Ankle pain is more common than you might think — affecting between 9% and 15% of adults — and it often comes with visible swelling. That swelling usually points to soft tissue damage, like a sprain, where ligaments are stretched or torn. You can occasionally have an ankle injury without swelling, but what happens when seemingly your ankle hurts for no reason, and there’s no noticeable swelling at all? It can leave you wondering what’s going on — and whether you should be concerned.

Pain in the ankle without swelling can still signal an underlying issue that deserves attention. In fact, chronic ankle pain — even without visible inflammation — can significantly affect your quality of life, limiting your ability to walk, run, or simply enjoy daily activities.

Here’s what could be going on when your ankle hurts for no apparent reason and how physical therapy can help.

4 Potential Reasons Your Ankle Hurts With No Swelling

1. Osteoarthritis
   Osteoarthritis (OA) is a common degenerative joint condition that often affects people over the age of 50. It occurs when the protective cartilage in the joint wears down over time, leading to pain, stiffness, and decreased range of motion. In the ankle, OA may not always cause swelling, especially in early stages — but can result in pain that worsens with prolonged activity or after periods of rest.
2. Joint instability
   An old ankle injury without swelling, such as a sprain or other repeated minor injuries, can lead to lingering joint instability, even if your ankle looks fine on the outside. Weakness in the ligaments and tendons that support the joint can cause discomfort, balance problems, or a feeling of “giving out,” often without visible swelling. This is especially common in people who’ve sprained the same ankle more than once.
3. Achilles tendinitis
   Your Achilles tendon connects your calf muscles to your heel. Overuse, especially from running or sports, can cause small tears or irritation in this tendon. Pain from Achilles tendinitis often feels sharp or burning near the back of the ankle, especially after activity. Despite this discomfort, it typically doesn’t cause much swelling, at least not in the way a sprain might.
4. Peripheral neuropathy
   If your ankle pain feels more like tingling, burning, or numbness, you might be dealing with nerve-related discomfort. Peripheral neuropathy, which can be caused by diabetes, autoimmune conditions, or viral infections, occurs when nerves in the lower legs or feet are damaged. This condition can lead to ankle pain without swelling, and it may feel worse at night or during rest.

Physical therapy can help your sprained ankle no swelling but painful symptoms!

If you’re dealing with ongoing ankle pain and aren’t seeing obvious signs of swelling, a physical therapist can help identify the root cause and develop a treatment plan to help you move better and feel stronger. Here are three effective PT methods for ankle pain relief:

1. Manual therapy
   Manual therapy techniques like soft tissue mobilization and joint mobilization can help restore movement and reduce discomfort. Your therapist may use gentle manipulation to improve joint function or massage techniques to release tension in tight muscles and tendons. Even if swelling isn’t visible, manual therapy can address stiffness and restore more normal ankle movement.
2. Aquatic therapy
   Working out in water can be especially helpful for ankle pain, whether or not swelling is present. Aquatic therapy uses the buoyancy of water to reduce stress on the joint while still allowing for movement and strengthening. Warm water also improves circulation, and the hydrostatic pressure can help with hidden or internal inflammation. You can build strength and range of motion without aggravating your symptoms.
3. Active ankle exercises
   Targeted exercises designed to strengthen the muscles surrounding your ankle joint can help improve balance, reduce instability, and decrease long-term pain. Your physical therapist may guide you through movements like:
   • Ankle dorsiflexion and plantar flexion with resistance bands
   • Balance work on a foam pad or wobble board
   • Heel raises or toe taps to activate foot and ankle stabilizers

These exercises can help distribute pressure more evenly across the ankle joint, even when the cause of your pain isn’t visible on the surface.

Can physical therapy help with twisted ankle pain no swelling symptoms?

Absolutely. While swelling is often a sign of acute injury, pain without swelling may be linked to deeper or more chronic issues that require expert guidance. Physical therapists are trained to detect subtle imbalances, movement issues, and neuromuscular deficits that could be contributing to your symptoms, and they’ll design a custom plan to help you recover safely.

Lattimore Physical Therapy is here to help you get back on your feet!

If you’re struggling with ankle pain — even if there’s no swelling — the team at Lattimore PT is ready to help. Our licensed physical therapists take a hands-on, compassionate approach to care, combining advanced techniques with personalized plans to get you moving with confidence again.

We offer services like manual therapy, aquatic therapy, and strength-building exercises to help you manage and reduce your ankle pain. No matter the cause, we’ll work with you to find a solution that fits your goals and your lifestyle.

Contact us today to learn more or schedule your first appointment — and start taking the next step toward ankle pain relief.