Why Are Your Ankles Swollen?

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Medically reviewed by Adam H. Kaplan, DPM

Swollen ankles—sometimes also known as peripheral edema—occur when there is an abnormal build-up of fluid in the tissues of the lower legs. Anyone can develop swollen ankles, but older people, those who have sedentary lifestyles, people who are on their feet all day, those who live with obesity, and pregnant people are more likely to experience swelling. In many cases, swollen ankles can also be a sign of an underlying health condition. So, it’s important to seek treatment if you notice swelling.

How To Identify Swollen Ankles

You may not notice your swollen ankles immediately because the interstitial spaces, or the spaces between the tissues, can hold several liters of fluid. In fact, swelling in your ankles may not be visible until the tissues have about two to three liters of fluid—which is equivalent to about six bottles of water. Swelling may happen quickly if an acute condition like a blood clot causes it. But if a chronic condition is the cause of your swelling, it can take longer to develop.

Swelling can occur in one or both of your ankles. The skin around your ankles may also look stretched out or shiny. Ankle swelling is usually most noticeable in the lower legs because of the effects of gravity. The swelling can worsen after walking around, standing, or sitting for long periods. Pressing a finger into the swollen area may leave a small dent in the skin, which is known as pitting edema.

It’s worth noting that swollen ankles don’t always cause pain. But it is possible to experience some aches, heaviness, or difficulty moving around. In severe cases, walking may become increasingly challenging. But, assistive devices (such as a walker or cane) can offer support.

Common Causes of Swollen Ankles

Your lymphatic system is responsible for managing the fluid levels in your body. When your lymphatic system isn’t able to maintain excess fluid properly (such as due to an underlying condition) you may experience edema which can cause your ankles to swell.

Chronic Venous Insufficiency

Inside your veins, some valves keep your blood moving correctly toward your heart. Chronic venous insufficiency occurs when the walls of your veins have weakened, which causes these valves to become damaged. When this occurs, blood cannot flow correctly and ends up pooling (or, staying) in the veins. As a result, the pooling of blood can contribute to swollen ankles. While anyone can develop this condition, the most common risk factors include:

• Older age
• Family history of venous insufficiency or congestive heart failure
• Personal history of deep vein thrombosis
• Obesity
• Pregnancy
• Sitting or standing for long periods
• Being tall
• Smoking

Chronic venous insufficiency is a lifelong condition that can become worse over time. But, with early treatment, you may notice an improvement in symptoms.

Medications

Side effects of some medications can cause edema to occur. Common medications that can contribute to ankle swelling include:

• Antidepressants
• Calcium channel blockers
• Hormones like estrogen and testosterone
• Corticosteroids

It’s important to note that you should not stop taking any medications without approval from your healthcare provider. If you are worried that your medications are contributing to swelling, talk to your provider about your symptoms and see if they can adjust your treatment plan.

Heart Failure

Heart failure is a condition that occurs when the heart is too weak to pump blood effectively. As a result, your blood can pool in places like your lower limbs (e.g., legs, feet, and ankles). If congestive heart failure is causing your swelling, you’ll likely experience swelling in both legs.

It’s also worth noting that edema due to heart failure can affect other parts of your body. For example, fluid can become backed up into the lungs, causing pulmonary edema (excess fluid in the lungs), which can lead to symptoms like shortness of breath or coughing.

Cirrhosis

Cirrhosis is a term that describes severe scarring of the liver. When cirrhosis occurs, the liver doesn’t function as properly and obstructs blood flow. This obstruction can lead to swelling in the lower legs and abdomen. It’s also important to note that if you notice ankle swelling and have a history of liver disease, it’s essential to follow your treatment plan and tell your provider about your symptoms.

Without treatment, the risk of complications like portal hypertension (high blood pressure in the portal veins), urinary tract infections, pneumonia, liver cancer, and liver failure all increase.

Kidney Disease

Your kidneys are responsible for removing waste products and fluids from the bloodstream. But when you develop chronic kidney disease (CKD), your kidneys lose their ability to filter out your blood properly. As a result, excess fluid can build up in your body and cause your feet and legs to swell up. Unfortunately, most people don’t know that they have CKD until their kidneys become severely damaged. In fact, providers usually discover that you have CKD when you undergo blood or urine tests for a different health reason.

