Swollen ankles, feet, and legs are a common concern, often causing discomfort and worry. This swelling, known as oedema, is usually due to a build-up of fluid in these lower extremities. While it frequently resolves on its own, understanding the reasons behind ankle swelling and knowing when to seek medical advice is crucial for your health and well-being.
Common Causes of Swollen Ankles, Feet, and Legs (Oedema)
Oedema occurs when excess fluid accumulates in your body’s tissues, most noticeably in the ankles, feet, and legs due to gravity. Many factors can contribute to this fluid retention, ranging from everyday habits to underlying medical conditions.
Lifestyle and Environmental Factors
In many instances, swollen ankles are linked to simple lifestyle factors:
- Prolonged Standing or Sitting: Remaining in the same position for extended periods can hinder blood circulation. Gravity pulls blood downwards, and without movement, fluid can pool in the lower legs and ankles.
- High Salt Intake: Consuming excessive amounts of sodium can cause your body to retain more water, leading to swelling. Salt affects the fluid balance in your body, and too much can tip the scales towards fluid retention.
- Being Overweight or Obese: Excess weight can put additional pressure on your veins and lymphatic system, making it harder for fluids to circulate efficiently. This increased pressure can contribute to fluid build-up in the lower extremities.
Pregnancy
Swollen ankles, feet, and legs are a very common experience during pregnancy. As the body undergoes significant hormonal changes and increased blood volume, fluid retention is a natural consequence. The growing uterus also puts pressure on the veins in the pelvis and legs, further impeding blood flow back to the heart and contributing to swelling.
Medications
Certain medications can list oedema as a side effect. These include:
- Blood Pressure Medications: Some calcium channel blockers, used to treat high blood pressure, can cause fluid retention.
- Contraceptive Pills and Hormone Therapy: Hormones like estrogen and progesterone can influence fluid balance in the body and may lead to swelling in susceptible individuals.
- Antidepressants: Certain antidepressants can have side effects that contribute to fluid retention.
- Steroids: Both corticosteroids and anabolic steroids can cause fluid retention as a side effect.
It’s important to note that if you suspect a medication is causing your ankle swelling, you should consult your doctor before making any changes to your prescribed drugs.
Injuries and Trauma
Trauma to the ankle, foot, or leg can also result in localized swelling:
- Sprains and Strains: Injuries like ankle sprains involve ligament damage, which triggers inflammation and fluid accumulation as part of the healing process.
- Insect Bites and Stings: Venom or irritants from insect bites or stings can cause a localized inflammatory response, leading to swelling around the affected area.
Underlying Medical Conditions
In some cases, persistent or sudden ankle swelling can be a sign of a more serious underlying medical condition that requires medical attention:
- Kidney Problems: Kidneys play a vital role in regulating fluid balance in the body. If the kidneys are not functioning properly, they may not be able to remove excess fluid effectively, leading to oedema.
- Liver Problems: Liver disease can lead to a decrease in albumin production, a protein in the blood. Albumin helps keep fluid in the blood vessels, and a deficiency can cause fluid to leak into tissues, resulting in swelling.
- Heart Problems: Heart failure can lead to fluid build-up because the heart is not pumping blood effectively. This can cause fluid to back up in the veins and accumulate in the lower legs and ankles.
- Blood Clots: A blood clot in a leg vein (deep vein thrombosis or DVT) can obstruct blood flow, leading to swelling, pain, and warmth in the affected leg. This is a serious condition requiring immediate medical attention.
- Infections: Infections in the leg, ankle, or foot can cause inflammation and swelling. Cellulitis, a bacterial skin infection, is a common cause of leg swelling.
Alt text: Swollen ankles and feet of an adult woman, illustrating oedema.
Recognizing Oedema: Symptoms to Watch For
Identifying oedema involves recognizing the characteristic signs of fluid retention. Common symptoms include:
- Visible Swelling: Noticeably puffy ankles, feet, or legs are the most obvious sign. The swelling may make it difficult to see the usual contours of your ankles and feet.
- Shiny or Stretched Skin: The skin in the swollen area may appear shiny and stretched due to the underlying fluid build-up.
- Skin Discoloration: Changes in skin color can occur in the swollen area. It might appear redder, paler, or even bruised depending on the cause and severity of the oedema.
