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What Causes Foot and Ankle Swelling?

Christina Crockett
Christina Crockett

Foot and ankle swelling is quite common and can be caused by many things, including prolonged standing or sitting; injury, such as a sprained ankle; being overweight; and some health conditions that include high blood pressure, heart failure, and arthritis. Swelling generally happens when there’s a buildup of fluid in the veins, or when the body’s cells begin retaining water. Temporary cases usually have to do with a person’s diet or physical habits, like eating a lot of salty foods or putting persistent weight on the feet and. Swelling that persists or seems to come about more randomly may be a sign of a more serious condition or injury.

Pressure From Standing or Sitting

Eating lots of salt can cause water retention, and foot and ankle swelling.
Eating lots of salt can cause water retention, and foot and ankle swelling.

By far the most common cause is prolonged pressure put on the foot or ankle, which happens when someone has been standing on their feet or, in some cases, sitting with weight on their feet. The human body was designed for movement, and long stretches of inactivity can lead to many different problems. When it comes to swelling, gravity plays an important role. Since the feet and ankles sit nearest the ground, they bear the majority of a person’s weight, and the pull of gravity is often strongest here. This sort of swelling is usually relieved when a person changes position or elevates the feet off the ground.

A person with foot and ankle swelling.
A person with foot and ankle swelling.

People who spend a lot of time standing, like sales clerks or bank tellers, sometimes notice varicose veins — purplish, spider-like skin aberrations — on or around their ankles. These can also cause swelling by forcing the blood to re-route itself down the leg and into the foot, a condition known as “venous insufficiency.” Healthcare providers can sometimes remove varicose veins, but the process can be long and painful; people who are bothered by this sort of swelling are usually able to relieve the problem by wearing special compression stockings or socks and elevating the feet and ankles every couple of hours.

Special Concerns for Air Travelers

Varicose veins can cause swelling in the feet.
Varicose veins can cause swelling in the feet.

Many people experience swelling in their feet and ankles after long flights, mostly in response to the high pressure of most commercial airline cabins. When the air is pressurized, blood vessels are more likely to constrict; this combined with peoples’ tendency to sit relatively still for hours on end often leads to puffiness and water retention in the feet and, sometimes, hands. In most cases this is harmless and will disappear on its own once on the ground. People who are prone to blood clots or who are on blood thinning medications are usually at special risk of swelling that can turn more dangerous, often leading to aneurisms; wearing compression stockings, drinking plenty of fluids, and trying to walk around or change position regularly are some of the best ways to avoid this.

Injury and Trauma

Combined with more severe symptoms, heart disease may be a cause of foot and ankle swelling.
Combined with more severe symptoms, heart disease may be a cause of foot and ankle swelling.

It’s also common to notice swelling after an injury or accident. Sprained ankles, broken toes, and torn ligaments in the feet can all lead to temporary swelling as the body rushes blood and other fluids to the site of the trauma. In these cases the swelling is a sign that something is wrong on the inside, and it will usually get worse until the underlying injury has been addressed or cured.

Weight Problems

Prolonged periods of physical inactivity may lead to swollen ankles and feet.
Prolonged periods of physical inactivity may lead to swollen ankles and feet.

People who are overweight typically experience more incidences of swollen feet and ankles due in part to the strain their size puts on their lower legs. Most medical experts encourage patients to maintain a healthy weight for many reasons, but reducing stress on the feet is often on the list. Very heavy people are more prone to excess fluid buildup, too, which is called peripheral edema and can lead to swelling.

Circulatory Concerns

A sprained ankle may cause foot and ankle swelling.
A sprained ankle may cause foot and ankle swelling.

Blood pressure also plays an important role in swollen feet. When the fluid pressure pumping through the body’s veins is either higher or lower than is optimal, the hands and feet often start to grow puffy. Hands and feet are known as the body’s “extremities” because they are farthest from the heart; as a result, they often experience the worst effects when things go wrong with the circulatory system. Heart disease or heart failure can also be a cause, though in these cases swelling is usually just one of many other more pronounced symptoms.

Organ Failure

After long airplane flights, some people may experience swelling in the feet and hands.
After long airplane flights, some people may experience swelling in the feet and hands.

When any major organ fails, swelling in the extremities often happens as something of a side effect. Liver and kidney failure are two of the worst for feet. In these circumstances, an excess of fluid develops in the body around the failing organ, which in turn bloats cells and blocks blood pathways. Most patients know that something is wrong well before they notice puffier feet, but seeking prompt medical help can be the difference between life and death in many of these cases.

As a Pregnancy Symptom

Swollen feet and ankles are very common pregnancy symptoms, particularly in the third trimester.
Swollen feet and ankles are very common pregnancy symptoms, particularly in the third trimester.

Swollen feet and ankles are very common pregnancy symptoms, particularly in the third trimester. Women typically retain more water while pregnant, which is one of the first causes, but hormonal changes may also be to blame. Spiking levels of estrogen and progesterone can cause bloating, and the weight of the baby as it grows also puts added pressure on the ankles when a woman walks or stands.

Other Causes

Compression stockings can be helpful in treating ankle swelling.
Compression stockings can be helpful in treating ankle swelling.

There are a great many reasons why a person’s feet and ankles might be swelling apart from the most common examples listed above. Infections, blood clots, burns, insect bites and malnutrition can all be to blame; arthritis in the foot or ankle is also a possibility. Medications, particularly those that impact blood chemistry and fluid retention, can also play a significant role, and steroids, blood pressure medications and antidepressants are some of the most common examples. Lymphatic obstruction, a blockage of the lymph nodes in the legs, can lead to swelling, too.

