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Foot, leg, and ankle swelling

Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema

 

Painless swelling of the feet and ankles is a common problem, especially among older people.

Abnormal buildup of fluid in the ankles, feet, and legs can cause swelling. This fluid buildup and swelling is called edema.

Considerations

 

Painless swelling may affect both legs and may include the calves or even the thighs. The effect of gravity makes the swelling most noticeable in the lower part of the body.

 

Causes

 

Foot, leg, and ankle swelling is common when the person also:

  • Is overweight
  • Has a blood clot in the leg
  • Is older
  • Has a leg infection
  • Has veins in the legs that cannot properly pump blood back to the heart

Injury or surgery involving the leg, ankle, or foot can also cause swelling. Swelling may also occur after pelvic surgery, especially for cancer.

Long airplane flights or car rides, as well as standing for long periods of time, often lead to some swelling in the feet and ankles.

Swelling may occur in women who take estrogen, or during parts of the menstrual cycle. Most women have some swelling during pregnancy. More severe swelling during pregnancy may be a sign of preeclampsia , a serious condition that includes high blood pressure and swelling.

Swollen legs may be a sign of heart failure , kidney failure , or liver failure . In these conditions, there is too much fluid in the body.

Certain medicines may also cause your legs to swell. Some of these are:

  • Antidepressants, including MAO inhibitors and tricyclics
  • Blood pressure medicines called calcium channel blockers
  • Hormones, such as estrogen (in birth control pills or hormone replacement therapy) and testosterone
  • Steroids

 

Home Care

 

Some tips that may help reduce swelling:

  • Put your legs on pillows to raise them above your heart while lying down.
  • Exercise your legs. This helps pump fluid from your legs back to your heart.
  • Follow a low-salt diet, which may reduce fluid buildup and swelling.
  • Wear support stockings (sold at most drugstores and medical supply stores).
  • When traveling, take breaks often to stand up and move around.
  • Avoid wearing tight clothing or garters around your thighs.
  • Lose weight if you need to.

Never stop taking any medicines you think may be causing swelling without first talking to your health care provider.

 

When to Contact a Medical Professional

 

Call 911 if:

  • You feel short of breath.
  • You have chest pain, especially if it feels like pressure or tightness.

Call your provider right away if:

  • You have heart disease or kidney disease and the swelling gets worse.
  • You have a history of liver disease and now have swelling in your legs or abdomen.
  • Your swollen foot or leg is red or warm to the touch.
  • You have a fever.
  • You are pregnant and have more than just mild swelling or have a sudden increase in swelling.

Also call your provider if self-care measures do not help or swelling gets worse.

 

What to Expect at Your Office Visit

 

Your provider will take a medical history and do a thorough physical examination, paying special attention to your heart, lungs, abdomen, lymph nodes, legs, and feet.

Your provider will ask questions like the following:

  • What body parts swell? Your ankles, feet, legs? Above the knee or below?
  • Do you have swelling at all times or is it worse in the morning or evening?
  • What makes your swelling better?
  • What makes your swelling worse?
  • Does the swelling get better when you raise your legs?
  • Have you had blood clots in your legs or lungs?
  • Have you had varicose veins?
  • What other symptoms do you have?

Diagnostic tests that may be done include:

  • Blood tests such as a CBC or blood chemistry
  • Chest x-ray or extremity x-ray
  • Doppler ultrasound examination of your leg veins
  • ECG
  • Urinalysis

Your treatment will focus on the cause of the swelling. Your provider may prescribe diuretics to reduce the swelling, but these can have side effects. Home treatment for leg swelling that is not related to a serious medical condition should be tried before drug therapy.

 

 

Open References

References

Falk RH, Hershberger RE. The dilated, restrictive, and infiltrative cardiomyopathies. In: Mann DL, Zipes DP, Libby P, Bonow RO, Mann DL, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 65.

Goldman L. Approach to the patient with possible cardiovascular disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 51.

Trayes KP, Studdiford JS, Pickle S, Tully AS. Edema: Diagnosis and management. Am Fam Phys . 2013;88(2): 102-110.

 
  • Foot swelling

    Foot swelling - illustration

    The abnormal buildup of fluid in the body is called edema. Edema is commonly seen in the feet and ankles, because of the effect of gravity, swelling is particularly noticeable in these locations. Common causes of edema are prolonged standing, prolonged sitting, pregnancy, being overweight, and increase in age.

    Foot swelling

    illustration

  • Lower leg edema

    Lower leg edema - illustration

    Painless swelling of the feet and ankles is a common problem, particularly in older people. Most of the time swelling can be relieved by elevating the legs above the heart while lying down and avoiding sitting or standing without moving for prolonged periods of time. Although swelling of the feet and ankles can be a minor problem, it can also be an indication of more serious illnesses such as heart failure, renal failure, or liver failure.

    Lower leg edema

    illustration

    • Foot swelling

      Foot swelling - illustration

      The abnormal buildup of fluid in the body is called edema. Edema is commonly seen in the feet and ankles, because of the effect of gravity, swelling is particularly noticeable in these locations. Common causes of edema are prolonged standing, prolonged sitting, pregnancy, being overweight, and increase in age.

      Foot swelling

      illustration

    • Lower leg edema

      Lower leg edema - illustration

      Painless swelling of the feet and ankles is a common problem, particularly in older people. Most of the time swelling can be relieved by elevating the legs above the heart while lying down and avoiding sitting or standing without moving for prolonged periods of time. Although swelling of the feet and ankles can be a minor problem, it can also be an indication of more serious illnesses such as heart failure, renal failure, or liver failure.

      Lower leg edema

      illustration

    A Closer Look

     

    Self Care

     

    Tests for Foot, leg, and ankle swelling

     
     

    Review Date: 4/30/2015

    Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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