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10 Reasons for swollen feet and ankles and how to treat it

Swelling of the feet and ankles is a very common symptom and is usually not a sign of serious problems. In most cases it is related to normal changes in circulation, especially in people who spend a lot of time standing or walking, for example.

When the feet remain swollen for more than 1 day or is accompanied by other symptoms such as pain, severe redness or difficulty walking, it may indicate a problem or injury, such as sprain, infection or even thrombosis.

In pregnancy, this problem is very common and is usually related to changes in the woman's circulatory system, and rarely is a sign that something is wrong with pregnancy.

10 Reasons for swollen feet and ankles and how to treat it

1. Poor circulation to the legs and feet

This is the most common cause of swelling in the legs, feet and ankles and usually arises at the end of the day in adults, elderly or pregnant women. This poor circulation, does not cause pain, but can cause a slight discomfort, similar to having heavier feet or full of fluid.

Poor circulation in the legs is a natural process that arises due to the aging of the veins, which makes them less able to push the blood back to the heart and, therefore, the blood accumulates excessively in the feet and legs.

What to do: to relieve swelling one should lie down and raise one's legs above the level of the heart. Another option is to do a light massage from the feet to the hip, to help the blood go back to the heart. People who work standing or walk a long time can use elastic compression stockings purchased at pharmacies to prevent the problem from arising, for example. 

2. Sprain and other injuries

Any type of injury or ankle trauma can cause swelling that is accompanied by pain and difficulty in moving the foot. It can also present redness on the side of the foot. One of the most common injuries is a sprain, which occurs when the foot is badly placed on the floor or if a foot injury occurs.

In these situations, the ankle and foot ligaments are excessively elongated and, therefore, small fissures may arise, which initiate the inflammatory process leading to the onset of swelling, often accompanied by severe pain, purple spots and difficulty walking or moving the foot. Often this situation can be confused with a fracture, but it is more likely to be just a sprain.

What to do: the most important thing in these cases is to put ice on the area right after the injury, bandage the ankle and rest the foot, avoiding intense sports or walking for a long time, at least for 2 weeks. See how you can treat a sprained ankle at home. Another strategy is to place the foot in a basin of warm water and then swapping it into a basin with cold water because this temperature difference will make the swelling go down quickly.

In more severe cases it may be necessary to perform a surgery to place plaques and / or screws to stabilize the joint, and it is necessary to perform physical therapy for a few months. About 1 year after surgery it may be necessary to do a new surgery to remove the pins / screws.

3. Pre-eclampsia in pregnancy

Although swelling of the ankles is a very common symptom in pregnancy and is not related to serious problems, there are cases in which this swelling is accompanied by other symptoms such as abdominal pain, decreased urination, headache or nausea, for example. In these cases, the swelling may be a sign of pre-eclampsia, which happens when blood pressure is too high and needs to be treated.

What to do: If pre-eclampsia is suspected, it is very important to consult your obstetrician to have your blood pressure checked. However, to avoid this problem the pregnant woman should follow a diet low in salt and increase the intake of water to 2 or 3 liter a day. 

4. Heart failure

Heart failure is more common in the elderly and is due to the aging of the heart muscle, which has less ability to push the blood and therefore accumulates in the legs, ankles and feet because of the force of gravity.

Generally, swelling of the feet and ankles in the elderly is accompanied by fatigue, feeling of shortness of breath and a feeling of pressure in the chest. 

What to do: Heart failure needs to be treated with medication prescribed by a doctor and it is therefore advisable to see a cardiologist to start the appropriate treatment.

5. Stroke

Stroke occurs when a blood clot can blocks one of the veins in the leg, so the blood does not return properly to the heart, accumulating in the legs, feet, and ankles.

In these cases, in addition to the swelling of the feet and ankles, other symptoms such as pain, tingling sensation, intense redness and even low fever may occur.

