Swollen Feet and Ankles: 12 Causes & What to Do

Swollen feet and ankles are a common symptom that is often linked to fluid buildup caused by standing for long periods, poor circulation, or pregnancy. In many cases, this type of swelling is mild and improves with simple measures like elevating the legs or using compression stockings.

However, swollen feet and ankles can sometimes be a sign of a more serious problem, especially when swelling lasts more than a day or is accompanied by pain, redness, or difficulty walking. Conditions like injuries, blood clots, heart disease, or infections may need prompt medical care.

Other possible causes include liver or kidney disease, medication side effects, and conditions like lymphedema or hypothyroidism. Treatment depends on the cause and may include rest, medications, lifestyle changes, or specialist care.

What causes swollen feet and ankles?

The main causes of swelling in the feet and ankles include:

1. Chronic venous insufficiency

Swelling in the feet and ankles can be a sign of chronic venous insufficiency, a condition in which the vein valves do not work properly. Normally, these valves help keep blood moving upward from the legs back to the heart, but when they become weak, blood can flow backward and build up in the legs and feet.

This condition tends to cause more persistent or recurrent swelling and may also lead to skin changes, skin ulcers, or infections if left untreated.

What to do: Venous insufficiency should be treated to avoid serious complications, such as skin ulcers and infections. A cardiologist or vascular surgeon may recommend compression stockings, diuretics to help remove excess fluid, or other medicines to strengthen the blood vessels.

2. Poor circulation in the legs and feet

Poor circulation in the legs is usually linked to a lack of physical activity, spending long periods sitting or standing, obesity, or natural aging, and is more common with aging. In this situation, temporary changes in blood flow make it harder for blood to return from the legs to the heart, especially after long periods without moving.

In addition to swelling in the ankles, which is more noticeable at the end of the day, poor circulation can also cause mild discomfort or a feeling of heaviness in the legs.

What to do: Elevating the legs above heart level can help reduce swelling. If sitting for long periods during the day, taking short breaks to stand up and move the legs is recommended.

Other important measures include regular physical activity, weight loss, and reducing salt intake. A natural option is horse chestnut, which has anti-inflammatory and vasoconstrictive properties and may help improve circulation.

3. Sprains and other injuries

Any sprain or injury to the ankle can cause swelling, pain, bruising on the side of the foot, and difficulty moving or putting weight on the foot.

Ankle sprains are among the most common ankle injuries. They usually happen when the foot lands awkwardly and rolls to one side, or when the ankle is hit directly.  Sprains are often mistaken for fractures, but they tend to be more common.

In a sprain, the ligaments that support the ankle and foot are stretched too far and may develop small tears. This triggers inflammation, which can cause swelling, often intense pain, bruising, and difficulty walking or moving the foot.

What to do: It is important to apply ice following the injury and to keep the foot immobilized. Avoid intense sports or long walks for at least 2 weeks. You can also alternate soaking the injured foot in a basin of warm water and then in a basin of ice-cold water, as this temperature change can help reduce swelling more quickly.

In more severe cases, surgery may be necessary to stabilize the joint with rods and screws. Several months of physical therapy are usually necessary following surgery, as well as a follow-up procedure about a year later to remove the hardware.

4. Cardiac insufficiency

Cardiac insufficiency is most common in older adults and occurs as the heart muscle ages and becomes weaker. As a result, the heart cannot pump blood effectively, causing fluid to build up in the legs, ankles, and feet.

Older adults with this kind of swelling often also feel very tired, short of breath, and may experience a feeling of pressure or tightness in the chest.

What to do: Cardiac insufficiency can be treated with prescription medication. You should be followed by a cardiologist to ensure you are receiving adequate treatment.

5. Thrombosis

According to the National Heart, Lung, and Blood Institute, deep vein thrombosis (DVT) can occur when a blood clot forms in a deep vein, usually in the lower leg, thigh, or pelvis.

In these cases, in addition to swelling in the lower leg, you may also experience pain, tingling, marked redness, and even a low‑grade fever.

What to do: If you suspect you have a blood clot, go to the emergency department right away so you can start anticoagulant (blood-thinning) treatment as soon as possible. This helps stop the clot from growing or moving to the lungs, where it could cause a pulmonary embolism.

