Severe knee pain with physiotherapy is common (e.g., arthritis, injury, or overuse), but new dark patches on your ankle joint with severe pain are concerning and likely point to a vascular or skin issue rather than just the knee problem.
The most likely cause is venous stasis dermatitis (from chronic venous insufficiency or varicose veins) — this causes brownish/dark discoloration (from iron deposits/hemosiderin), pain, swelling, and itching around the ankles. It’s very common in people with leg issues and can worsen with reduced mobility from knee pain/physio.
• Cellulitis (bacterial infection): Possible if the area is suddenly very red, hot, swollen, tender, and you have fever/chills — but dark/brown patches alone (without bright red spread) make this less likely. Cellulitis is often misdiagnosed when it’s actually stasis dermatitis.
• Peripheral artery disease (PAD): Less likely here — PAD usually causes pale/bluish/cold skin, hair loss, pain on walking (claudication), not dark patches or severe local pain at rest.
• Varicose veins: Often linked — they can lead to the stasis changes you describe.
This needs professional check-up soon, as untreated venous issues can lead to ulcers or infection.
Next Steps
• See a doctor urgently (within 1-2 days) — go to a vascular specialist, dermatologist, or your general physician/orthopedist who can refer. They may examine, do Doppler ultrasound (to check veins/arteries), or rule out infection.
• If the area is hot, very red/spreading, feverish, or extremely painful/swollen — go to ER or urgent care today (to rule out cellulitis needing antibiotics).
• Continue physiotherapy for knee but mention the ankle changes — they may adjust exercises to avoid pressure on ankles.
• Avoid self-treating with creams/ointments without advice, as some can worsen it.
Health Tips
• Elevate your legs above heart level when sitting/resting (helps reduce swelling and pooling).
• Wear compression stockings (if doctor approves — class 1 or 2) to improve vein flow and reduce discoloration/pain.
• Keep skin moisturized (use gentle, fragrance-free cream like petroleum jelly) to prevent cracking/itching.
• Avoid long standing/sitting; walk gently if possible, and stay hydrated.
• Watch for worsening: more swelling, warmth, pus, fever, or ulcers — seek help immediately.
For the best guidance based on how the patches look, your full symptoms, age, and other health factors, please consult with me online — I can help explain more or guide what to tell the doctor. Get checked soon — most cases improve with right treatment! Take care