Why Are My Ankles Swollen? 9 Causes of Swollen Ankles

Understand your swollen ankles symptoms, including 8 causes & treatment options for your swollen ankles.

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Contents

  1. Symptoms
  2. Causes
  3. 8 Possible Swollen Ankles Conditions
  4. Treatments and Relief
  5. FAQs
  6. Questions Your Doctor May Ask
  7. Statistics
  8. Related Articles
  9. References

Swollen Ankles Symptoms

As the day wears on, your feet start to throb and your shoes feel tighter. When you finally get to rest your feet and peel off those socks and shoes, you notice it's happened again — swollen ankles can be unsightly and uncomfortable. The swelling can be a sign of a problem with the ankle itself or a more serious medical condition [1].

Common accompanying symptoms of swollen ankles

If you're experiencing ankle swelling, it's likely to also experience:

Swollen Ankles Causes

Swelling in the body is usually a sign of an underlying problem. Sometimes swelling is a sign of inflammation in the affected area, after an injury, for instance. Inflammation is more likely to affect one area or one side of the body. Swelling can also be caused by problems with fluid balance. When the body holds on to too much fluid, it collects in the legs and ankles due to gravity. This is more likely to affect both sides of the body equally. Some common causes of swollen ankles, divided by category, are outlined below.

Fluid problems

Issues with how fluid moves throughout your body may lead to ankle swelling.

  • Vein issues: Your veins drain blood from the ankles and transport it back to the heart. As we age, problems can develop with this system and fluid can build up.
  • Heart disease: When your heart struggles to pump blood (heart failure), the body holds on to extra fluid that can buildup in your ankles and other areas.
  • Liver disease: A damaged or diseased liver, such as cirrhosis or severe hepatitis, can cause fluid retention or leakage into certain areas of the body.
  • Kidney disease: Your kidneys do the complex job of keeping salt, fluid and electrolytes in balance.

Physical causes

Your ankles may swell due to causes that directly affect their functioning, such as the following.

  • Overuse: Walking all day or exercising more than usual puts strain on the ankles that may lead to temporary inflammation and swelling [3].
  • Trauma: Swelling may be the most obvious sign of a broken or sprained ankle that may also be painful.
  • Sitting still: Remaining seated for long periods of time, such as during an airplane ride, allows blood and fluid to pool in the ankles due to the force of gravity.

Other medical causes

Causes of swollen ankles related to other medical conditions may include:

  • Pregnancy: Hormones and other effects of pregnancy make the body hold on to more fluid and reduce venous return from the lower extremities and increase the amount of fluid that collects in areas like the ankles. [2,4]
  • Autoimmune problems: Certain diseases like lupus increase inflammation throughout the body and may lead to ankle swelling [4].
  • Blood clot: A blockage in your vein (deep vein thrombosis or DVT) prevents blood from draining from the ankle and may travel to arteries in your lungs if not treated appropriate.
  • Infection: Bacteria can invade the skin around the ankles or the ankle joint itself, leading to swelling that is usually also accompanied by warmth and redness.
  • Medications: Certain pills, such as some kinds of blood pressure medications, make it more likely that fluid will pool in your legs and ankles. Your doctor or pharmacist can tell you the side effects of the medicines you take on a regular basis.

8 Possible Swollen Ankles Conditions

The list below shows results from the use of our quiz by Buoy users who experienced swollen ankles. This list does not constitute medical advice and may not accurately represent what you have.

Ankle arthritis

Arthritis simply means inflammation of the joints. Because the feet and ankles have many small joints and carry the weight of the body, they are often the first place that arthritis appears.

Arthritis is caused by a breakdown in the protective cartilage at the end of each joint, so that the bones begin to wear against each other and the joint becomes stiff and painful. This breakdown may be due to simple wear and tear; an injury; or from rheumatoid arthritis, an autoimmune condition which causes the body to break down its own cartilage.

Symptoms include swelling, warmth, and redness in the joint, and pain with movement or with pressure on the joint.

Diagnosis is made through patient history, physical examination, and imaging such as x-rays, CT scan, or MRI.

There is no cure for arthritis, but treatment is important because the symptoms can be managed to prevent further damage, ease pain, and improve quality of life. Treatment involves physical therapy, pain-relieving medications, and sometimes surgery to help repair damaged joints.

Rarity: Uncommon

Top Symptoms: swollen ankle, swollen foot, joint stiffness, pain in one ankle, ankle stiffness

Urgency: Self-treatment

Rheumatoid arthritis

Arthritis is a general term for multiple conditions that cause painful inflammation and stiffness throughout the body. Rheumatoid arthritis (RA) is a chronic condition that is autoimmune in nature, meaning that the body's immune system which normally protects the body by att...

