Why Do My Ankles Hurt When I Wake Up?

Publish Date: 22 December 2025

Why do my ankles hurt when I wake up is a question many people ask after experiencing stiffness, aching, or sharp pain in their ankles during the first steps of the day. Morning ankle pain can be surprising and frustrating, especially when it improves after walking for a few minutes, only to return the next morning. This pattern often indicates underlying mechanical, inflammatory, or circulatory issues rather than an isolated injury.

During sleep, the body is relatively inactive for several hours. Joints, tendons, and surrounding soft tissues are not moving through their normal ranges of motion, which can lead to stiffness and discomfort upon waking. In some cases, morning ankle pain is harmless and temporary, but in others, it may be an early sign of a condition that requires attention. Understanding the possible causes helps determine whether simple home care is sufficient or if medical evaluation is necessary.

Common Causes of Ankle Pain Upon Waking Up

Morning ankle pain is rarely random. It is usually related to how joints, muscles, tendons, and ligaments respond to prolonged rest, inflammation, or repetitive stress. Identifying the most common causes can help narrow down the source of discomfort.

Inactivity and Reduced Joint Lubrication

When you sleep, your ankle joints remain relatively still for hours. Joint movement is essential for distributing synovial fluid, which acts as a lubricant and shock absorber. Without regular movement, this lubrication decreases temporarily, leading to stiffness and pain when you first put weight on your ankles.

This type of pain is often described as stiffness rather than sharp pain and usually improves after a few minutes of walking. It is more common in people who are sedentary, older adults, or those with mild degenerative joint changes. While generally not serious, persistent stiffness may indicate early joint degeneration or inflammation.

Plantar Fasciitis

Plantar fasciitis is one of the most common causes of morning foot and ankle pain. It involves inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot and connects the heel to the toes. Although the pain is often felt in the heel, it can radiate toward the ankle.

During sleep, the plantar fascia tightens as the foot rests in a pointed position. When you stand up in the morning, the sudden stretch can cause sharp pain. This condition is especially common in people who stand for long periods, have flat feet or high arches, or wear unsupportive footwear.

Tendinitis (Tendon Inflammation)

Tendinitis occurs when tendons around the ankle become inflamed due to overuse, repetitive strain, or sudden increases in activity. The Achilles tendon and posterior tibial tendon are commonly affected and can cause pain that is worse in the morning.

During rest, inflamed tendons stiffen, making the first movements of the day painful. As the tendon warms up with activity, pain may decrease temporarily. However, without proper management, tendinitis can worsen and lead to chronic discomfort or even tendon tears.

Types of Arthritis (Osteoarthritis and Rheumatoid Arthritis)

Arthritis is a major cause of morning ankle pain, particularly when stiffness lasts longer than 30–60 minutes. Osteoarthritis results from wear and tear of joint cartilage and commonly causes stiffness and aching after periods of inactivity. Rheumatoid arthritis, on the other hand, is an autoimmune condition that leads to joint inflammation and prolonged morning stiffness.

In inflammatory arthritis, ankle pain is often accompanied by swelling, warmth, and reduced range of motion. Morning stiffness that improves slowly over time is a hallmark sign and should not be ignored.

Improper Sleeping Postures and Bedding

The way you sleep can also influence ankle pain. Sleeping with the feet pointed downward for long periods can shorten the Achilles tendon and surrounding muscles, leading to stiffness upon waking. Mattresses that are too soft or too firm may also alter joint alignment and increase stress on the ankles.

Additionally, lack of proper foot support during sleep can contribute to muscle tightness and discomfort. While this cause is often overlooked, simple changes in sleeping posture or bedding can make a noticeable difference.

Potential Medical Conditions Based on Pain Origin

In some cases, morning ankle pain is linked to specific medical conditions rather than general stiffness or overuse. Understanding these possibilities is important, especially when pain is persistent or worsening.

Residual Effects of Previous Ankle Sprains or Injuries

A previous ankle sprain can leave lasting effects even after the initial injury seems healed. Ligament damage, scar tissue, or subtle joint instability can cause stiffness and pain after periods of rest. Morning pain is common because the ankle has not been moving overnight, allowing stiffness to set in.