6. Liver failure and cirrhosis

Swelling in the ankles can also be a sign of advanced liver disease, such as liver failure or cirrhosis. It can happen when the liver makes less albumin, a protein that helps keep fluid inside the blood vessels.

In addition to ankle swelling, you may also notice swelling in the feet or abdomen. Liver disease can also cause other symptoms, such as yellowing of the skin and eyes (jaundice).

What to do: It is important to see a liver specialist, gastroenterologist, or your primary care provider for an evaluation. This may include blood tests to check liver enzymes, bilirubin, alkaline phosphatase, and gamma‑glutamyl transferase (GGT).

7. Nephrotic syndrome

Nephrotic syndrome is a kidney condition in which the body loses too much protein in the urine. It can be caused by infections, such as HIV and hepatitis, or by diseases like diabetes and lupus.

The swelling from nephrotic syndrome can affect the ankles and other parts of the body, including the feet, face and arms. It can also cause foamy urine, tiredness and loss of appetite.

What to do: If nephrotic syndrome is suspected, it is important to see your primary care provider or a nephrologist for a full evaluation, as the treatment depends on what is causing the condition.

8. Infection

Infection with foot or ankle swelling usually only happens when there is a wound in this area that has been left untreated. This is more common in people with poorly controlled diabetes who develop sores on their feet but do not notice them because of loss of sensation.

What to do:A person with diabetes should see their health care provider right away if they are worried a wound might be infected. Until they can be seen, the wound should be gently cleaned and covered with a bandage to help prevent further bacterial growth.

9. Medication side effects

Some medications can cause swelling in the legs and feet as a side effect. These include birth control pills, heart medicines, steroids, diabetes medications, and antidepressants.

What to do: Be sure to talk to your healthcare provider if a medicine you are taking is causing swelling. Depending on how severe it is, they may be able to change your prescription to a different medication that does not cause this side effect.

10. Lymphedema

Lymphedema happens when fluid builds up in body tissues outside of the blood vessels. It can develop after lymph nodes are removed or if there is a problem with the lymphatic system.

This fluid buildup can become chronic and hard to treat. It is especially difficult to manage when lymph nodes are removed from the groin, such as during some cancer treatments.

What to do: See your primary care provider or a vascular or lymphatic specialist to confirm the diagnosis. Treatment usually includes physical therapy sessions, wearing compression stockings, and better positioning and posture to help reduce swelling.

11. Cellulitis

Cellulitis is a bacterial skin infection that can occur on the legs, face, arms, or other parts of the body and usually causes pain, swelling, and redness in the affected area.

What to do: If you think you might have cellulitis, it is important to see a doctor for assessment and diagnosis. According to the Centers for Disease Control and Prevention (CDC), cellulitis is usually diagnosed by how the skin looks and is treated with antibiotics.

12. Hypothyroidism

Hypothyroidism is a condition in which the thyroid gland does not work properly and produces less of the hormones T3 and T4 than the body needs. This can cause symptoms such as excessive tiredness, slower heart rate, weight gain, hair loss, and, in some cases, inflammation in the joints of the hands, legs and ankles.

What to do: If you think you might have hypothyroidism, you should see your primary care provider or an endocrinologist for blood tests to check your thyroid hormone levels. If these levels are low, a provider may recommend hormone replacement therapy.

Joint swelling or pain linked to hypothyroidism can often be managed with anti‑inflammatory medicines, but only if they are recommended by a healthcare professional.

Swollen ankles during pregnancy

Ankle swelling is common in pregnancy and is not always a sign of a serious problem. However, you should contact your OB‑GYN or midwife right away if the swelling occurs along with abdominal pain, reduced urine output, headache, nausea, or high blood pressure, as this may be a sign of preeclampsia.

If you think you may have preeclampsia, seek urgent medical care.

Which doctor to see

You should see a cardiologist if a heart problem is suspected, but a primary care provider can usually make the initial diagnosis and start appropriate treatment, and then refer you to a cardiologist if needed.

A physical exam and blood tests can check for conditions such as high cholesterol or high triglycerides, and imaging tests such as X‑ray, echocardiogram, or cardiac MRI may be needed to assess the heart and blood vessels.

In an older adult, a broader range of tests may be needed to confirm the diagnosis and rule out several possible causes at the same time.