When to See a Doctor For Swollen Ankles
It’s not unusual to have swollen ankles, especially if you’re older or you are on your feet for long periods. But how can you tell if a swollen ankle is a sign of something serious or a minor problem you can deal with at home? And what is the difference between edema caused by heart disease and swelling caused by a sprain? Learn about what causes swollen ankles, and what to do if you have ankle pain and swelling.
Some causes for swollen ankles are quite common and can be due to lifestyle. Other causes may be more traumatic or serious.
Swelling can also look and feel different depending on the cause. For example, edema, which is the accumulation of fluid in the body’s tissues, looks puffy. If you press your finger into a spot with edema, and then remove the finger, the indentation will stay there for a few seconds before the skin rebounds. Other types of swelling, such as from a sprain, don’t have that few seconds of delay.
Here are some of the most common causes of swollen ankles:
Standing for long periods. Leg movement usually encourages blood circulation, but standing for too long can cause the blood in your legs to flow more slowly than usual.
Sitting without moving your legs for long periods. This may happen if you sit at your desk for too long; watch TV for hours; or travel by car, plane or train. If you sit still for a long time or you cross your legs while sitting, the blood flow may slow down, resulting in edema.
Too much salt (sodium) in your diet. Consuming excess sodium can cause edema in your ankles.
Sprains, strains, and fractures. If you injure your ankle and have a sprain, strain, or broken bone, you will likely see your ankle swell up quickly. This swelling is your body’s inflammatory reaction to the injury.
Pregnancy. The pressure from the baby on the blood vessels that drain blood from the lower part of your body can cause swelling in the ankles.
Preeclampsia. Pregnant women are at risk of developing preeclampsia, a condition that causes high blood pressure and can also cause organ damage and death if not diagnosed and treated quickly. Swollen ankles are one sign of preeclampsia.
Lymphedema. Lymph is a colorless fluid that circulates through your body in the lymphatic system. The lymph can get trapped if your lymph nodes are blocked or damaged. People who have had cancer are at risk of developing lymphedema. The location of the blocked or damaged lymph node determines where the fluid will accumulate and cause swelling. If the lymph nodes in your leg are blocked, this could cause swollen ankles.
Heart disease. If your heart can’t pump blood effectively, blood may end up pooling in the lowest part of your body—your feet and legs.
Kidney disease. Kidneys that don’t work properly may not help your body rid itself of extra or excess fluids, which can then accumulate in your feet and legs.
Liver disease. Liver disease affects your entire body. Albumin is a protein made in the liver. If your albumin levels are too low, blood moves from the veins to the tissues surrounding them, causing edema.
Venous insufficiency. Your veins return blood to the heart after the blood has circulated to the rest of your body. If the veins are damaged, they can’t help push the blood back to the heart.
Medication side effects. Some medications, particularly those for high blood pressure, could cause ankle swelling as a side effect.
When the cause is minor or temporary, swollen ankles are often treatable at home, but there are some cases when they need to be treated by a doctor. In these situations, swollen ankles could be a sign of a serious illness.
If your swollen ankles occur along with shortness of breath or chest pain, call 911. This could be a sign of serious heart disease or heart failure. If your ankle is swollen following a trauma, like a fall or a motor vehicle accident, you should be seen in an emergency room to rule out a fracture or other serious injury.
You may not need to call 911, but you should contact your doctor immediately or visit an urgent care clinic if you have new or increasing ankle swelling and:
You have a history of heart disease.
You have a history of kidney disease.
You are pregnant and the swelling has gotten worse or appeared suddenly.
You have a fever.
For more serious causes of swollen ankles, you will be seen by an emergency room doctor who will determine if you should be treated right away or if you need to be referred to a specialist, like a cardiologist or nephrologist (kidney specialist).
In cases when your symptoms don’t indicate an emergency, you would likely see your family doctor. If you already have a cardiologist or nephrologist, or if you are pregnant and have an OB/Gyn, you could see these specialists.
Your doctor will examine you to check for swelling beyond your ankles and for any other symptoms. He or she will ask for more details about your symptoms, such as what makes the swelling better or worse, and whether your ankles are more swollen at any particular time of the day.
You may be sent for tests, including blood and urine tests, chest x-rays, or an electrocardiogram (ECG). Your doctor may also ask for a Doppler ultrasound of your leg veins. This would indicate if there are any blood clots.
If your family doctor or obstetrician believes the swelling or edema may be caused by heart, kidney or liver disease, you may be referred to a specialist. If the swelling is caused by varicose veins (venous insufficiency), you may be referred to a vascular surgeon.
Treatment for swollen ankles depends entirely on the cause. If it is caused by a fracture or sprain, the ankle will be immobilized to allow it to heal. If it is caused by heart, liver, or kidney disease, you will be treated for the diseases, which then may result in the edema going down. A common medication given to people with ankle edema is a diuretic—a water pill. These medications cause you to urinate more often than usual to eliminate excess fluid from your body.
If you haven’t injured your ankle seriously or you don’t have reason to believe there’s a serious cause for the swelling, you may want to try some at-home treatments before calling your doctor, including:
Elevate your legs. While in bed or sitting comfortably, raise your legs with pillows or a foot rest.
Move your legs. If standing or sitting for long periods, move your legs as much as you can to help your blood pump back up to your heart.
Wear compression socks or support stockings. The pressure from these socks or stockings helps promote blood flow in your legs.
Eat a healthy diet, low in salt. Excess sodium can cause fluid retention that leads to swelling.
Avoid wearing tight clothing, other than well-fitting compression or support socks. (Compression socks should be snug to your leg, but if they leave a mark on your skin from the elastic, they are too tight. It’s wise to have a health professional measure and prescribe compression stockings.)
For most people, swollen ankles are not serious, but in the cases when they are, it’s important to get prompt medical care. Pay attention to your symptoms and call your doctor when in doubt.