Read more

Acute or worsening heart failure

Heart failure is a condition in which the heart can't pump enough blood to meet the body's needs. Heart failure does not mean that the heart has stopped or is about to stop working, but rather that the heart is not able to pump blood the way it should. Usually this happens when the heart has been damaged by another medical condition.

Rarity: Rare

Top Symptoms: fatigue, shortness of breath, chest pain, nausea, shortness of breath on exertion

Urgency: Emergency medical service

Nephrotic syndrome

Nephrotic syndrome is a disorder of the kidneys that results in too much protein excreted into your urine. It is usually associated with damaged kidneys specifically damage to the kidneys' filters, called glomeruli.

Kidney damage and nephrotic syndrome primarily include albuminur...

Read more

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Acute ankle bone infection (osteomyelitis)

Osteomyelitis of the ankle is a bacterial or fungal infection of the ankle bones, typically caused by Staph Aureus (40-50% of the time). It is difficult to diagnose as the infection can come from a break in the skin at the area or anywhere else in the body that spreads by blood.

Rarity: Rare

Top Symptoms: moderate fever, constant ankle pain, spontaneous ankle pain, warm red ankle swelling, painful surgical site

Symptoms that always occur with acute ankle bone infection (osteomyelitis): spontaneous ankle pain, constant ankle pain

Urgency: Hospital emergency room

Chronic obstructive pulmonary disorder (copd) exacerbation

A COPD (chronic obstructive pulmonary disease) exacerbation is a worsening of your COPD, causing you to struggle for breathe. This is often caused by an infection in the lungs.

Rarity: Common

Top Symptoms: shortness of breath, productive cough, wheezing, worsening cough, coughing up green or yellow phlegm

Urgency: Hospital emergency room

Right heart failure (cor pulmonale)

Acute cor pulmonale is also called acute right-sided heart failure and acute RHF. It is the sudden failure of the right ventricle of the heart.

The right ventricle pumps blood out of the heart, into the pulmonary artery, and into the lungs. If the pulmonary artery is blocked, the right ventricle will quickly become overworked and in danger of shutting down. A blood clot, called an embolism, or plaque lining this artery can suddenly cut off blood flow from the heart into the lungs.

Risk factors for acute cor pulmonale include surgery, obesity, smoking, and prolonged immobility. All of these leave the person prone to blood clots and/or plaque in the arteries.

Symptoms include sudden chest pain with rapid heartbeat, pale skin, cold sweat, shortness of breath, and coughing, sometimes with blood.

Acute cor pulmonale is a life-threatening medical emergency. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through physical examination, blood tests, echocardiogram, and chest x-ray.

Treatment involves oxygen, diuretics, blood-thinning and clot-dissolving medications, and sometimes surgery.

Rarity: Common

Top Symptoms: fatigue, chest pain, shortness of breath on exertion, wheezing, decreased exercise tolerance

Symptoms that never occur with right heart failure (cor pulmonale): severe chest pain

Urgency: Hospital emergency room

Cirrhosis

Cirrhosis is scarring of the liver. Scar tissue forms because of injury or long-term disease. In the United States, alcoholism and Hepatitis C are the most common causes. Scar tissue cannot do what healthy liver tissue does - make protein, help fight infections, clean the blood, help digest food and store energy.

Rarity: Common

Top Symptoms:

Urgency: Primary care doctor

Swollen Ankles Treatments and Relief

If you have some occasional swelling, the good news is that there are several swollen ankle treatments you can try in the comfort of your own home. These common-sense measures can reduce discomfort and get you back on your feet. If the swelling persists for a long period of time or becomes particularly severe or bothersome, then visit your doctor as medications and tests may be in order.

At-home treatment

Treatment for swollen ankles can begin at home with the following.

  • Get moving: If you've been sitting still, get up and use those legs. The contraction of the leg muscles helps push fluid back into the veins and out of your ankles.
  • Rest: On the other hand, if you've been on your feet or have injured your ankle, it's best to take it easy for a few days [5].
  • Ice: Cold temperatures constrict blood vessels, reduce swelling, and can help with discomfort.
  • Elevation: Keep those legs up on a chair or ottoman to counteract the effect of gravity, which naturally pulls fluid down into your ankles.
  • Compression stockings: These tight socks can be worn for several hours to help reduce ankle swelling.

When to see a doctor

You and your doctor can discuss the following treatment options if at-home treatments are ineffective.

  • Detailed physical examination: Your doctor will examine the area of swelling but will also look for signs of problems with your heart, kidneys, and liver as these can lead to swelling throughout the body.
  • Medication: Certain drugs, such as water pills or diuretics, help the body remove excess fluid in a natural way. Other medicines can treat underlying medical conditions that lead to ankle swelling.
  • Blood tests: These can inform your doctor if your organs are functioning properly and if your medications are having the desired effect.
  • Imaging: An ultrasound or other type of image may be taken of the area of swelling to look for problems like blood clots.