- Discomfort and Stiffness: Swelling can cause feelings of discomfort, heaviness, or stiffness in the affected areas. Movement might feel restricted or uncomfortable.
- Pitting Oedema: A key sign of oedema is “pitting.” If you press your finger firmly on the swollen area for a few seconds and then release, a dent or pit will remain in the skin for a short while.
Alt text: Close-up of shiny and stretched skin on a swollen leg, a symptom of oedema.
Self-Care Strategies to Ease Swollen Ankles
For mild cases of ankle swelling, particularly those related to lifestyle factors, several self-care measures can help alleviate symptoms:
Recommended Actions (Do’s)
- Elevate Your Legs: When resting or sitting, raise your legs above your heart level using pillows or a chair. Elevation helps gravity assist in draining excess fluid from your legs back into circulation.
- Gentle Exercise: Engaging in light activities like walking can improve blood flow and circulation. Movement helps pump fluids out of the legs and reduces pooling.
- Wear Comfortable Footwear: Opt for wide, comfortable shoes with low heels and soft soles. Avoid tight shoes or high heels that can restrict circulation and worsen swelling.
- Foot Hygiene and Moisturizing: Regularly wash, thoroughly dry, and moisturize your feet. This is especially important for individuals with oedema as stretched skin is more prone to cracking and infection.
Actions to Avoid (Don’ts)
- Prolonged Static Positions: Avoid standing or sitting in one position for long periods. Take breaks to move around and stretch your legs to encourage circulation.
- Tight Clothing and Footwear: Refrain from wearing tight clothing, socks, or shoes that can constrict blood flow to your lower extremities.
When to Seek Medical Advice for Swollen Ankles
While self-care can manage mild swelling, it’s important to know when swollen ankles warrant medical attention.
Consult a GP (Non-Urgent Advice)
Schedule a non-urgent appointment with your General Practitioner (GP) if:
- Persistent Swelling: Your ankle, foot, or leg swelling doesn’t improve after a few days of home treatment.
- Worsening Swelling: The swelling progressively gets worse over time despite self-care measures.
Seek Urgent Medical Attention
Seek urgent medical advice by asking for an urgent GP appointment or contacting NHS 111 if:
- Sudden Swelling with No Obvious Cause: You experience swelling in one ankle, foot, or leg, and there’s no apparent reason like an injury.
- Severe or Painful Swelling: The swelling is significant, intensely painful, or develops very rapidly.
- Redness or Warmth: The swollen area becomes red, feels hot to the touch, and may indicate an infection.
- Fever or Chills: You develop a high temperature or experience chills alongside the swelling, suggesting a possible infection or systemic issue.
- Diabetes and Swollen Lower Extremities: If you have diabetes and notice swelling in your feet, ankles, or legs, it’s crucial to seek prompt medical evaluation.
You can contact NHS 111 by phone or utilize their online service for guidance.
Immediate Emergency Action (Call 999)
Call emergency services immediately (999 in the UK) if you experience swollen ankles along with any of the following serious symptoms:
- Shortness of Breath or Difficulty Breathing: Sudden onset of breathlessness or struggling to breathe could indicate a serious underlying condition.
- Chest Tightness, Heaviness, or Pain: Chest discomfort, pressure, or pain, especially when accompanied by swelling, requires immediate medical attention.
- Coughing Up Blood: Coughing up blood is a serious symptom that needs urgent evaluation.
These symptoms could indicate a pulmonary embolism (blood clot in the lungs), a life-threatening condition requiring immediate hospital treatment. Do not drive yourself to the Emergency Department; call 999 for an ambulance.
Medical Treatment for Swelling and Oedema
If your ankle swelling doesn’t resolve with self-care or is linked to an underlying medical condition, your GP will determine the appropriate treatment plan. Treatment will be tailored to the underlying cause of the oedema. This may involve medication to manage heart, kidney, or liver conditions, diuretics to reduce fluid retention, or other specific therapies. Your doctor may also recommend lifestyle adjustments, such as weight loss or a low-sodium diet, to help manage chronic swelling.
Page last reviewed: 18 January 2022
Next review due: 18 January 2025
