A person may experience swelling in their legs and ankles for a range of reasons, including those below.
Heart failure is one of the most common causes of swollen legs and ankles.
If the heart is unable to pump blood around the body effectively, blood can build up, causing swelling known as edema. For people with heart failure, is common for edema to occur in the lower legs, ankles, and feet.
Heart failure has no cure, but self-care strategies and ongoing treatments can help manage the condition.
Treatment options include:
- lifestyle changes, such as boosting physical activity levels and having a low sodium diet
- medications, such as beta-blockers
- surgical procedures, such as a coronary artery bypass
- implantable devices, such as a left ventricular assist device
- a heart transplant
Many people living with heart failure require ongoing support from a cardiologist.
Learn more about heart failure and swollen feet here.
The liver produces albumin, a protein that prevents fluid from leaking out of blood vessels and into surrounding tissues. A diseased liver does not produce enough albumin. As a result, fluid can pool in the legs, ankles, and feet.
Most people with liver disease have no symptoms until severe liver damage or cirrhosis develops.
The only cure for chronic cirrhosis is a liver transplant. But with other approaches, doctors aim to manage the disease, relieve any symptoms, and prevent complications.
If swollen legs result from cirrhosis, a doctor may prescribe diuretics, such as spironolactone (Aldactone) or furosemide (Lasix). They may also recommend a low-sodium diet, which can help alleviate fluid retention.
The kidney’s main role is to regulate the amount of water in the body and balance levels of salt and other minerals in the blood.
Diseases can severely damage the kidneys, keeping them from filtering the blood effectively and excreting fluid and other waste through the urine. This can lead to a buildup of waste in the lower legs and ankles.
Some other early signs and symptoms of kidney disease include:
- swollen hands or feet
- persistent puffiness around the eyes
- more frequent urination, especially at night
- high blood pressure, also called hypertension
- blood or protein in the urine
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The treatment for kidney disease depends on its cause.
The damage may result from a medical condition, such as high blood pressure or diabetes. Doctors prescribe medications to manage these conditions and slow the rate of kidney disease.
In some cases, chronic kidney disease progresses to kidney failure. At this stage, a person needs dialysis or a kidney transplant.
Injury to the foot or ankle
An injury to the foot or ankle could cause swelling in the ankle and lower leg. One of the most common injuries in this area is a sprained ankle.
This can result from a simple misstep when walking, playing sports, or working out. It happens when the ligaments that connect the ankle to the foot and leg are pulled out of alignment.
A sprained ankle can cause pain and limited mobility.
The most common approach to foot or ankle injuries is the RICE method. RICE stands for:
- Rest: Resting the affected ankle helps prevent further damage.
- Ice: Applying ice or an ice pack wrapped in a towel helps numb the pain and reduce swelling. Apply it for 15-20 minutes at a time at least three times a day.
- Compression: Wearing a compression bandage helps limit swelling.
- Elevation: Elevating the foot or ankle above level of the heart helps reduce swelling.
An infection in the feet, ankles, or lower legs can cause swelling in the area. Cellulitis is one type of skin infection that commonly affects the lower limbs.
People with diabetes have an increased risk of infection in their feet. It is important to inspect the feet regularly for bruising, cuts, and scrapes.
A person with diabetes and an untreated infection in a foot or leg may develop gangrene. Gangrene involves tissues dying as a result of severe infection or reduced blood supply.
The treatment for a foot, ankle, or leg infection depends on its type and severity. If the infection is bacterial, a doctor tends to prescribe antibiotics.
If the infection has resulted in gangrene, surgery to remove the damaged area may be necessary.
Lymphedema involves excess fluid accumulating in tissues, causing swelling. It occurs when lymph nodes are damaged or have been removed.
The lymph nodes are glands that are part of the immune system, and they help remove fluid. If lymph nodes in the pelvis are damaged or absent, it can cause fluid to build up in the legs.
A person with lymphedema may have a feeling of heaviness or swelling in their legs or other affected areas.
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Treatment options for lymphedema include:
- bandaging the affected leg
- wearing compression stockings
- massaging the lymph nodes to encourage drainage
- performing gentle exercises to encourage drainage
- caring for the skin to reduce the risk of infection and associated lymphedema
The veins in the legs contain valves that prevent blood from flowing backward. Venous insufficiency involves these valves not functioning effectively. As a result, the veins no longer transport enough blood to the heart.
When a person has venous insufficiency, blood becomes trapped in the soft tissues of the lower legs and ankles. A person may also have:
- skin ulcers
- changes in skin color
The treatment for venous insufficiency aims to restore healthy blood flow. This may involve:
- not crossing the legs when sitting or lying down
- elevating the legs
- getting more regular exercise
- wearing compression stockings
A doctor may also recommend medications, and the type depends on the severity of the venous insufficiency and the person’s overall health.
A blood clot in a leg can cause the ankle and leg to swell. This may only happen on one side of the limb.
There are two main types of blood clot. Superficial blood clots occur in a vein closer to the surface of the skin. Deep vein thromboses (DVTs) occur in a vein deeper within the body.
A person needs immediate medical attention if they have any of these symptoms of a blood clot:
- swelling and pain in one leg
- a heavy ache in the leg
- an area of warm skin on the leg
- an area of red or flushed skin behind and below the knee
- a change in the color of the leg
- a low fever
Sometimes, a piece of the clot breaks loose and travels to the heart, lungs, or brain. This can be life threatening without treatment.
The risk of a blood clot is highest for people who:
- are pregnant
- are immobile due to surgery or hospitalization for another reason
- have obesity
- are older adults
Oral anticoagulants are the primary treatment for blood clots. These medications help prevent clots from getting bigger and help prevent new clots from forming.
Warfarin is the most common oral anticoagulant. Other oral medications include:
- rivaroxaban (Xarelto)
- apixaban (Eliquis)
- edoxaban (Savaysa)
- dabigatran (Pradaxa)
However, the high cost of these medications can limit access to them.
Medication side effects
Some medications can cause a person’s ankles or legs to swell. Examples of these include:
- hormones, such as estrogen
- nonsteroidal anti-inflammatory drugs, also known as NSAIDs
- diabetes medications
- calcium channel blockers
Contact a doctor about any side effects of medication. They may lower the dosage or recommend a different drug. Always receive the approval of a doctor before stopping a treatment.
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