What to do: Whenever a thrombosis is suspected, one should go to an emergency room quickly to start treatment with anticoagulants, avoiding that this clot be transported to other places such as the brain or the heart, which can lead to a heart attack or stroke.

10 Reasons for swollen feet and ankles and how to treat it

6. Problems in the liver or kidneys

In addition to heart problems, changes in kidney or liver  function can also cause swelling in the body, especially in the legs, feet and ankles.

When the swelling is due to liver problems this happens due to a decrease in albumin levels, which is a protein that helps keep the blood inside the vessels. When the swelling is due to kidney problems it is because the liquids are not eliminated properly by the urine.

What to do: If swelling is frequent and other symptoms are present such as decreased urination, swelling of the belly, or yellowing of the skin and eyes, it is recommended you consult a general practitioner for blood or urine tests. So they can identify if there is a problem with the kidneys or liver, for example. See the symptoms of liver disease.

7. Infection

An infection associated with foot or ankle swelling usually only happens when there is a wound in the foot or leg that is not being treated properly and, therefore, becomes infected. This situation is more common in people with uncontrolled diabetes who suffer cuts in the feet, but do not feel it due to the destruction of the nerves of the feet by the disease.

What to do: Any infected wound in a diabetic should be treated by a nurse or doctor, and it is recommended to go to an emergency room. Until then, keep the area clean and covered, to avoid the growth of more bacteria.

8. Venous insufficiency

The swelling in the feet and ankles can also represent a venous insufficiency, which is when the blood of the lower limbs finds some difficulty in returning to the heart. Inside the veins there are several small valves that help direct blood to the heart, overcoming the force of gravity, but when these valves are weakened there is a small return of blood back and  it accumulates in the legs and feet.

What to do: Venous insufficiency should be treated to prevent serious complications such as skin sores and infection. The cardiologist or vascular doctor may indicate taking medications to strengthen blood vessels, and diuretics to eliminate excess fluid from the body.

9. Side effect of some medicine

Certain medications may have side effects such as swelling of the legs and feet, such as birth control pills, heart medicines, steroids, steroids, diabetes medicines, and antidepressants.

What to do: If you are taking any medication that is causing swelling, you should talk to your doctor about swelling, because depending on its severity it is possible to switch to another medication that does not have this unpleasant effect.

10. Lymphedema

Lymphedema is when there is an accumulation of fluid between tissues outside the blood vessels, this can happen due to the withdrawal of lymph nodes or alteration in the lymphatic vessels. This accumulation of fluids may be chronic and difficult to resolve, especially after removal of lymph nodes from the groin area due to cancer treatment, for example. 

What to do: The doctor should be consulted for a diagnosis. The treatment can be done with sessions of physiotherapy, use of compression socks and posture habits.

What type of doctor to search for

When cardiac changes are suspected, it is more appropriate to go to a cardiologist, but usually you should see a general practitioner so that he can give you a diagnosis and initiate the appropriate treatment. Physical and blood tests can be performed to assess suspected high cholesterol and triglycerides in case of history of sprain, depending on the severity of the symptoms it may be necessary to perform an x-ray, resonance or ultrasound examination to check for bones and ligaments. In the elderly the geriatrician may be more indicated for having a broader view of all aspects that may be present at the same time.


Bibliografia

  • AL-MOHREJ, Omar A; AL-KENANI, Nader S. Acute ankle sprain: conservative or surgical approach?. EFORT Open Rev. Vol.2. 1.ed; 34-44, 2016
  • HUANG J; WANG, Yu N; LONG, X. Incidence of lower limb lymphedema after vulvar cancer: A systematic review and meta-analysis. Medicine (Baltimore). Vol.96. 46.ed; 2017
  • FILHO, Roberto Kalil; FUSTER, Valentin. Medicina Cardiovascular: Reduzindo o impacto das doenças. 1.ed. São Paulo: Atheneu, 2016.
  • WEBMMD. Swollen Ankles and Feet. 2019. Link: <www.webmd.com>. Access in 16 Apr 2019
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