Swollen ankles are so common that they tend to be ignored. While ankle swelling could occur because of age and increasing body weight, there are also some serious potential causes— such as a blood clot, an infection, or even a malfunctioning heart, kidney or liver.
Ankle swelling may not cause any discomfort— at least in the early stages— so it’s fairly easy to overlook. And in fact, most of us will accumulate some fluid in the lower extremities after we’ve been sitting for a while, in an airplane or car, for instance.
Normally, valves in the leg veins keep blood moving towards the heart. But a condition called chronic venous insufficiency, characterized by weak vein walls and damaged valves, causes the veins to stay filled with blood.
While there are many possible reasons for swollen ankles, fluid buildup in the lower legs and feet may indicate a problem with circulation. In pregnant women, this may be a sign of preeclampsia (toxemia) and high blood pressure that can be dangerous for mother and baby. In seniors, swollen ankles may indicate cardiovascular problems.
In some cases, swelling in the lower legs could be caused by an infection or some type of trauma such as a fracture.
What Causes Puffy Ankles?
Some medications can lead to swollen ankles. Antidepressants, blood pressure medicines, hormone replacement drugs containing estrogen or testosterone, or corticosteroids— all have been associated on occasion with leg swelling.
But even if you suspect your medications are causing the swelling, never stop taking your medicine without talking with your doctor first.
There are things you can do yourself to relieve the swelling:
- Lie down with your legs elevated above the level of your heart
- Wear support stockings
- If you’re traveling by car, take frequent breaks and walk around a bit
- Keep your weight under control and limit your intake of salt
- Try to walk each day to improve circulation
- Avoid wearing tight stockings or garters around your legs
To diagnose the problem, the doctor will ask about your medical history and perform a physical exam.
Swollen ankles can come on so gradually that we don’t at first notice a problem. If your shoes feel tighter or if you start to have difficulty walking, call the clinic right away— especially if you have a history of heart disease or kidney disease; if the foot or ankle is warm or red; if you have a fever; or if you are pregnant and you notice a sudden increase in swelling.
What is the Treatment for Swollen Ankles?
Treating swollen ankles depends on finding the source. While there are certain actions we can take to reduce swelling and relieve discomfort, your doctor will want to know the root cause. Our clinics in Sunnyvale, DeSoto and Dallas are experienced, and equipped to diagnose and treat this problem.
Here are some questions the doctor may ask:
- Is the swelling worse in the morning? evening?
- What, if anything, makes the swelling go down?
- Have you had blood clots in your legs in the past?
- Do you have any history of blood clots in the lungs?
- Have you ever had varicose veins?
- Have you noticed any other symptoms?
Doctor may order blood tests or a chest x-ray. We may also conduct an ultrasound exam of your leg veins. An EKG to measure heart function and urinalysis are other diagnostic options.
Some patients may be given a diuretic (water pill) to help reduce the swelling. These medications are effective but they do have some side effects. Your doctor can discuss these with you.
If the swelling is due to inflammation, we need to identify the cause. Inflammation usually means there has been an injury, and it’s the body’s immune response that creates swelling.
For this type of swelling, we apply the RICE protocol— rest; ice; compression; elevation. This translates into staying off the affected foot or ankle so the body can start the healing process; applying cold packs to reduce swelling and pain; wrapping the ankle in a support garment; and resting the foot level with or slightly above the heart.