Prevention, Treatment, and Remedies

Medical professionals usually begin treating foot swelling by first identifying and treating the root cause. This is often wildly different from patient to patient. Still, there are a few things anyone can do to reduce their chances of experiencing this often painful and uncomfortable condition.

Avoiding sitting or standing for too long is a good place to start. Staying active and moving the feet and ankles regularly is a good way to prevent fluid from building up and blood clots from forming. Once swelling has already gotten underway, elevating the legs above the heart is a good way for people to get things to go back to normal, since this will help take pressure off of the heart and may allow the blood to flow more freely.

Paying close attention to food intake is also important. People who eat diets low in salt and processed foods but high in vegetables, fruits and whole grains are generally less at risk for swelling. Drinking plenty of water can also help flush toxins from the body; experts typically recommend regular exercise, too, as a way of staying healthy both in terms of weight management and when it comes to blood chemistry and cell fluid issues.

When to Get Help

Most cases of foot and ankle swelling are not serious, and the condition is rarely a medical emergency. However, any swelling that lasts for more than a day and does not lessen with movement, water intake, or elevation should typically be evaluated by a healthcare provider. So should swelling that is accompanied by pain, dizziness, or nausea. Medical practitioners will be able to take a patient’s full history into account are usually in the best position to uncover the true cause.

Discussion Comments

will31572

I've just been on a very large methamphetamine binge for two weeks and stayed basically in the same position for most of that time, and as a consequence my left foot up to just below my knee is severely swollen as well as my right foot. Will this go away?

sadhikari

I have been suffering from low back pain for about eight years. I saw doctor many times and doctor asked just for physiotherapy giving some painkiller for some days. It used to come and go. Two months back the pain started in my left leg. It was diagnosed as sciatica. The doctor gave me the injection and some medicine a week ago, but there is no significant improvement. I still have pain. Now there is swelling in my leg as well. I have been bothered by the pain and swelling. Can anyone help me?

burcidi

Hi, I'm suffering from varicose veins in my legs. I'm wondering could that be a cause of swelling in legs and ankles?

A friend of mine also had foot and ankle swelling and her problem was resolved after she had orthopedic shoes custom made for her. She works standing up for long hours, so I think that was the problem for her. Just wanted to put it out there that inappropriate shoes can cause feet and ankle pain and swelling too.

SteamLouis

I'm eight months pregnant and have been having a lot swelling in my feet and also sometimes in my hands in the morning. My doctor said that it can be due to hormones, weight gain and also sitting with my feet on the floor for too long.

I try not to sit all the time and move around the house a little bit. When I sit, I put my feet up on a chair. Sometimes I also do a foot soak with warm water and salt. While I sleep, I put some pillows under my feet or between my legs if I'm sleeping sideways.

These have helped a lot and there is not as much swelling now because I am not working. It used to be worse when I worked because I couldn't take care of myself too well in the office. But I recommend these tips for any pregnant ladies who have foot swelling.

ysmina

Whenever I travel by plane or bus, my ankles swell up and become huge. I'm only 25 years old and even my mom is shocked to see my ankles after I get home from a long trip. When I'm in the plane, I try to get up and walk around as much as I can, but it's still very limited. Especially if I have a window seat, I don't want to bother the person next to me all the time and the flight attendants also make us sit down for the majority of the flight if there is turbulence. I don't think I have to mention seat space in economy class, right?

I have found some ways to help with my swelling though. I think that my ankles swell partly because of the lack of blood flow when I'm sitting in one position all the time. So one thing I learned from my mom who is a nurse, is to take aspirin while I'm traveling. Aspirin thins out blood, so it actually flows more easily throughout your body. The other thing I do, is to try and change my sitting position as often as I can, and also to try to extend my legs as far out as I can.

I also don't eat very much during flights but drink plenty of water. I've noticed that the less I eat, the more comfortable my journey is. I don't know if it's because of flight food which might have additives or salt in it. I try and keep some natural snacks like unsalted nuts and dry fruits with me and much on those.

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    • Eating lots of salt can cause water retention, and foot and ankle swelling.
      By: Aaron Amat
      Eating lots of salt can cause water retention, and foot and ankle swelling.
    • A person with foot and ankle swelling.
      By: Dusan Kostic
      A person with foot and ankle swelling.
    • Varicose veins can cause swelling in the feet.
      By: roblan
      Varicose veins can cause swelling in the feet.
    • Combined with more severe symptoms, heart disease may be a cause of foot and ankle swelling.
      By: digitex
      Combined with more severe symptoms, heart disease may be a cause of foot and ankle swelling.
    • Prolonged periods of physical inactivity may lead to swollen ankles and feet.
      By: Pixinoo
      Prolonged periods of physical inactivity may lead to swollen ankles and feet.
    • A sprained ankle may cause foot and ankle swelling.
      By: lightwavemedia
      A sprained ankle may cause foot and ankle swelling.
    • After long airplane flights, some people may experience swelling in the feet and hands.
      By: Kalim
      After long airplane flights, some people may experience swelling in the feet and hands.
    • Swollen feet and ankles are very common pregnancy symptoms, particularly in the third trimester.
      By: Valua Vitaly
      Swollen feet and ankles are very common pregnancy symptoms, particularly in the third trimester.
    • Compression stockings can be helpful in treating ankle swelling.
      By: nito
      Compression stockings can be helpful in treating ankle swelling.