in two ways. During a typical ankle sprain, a ligament can pull off a piece of the outer ankle bone. This is called an avulsion fracture and is diagnosed with the aid of an x-ray. The fibula can also suffer a fracture when the ankle is turned forcefully outward and the foot and ankle bones collide. The patient will generally have difficulty bearing any weight on the involved ankle and should seek a physician's advice.

Tendinitis

The peroneal tendons run behind the outer ankle bone and can become inflamed and painful as a result of an ankle sprain or overuse. According to the American Academy of Orthopaedic Surgeons, symptoms of peroneal tendinitis include ankle pain that is not responding to treatment, swelling and tenderness around the outside of the ankle, pain behind the ankle bone and pain that transmits from the ankle down to the foot 123. The Academy of Orthopaedic Surgeons also suggests that a proper diagnosis is essential to treat peroneal tendon injuries correctly and to help alleviate chronic pain 23.

Arthritis and Gout

Osteoarthritis, or wear and tear arthritis, can occur in older individuals who have suffered frequent ankle sprains. According to the American Academy of Orthopaedic Surgeons, osteoarthritis progresses slowly and the pain and stiffness it causes worsens over time 23. According to the Mayo Clinic, with an attack of gout, the affected joint is hot, swollen and so tender that even the weight of a bedsheet on it seems intolerable 1.