Prolonged Standing or Sitting

While not a health condition on its own, sitting or standing for long periods can cause swelling in your ankles. Swollen ankles after flying, long car rides, and at the end of a long day frequently cause edema in your lower limbs—mostly because of the effects of gravity and the lack of movement of blood back to your heart.

Lymphedema

When the lymphatic system becomes damaged or blocked, tissues in your body become filled with fluid that causes swelling. This condition is known as lymphedema. These blockages can occur due to:

• Infection
• Injury
• Cancer
• Lymph node removal
• Radiation treatment
• Surgery that injures the lymphatic system

It’s worth noting that lymphedema usually causes swelling in the arms and legs, but it can develop in other body parts.

Deep Vein Thrombosis

Deep vein thrombosis (DVT) is the medical term for when blood clots form in the deep veins of your legs. A variety of circumstances can cause DVT, such as:

• Injury to the vein during surgery
• Decreased blood flow due to bed rest or lack of movement
• Birth control use
• Smoking
• History of cancer
• Previous cases of DVT

Complications of DVTs can be serious. If a clot breaks off and travels through the bloodstream, it can cause a pulmonary embolism (a blood clot in your lungs). Blood clots can also damage your heart valves and lead to chronic venous insufficiency.

Pregnancy

When you become pregnant, you may notice swelling in your legs, ankles, feet, and fingers. Some swelling is normal because your body holds on to more water when you are pregnant. The swelling also tends to increase if you’ve been on your feet all day or if it’s hot outside, as your body does its best to retain water.

But, swelling can become dangerous if you notice your face, hands, and feet becoming swollen in a very short amount of time. Suddenly developing swelling could be a sign of preeclampsia—a serious condition that causes high blood pressure after your 20th week of gestation. It’s important to monitor preeclampsia as soon as possible to reduce the risk of pregnancy complications.

Foot Injury

Common foot injuries like a sprained, strained, or rolled ankle can often cause swelling in your ankles and feet. Generally, this swelling starts to resolve within a few days. Using ice therapy or an ankle brace can help reduce the swelling. If pain doesn’t improve within a couple of days or you think you may have a fractured or broken foot, it’s important to see your healthcare provider promptly to get tested and receive proper treatment to heal your foot.

When to Contact a Healthcare Provider

Ankle swelling can be a symptom of another health condition, so seeking advice from a healthcare provider is important. If you are experiencing shortness of breath or chest pain alongside ankle swelling, call 911 immediately, as this may be a sign of a more serious condition. It’s also important to contact your provider if you have ankle swelling plus a history of heart disease, liver disease, or kidney disease, or are experiencing a fever or itchy ankles.

It’s also good practice to contact your provider if you notice your swelling is worsening despite trying at-home remedies.

How To Treat Ankle Swelling

Your exact treatment plan for swollen ankles will depend on the underlying cause of your swelling. Your healthcare provider may recommend one or more of the following treatments:

• Decreasing salt intake in your diet
• Taking medications (like diuretics) to reduce excess fluid
• Raising your legs above your heart level when lying down to drain fluid from your legs
• Trying leg exercises to improve circulation
• Standing up and moving around from time to time when traveling on a plane or train
• Avoiding wearing tight clothing around the thighs which can decrease circulation

Ways To Prevent Swollen Ankles

There are a variety of methods that you can use to prevent your risk of developing swollen ankles. If you are already experiencing ankle swelling, there are some things you can do to lower the risk of complications. These prevention strategies include:

• Eating a diet low in salt
• Maintaining a weight that is right for your
• Moving your body or participating in physical activity each day
• Keeping in contact with your healthcare provider to inform them about your symptoms and receive treatment sooner

A Quick Review

Swollen ankles occur due to an excess buildup of fluid in your body’s tissues. Swelling can occur for a variety of underlying reasons, such as side effects from medication, heart failure, blood clots in your veins, and pregnancy. If you’re experiencing swollen ankles, it’s important to contact your healthcare provider to get tested and receive proper treatment.

Read the original article on Health.com.