Ankle sprains are common injuries, often occurring during sports or everyday activities. They’re usually associated with ligament damage — but nerve injuries can also occur, leading to burning pain after an ankle sprain if left untreated. Understanding the symptoms of nerve damage after an ankle sprain, the nerves most commonly affected, and the treatment options is essential for recovery.
How does an ankle sprain damage nerves?
During an ankle sprain, excessive force stretches or compresses the tissues in the ankle and lower leg. This trauma can affect nearby nerves, leading to irritation, compression, or damage. Nerve injuries may occur directly from the sprain or develop later due to swelling, scar tissue, or improper healing.
Signs and symptoms of nerve damage after an ankle sprain
Nerve injuries following an ankle sprain cause different symptoms depending on the nerve involved. Common symptoms include:
- Burning pain — sharp, shooting, or burning sensations radiating from the knee to the foot
- Tingling or numbness — pins-and-needles or loss of feeling in specific areas
- Muscle weakness — difficulty moving or controlling certain parts of the foot
- Sensitivity — heightened pain or discomfort when the area is touched or exposed to cold
- Persistent pain — pain that lasts longer than a typical ligament-healing timeline
Nerves commonly affected by ankle sprains
Several nerves around the ankle are susceptible to injury during a sprain.
Common peroneal nerve
This nerve is most often injured near the fibular head, close to the outside of the knee. People often feel numbness or tingling on the top of the foot, and weakness turning the ankle outward (eversion).
Superficial peroneal nerve
Damage occurs halfway up the calf, as the nerve passes from the muscle through the fascia, or close to the outside of the ankle. Symptoms include numbness and pins-and-needles over the top of the foot, and touching the nerve as it exits the muscle reproduces the pain.
Deep peroneal nerve
This nerve is damaged at the front of the ankle. Symptoms include pain or numbness between the first and second toes, and weakness when lifting the foot.
Sural nerve
Damage occurs as the nerve passes from the muscle to the skin, halfway down the back of the calf or near the outer ankle. People report burning pain or tingling along the outer edge of the foot.
Tibial nerve and its branches
After an ankle sprain, the tibial nerve (and its medial and lateral plantar branches) can be damaged on the inside of the ankle. Symptoms include pain or numbness in the sole and difficulty moving the toes or arch of the foot.
Diagnosing nerve damage after an ankle sprain
Your doctor assesses the ankle for pain, tenderness, sensation, and muscle strength to identify the nerve involved.
Sometimes we use further investigations to confirm the diagnosis. Nerve conduction studies assess nerve function and look for trapping. MRI identifies scar tissue or other structural causes of nerve irritation. Ultrasound visualises the nerves and helps confirm irritation — often showing nerve thickening and swelling that confirms entrapment.
It’s also important to rule out other causes of ongoing pain after a lateral ligament ankle sprain, such as sinus tarsi syndrome or a cartilage injury.
Treatment options for burning pain after a sprained ankle
Conservative management
We start with simple treatments. Modifying your activity allows the nerve to heal and avoids aggravating symptoms. Physiotherapy — gentle stretching, mobility, and nerve-gliding exercises — helps reduce neural tension.
NSAIDs such as ibuprofen sometimes help. Nerve medications such as duloxetine and amitriptyline work better for nerve pain.
Injections to relieve trapping are often used. Cortisone injections around the nerve reduce trapping and improve symptoms, and PRP is sometimes used instead to reduce nerve swelling. On occasion, we use a more advanced procedure — a nerve hydrodissection. In this fluid, (saline, dextrose, or anaesthetic) is injected around the affected nerve under ultrasound guidance to separate it from scar tissue or compressing structures.
Surgical management
Surgery is rarely needed, but may be considered in severe cases where the nerve is entrapped or compressed by bone or scar tissue. Procedures include nerve decompression or neurolysis (removing scar tissue). We recommend exhausting all conservative measures, including injections, before considering surgery.
Frequently asked questions about nerve damage after an ankle sprain
Is burning pain after a sprained ankle normal?
Some short-lived nerve irritation can follow a sprain. But burning pain, tingling, or numbness that persists beyond the time the ligament should have healed suggests a nerve is involved — and is worth getting assessed, as it responds to specific treatment.
How long does nerve pain after an ankle sprain last?
It varies. Many cases settle over weeks to a few months with activity modification, physiotherapy, and nerve medication. More stubborn cases respond to an injection or nerve hydrodissection, and only a few need surgery.
Which nerves are damaged in an ankle sprain?
The superficial peroneal nerve is one of the most commonly affected, but the common peroneal, deep peroneal, sural, and tibial nerves can all be involved — each producing a slightly different pattern of numbness, tingling, or weakness that helps identify which nerve is affected.
Does nerve damage after an ankle sprain heal on its own?
Many milder cases improve with time, activity modification, and physiotherapy. Where the nerve is trapped in scar tissue, an injection or hydrodissection is often needed, and surgery is a last resort.
When should I worry about nerve symptoms after a sprain?
See a sports doctor if you have burning pain, numbness, tingling, or weakness in the foot, or pain that lasts longer than expected for ligament recovery. These point to a nerve injury that benefits from an accurate diagnosis and targeted treatment.
Final word from Sport Doctor London about nerve damage after an ankle sprain
Recognising the signs and symptoms of nerve damage after an ankle sprain is critical to getting people back to activity and sport. Conservative measures and advanced techniques, such as nerve hydrodissection, are central to recovery. If you suspect a nerve injury, seek assessment by a sports doctor for timely, effective management.
If you have burning or persistent pain after an ankle sprain, Dr Masci can assess you in London, including an ultrasound in the clinic. Contact the team here or call +44 (0) 203 488 0350.
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