When it is an emergency

Seek help without delay if you have:

  • Severe shortness of breath
  • Severe pain, including chest pain
  • Redness or warmth over the ankle joint
  • Swelling in one leg after sitting still for a prolonged time: Such as during plane travel

Prevention

Although not all causes of ankle swelling are preventable, your best defense is to stay hydrated by drinking plenty of water, getting regular exercise, and eating a healthy, balanced diet of fresh foods.

FAQs About Swollen Ankles

Here are some frequently asked questions about swollen ankles.

Why do my ankles swell after a flight?

Ankles swell after a flight because fluid collects in the legs over the duration of the flight. This is partially because of increasingly tight seating arrangements on planes; the long duration during which passengers do not rise and walk during travel; and the negative pressure that your body experiences during the flight. If your ankles tend to swell to the point of discomfort, you can wear compression socks.

Do certain medications cause ankle swelling?

Many medications can cause fluid retention. Once your body begins to retain fluid, the fluid settles in the lowest area of your body — your ankles. Medications that can cause ankle swelling include oral or topical steroids; non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin); several diabetes medications; antidepressant medications; and certain blood pressure and heart medications called calcium channel blockers.

Why do my ankles swell after giving birth?

After giving birth, the blood that was going to the baby and the placenta (the organ that keeps the baby alive) re-enters your bloodstream. You have a little more blood than you did before you became pregnant. This is generally a good thing. However, this blood can cause extra fluid to pool in your legs until it is reabsorbed into your body.

When should you seek medical attention for swollen ankles?

You should seek medical attention first if you see any changes in your skin. If you have a non-healing cut; a blue-colored or darkened area of skin on one or both legs; or a loss of hair along the legs, you should seek medical attention [6]. Second, if one leg is more swollen than the other, you should seek medical attention. This can be a sign of a blood clot (deep vein thrombosis or DVT), and if left untreated can travel to the lung and may be life-threatening. Finally, if you experience pain or a decrease in sensation of either one or both legs you should seek medical attention. This may be a sign of diabetes, severe edema, or a lack of blood flow to the lower extremity — all of which require medical treatment [7]. If one leg feels cold, seek emergency medical treatment immediately.

Can swollen ankles be a sign of menopause?

Yes, swollen ankles can be a sign of menopause. As the hormones of the body change, the fluid balance of the body also changes, and fluid can pool in many areas. When it pools in the tissues of the abdomen, one can feel bloated. One can also experience leg swelling during menopause [8].

Questions Your Doctor May Ask About Swollen Ankles

To diagnose this condition, your doctor would likely ask the following questions:

  • Have you been feeling more tired than usual, lethargic or fatigued despite sleeping a normal amount?
  • Have you ever been diagnosed with diabetes?
  • Do you have high blood pressure?
  • Are you having any difficulty walking?

If you've answered yes to one or more of these questions

Please take a quiz to find out what might be causing your swollen ankles. These questions are also covered.

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Swollen Ankles Symptom Checker Statistics

People who have experienced swollen ankles have also experienced:

  • 6% Swelling Of Both Feet
  • 5% Fatigue
  • 1% Headache

People who have experienced swollen ankles were most often matched with:

  • 63% Acute Or Worsening Heart Failure
  • 27% Rheumatoid Arthritis
  • 9% Ankle Arthritis

People who have experienced swollen ankles had symptoms persist for:

  • 30% Less than a week
  • 27% Over a month
  • 23% Less than a day

Source: Aggregated and anonymized results from Buoy Assistant (a.k.a. the quiz).

Swollen Ankles Symptom Checker

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References

  1. Swollen ankles, feet and legs (oedema). National Health Service. Reviewed Nov. 14, 2018. NHS Link
  2. Foot Changes During Pregnancy. American Orthopaedic Foot & Ankle Society: FootCareMD. AOFAS Link
  3. Krum LN. Understanding Muscle Soreness – How Much is Too Much? National Kidney Foundation. National Kidney Foundation Link
  4. What is myositis? Columbia University Irving Medical Center: ColumbiaDoctors. ColumbiaDoctors Link
  5. Swelling: The Body's Reaction to Injury. Nationwide Children's. Nationwide Children's Link
  6. The Society for Cardiovascular Angiography and Interventions: SecondsCount. SecondsCount Link
  7. What is Diabetic Neuropathy? National Institute for Diabetes and Digestive and Kidney Disorders. February 2018. NIDDK Link
  8. Stachenfeld NS. Hormonal changes during menopause and the impact on fluid regulation. Reprod Sci. 2014;21(5):555-61. NCBI Link