If you have a history of ankle injury and continue to experience morning pain, it may indicate incomplete healing or chronic instability. You can learn more about this condition by reviewing detailed information on ankle sprain at
https://omerbozduman.com/en/general/what-is-an-ankle-sprain-how-is-it-treated/

Stress Fractures and Bone Issues

Stress fractures are small cracks in the bone caused by repetitive force or overuse, often seen in athletes or individuals who suddenly increase physical activity. Ankle pain from stress fractures may be subtle at first and worse in the morning due to localized inflammation.

Bone-related pain is usually more persistent and may worsen with weight-bearing activity. Unlike simple stiffness, it does not improve significantly with gentle movement and often requires medical imaging for diagnosis.

Tarsal Tunnel Syndrome (Nerve Compression)

Tarsal tunnel syndrome occurs when the tibial nerve is compressed as it passes through the tarsal tunnel near the ankle. This condition can cause pain, tingling, burning, or numbness, which may be more noticeable in the morning after prolonged rest.

Symptoms can worsen at night and persist upon waking. Nerve-related pain often feels different from joint or tendon pain and may radiate into the foot or toes.

Impact of Systemic Diseases (Gout, Lupus, etc.)

Systemic conditions such as gout, lupus, or other inflammatory diseases can cause ankle pain that is worse in the morning. Gout, in particular, can cause sudden, severe pain due to uric acid crystal buildup in the joint.

These conditions are often accompanied by other systemic symptoms such as fatigue, fever, or pain in multiple joints. Morning ankle pain in this context should prompt medical evaluation.

Home Remedies to Alleviate Morning Ankle Pain

For many people, morning ankle pain can be managed effectively with simple home-based strategies. These approaches focus on improving flexibility, reducing inflammation, and supporting joint health.

Stretching Exercises Before Getting Out of Bed

Gentle stretching before standing up can significantly reduce morning pain. Ankle circles, calf stretches, and gentle dorsiflexion movements help warm up the joint and improve circulation.

Stretching the calves and Achilles tendon before placing full weight on the ankles reduces sudden stress on stiff tissues and can make the first steps of the day more comfortable.

RICE Protocol (Rest, Ice, Compression, Elevation)

The RICE protocol is a time-tested method for managing inflammation and pain. Resting the ankle, applying ice to reduce swelling, using compression for support, and elevating the leg can help relieve symptoms.

This approach is particularly useful after increased activity or mild injury and can prevent morning pain from becoming chronic.

Over-the-Counter Pain Relievers and Anti-inflammatories

Non-prescription medications such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation. These should be used cautiously and according to instructions, especially in individuals with other medical conditions.

While medications can provide relief, they should not replace addressing the underlying cause of ankle pain.

Use of Proper Footwear and Supportive Orthotics

Supportive footwear plays a crucial role in ankle health. Shoes with good arch support, cushioning, and stability reduce strain on the ankle joints and tendons. Orthotic inserts can be particularly helpful for individuals with flat feet or high arches.

Wearing supportive shoes even at home, instead of walking barefoot, can significantly reduce morning and daytime ankle pain.

Prevention Methods and Long-Term Solutions

Preventing morning ankle pain requires consistency and attention to daily habits. Regular stretching, maintaining a healthy weight, and staying physically active help keep joints flexible and strong. Gradually increasing activity levels reduces the risk of overuse injuries.

Incorporating strength training for the lower legs and improving balance can also protect the ankles from strain and instability. Long-term solutions focus on addressing biomechanical issues rather than just treating symptoms.

When to See a Doctor

While occasional morning ankle stiffness is common, certain signs indicate the need for medical evaluation. Persistent pain lasting several weeks, swelling, redness, warmth, or difficulty bearing weight should not be ignored. Pain accompanied by numbness, weakness, or systemic symptoms also warrants prompt attention.

Early diagnosis and appropriate treatment can prevent minor issues from progressing into chronic conditions. If morning ankle pain is affecting your daily life, seeking professional advice is the safest path to lasting relief.