Swollen Feet: Causes, Remedies, When to See a Doctor

Signs of edema in one or both feet include shiny skin and dimpling after pressing on the swollen area for several seconds.

Foot swelling may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms that frequently affect the feet may also involve other body systems.

Other foot symptoms that may occur along with foot swelling

Foot swelling may accompany other symptoms affecting the foot including:

• Bleeding or bruising

• Burning feeling

• Decreased or absent pulse

• Difficulty moving the foot, ankle or toes

• Difficulty standing or walking

• Itching

• Lumps or nodules

• Numbness

• Pain or tenderness

• Redness or warmth

• Stiffness

• Tingling or other unusual sensations

Other symptoms that may occur along with foot swelling

Foot swelling may accompany symptoms related to other parts of the body including:

• Difficulty breathing

• Enlarged lymph nodes

• Flu-like symptoms (fatigue, fever, sore throat, headache, cough, aches and pains)

• Rash, which may be itchy

Serious symptoms that might indicate a life-threatening condition

In some cases, foot swelling may occur with other symptoms that might indicate a life-threatening condition, such as heart failure, a severe allergic reaction, or an infection that has spread throughout the body, that should be evaluated immediately in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have foot swelling along with any of these life-threatening symptoms including:

• Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

• Chest pain, chest tightness, chest pressure, or palpitations

• Garbled or slurred speech or inability to speak

• High fever (higher than 101 degrees Fahrenheit)

• Paralysis or inability to move a body part

• Respiratory or breathing problems, such as shortness of breath, difficulty breathing or inability to breathe, labored breathing, wheezing, or choking

• Sudden change in vision, loss of vision, or eye pain

• Sudden swelling of the face, lips or tongue

• Worst headache of your life

Foot swelling is a common condition. When foot swelling is due to fluid buildup, the medical name for it is edema. It occurs when blood vessels leak fluid and it builds up. Even if edema is occurring throughout your body, swelling is more obvious in the feet (or hands) because of gravity. The underlying causes of edema are variable, from a localized foot injury to a serious medical condition affecting the whole body.

The severity of swelling largely depends on its underlying cause. For example, standing or walking for extended periods may cause minor and temporary edema in both feet. Severe swelling in both feet may be due to a medical condition, such as heart failure or vascular disease.

Severe swelling in one foot may be the result of an injury, infection or arthritis, among other causes. Swelling may be localized, such as on the top, side or bottom of the foot, or at a joint.

Common causes of swollen feet

Common causes of foot swelling include:

• Prolonged standing: Mild foot and ankle swelling from standing for a long time is one of the most common reasons for foot swelling. Eating too much salty food can increase swelling, because it makes the body retain fluid.

• Injury: Damage to any of the structures in the foot can cause foot swelling, such as a broken bone, stress fracture, ankle sprain, tendon rupture, turf toe, puncture wound, insect bite, bee sting, or skin burn. See a doctor for a foot, ankle or toe injury causing significant swelling or pain. In the meantime, try RICE: rest, ice, compression, elevation. For swelling from a bee sting or insect bite, also take an antihistamine (even if you have no known allergy).

• Infection: Infectious causes of foot swelling include cellulitis and septic arthritis. Foot swelling is more likely to be localized with an infection. Contact your healthcare provider for signs of infection, which include redness, warmth, fever and pain (the area will be tender to touch). Some infections will resolve, but prescription antibiotics for bacterial infections reduce the risk of complications, such as spread of infection deeper into the foot and up the leg.

• Alcohol use and liver damage: Alcohol causes your body to retain water, resulting in temporary swelling. Fluid buildup (edema) is more noticeable in the feet because of gravity. Reduce your salt intake, elevate your feet, and drink water. Seek medical help as soon as possible if swelling continues or occurs every time you drink. Chronic alcohol use damages the liver causing abdominal swelling, jaundice, and impaired thinking. Stop drinking and seek medical help as soon as possible if you are experiencing more than mild, occasional foot swelling.

• Pregnancy: Mild foot swelling or puffiness during pregnancy is very common because your body is producing more body fluids. To reduce foot swelling, wear compression stockings, stay cool, elevate your feet, and avoid standing for long periods. Also, eat low-salt food, drink more water, and apply cold compresses to your feet. In some cases, swelling during pregnancy is due to preeclampsia, a very serious condition. If your foot swelling is severe, does not go away with self-help measures, or suddenly affects your hands and face, contact your obstetrician or midwife right away. Seek immediate medical care if you cannot reach your provider.

• Warm weather: Hot temperatures increase the amount of fluid in your body as it tries to stay cool. Standing or walking can make foot swelling in hot weather worse. To reduce swelling and make yourself more comfortable, move to a cooler area if possible (or use a cold compress to cool off) and rest with your feet up. To prevent foot swelling in hot weather, wear compression stockings, rest in between periods of activity, drink water, and reduce your sodium intake. Contact your doctor if that does not help. You may have an underlying, potentially serious condition causing you to retain fluids.

• Medication side effects: Medicines that may cause edema include estrogen, testosterone, corticosteroids, certain blood pressure drugs, and certain diabetes medications. If you experience foot swelling on a regular basis and are taking medication, ask your doctor or pharmacist if the medicine could be the culprit.

• Blood clot: A blood clot in a leg vein can cause a swollen foot because more blood and fluids leak and pool. You may also notice pain in the affected limb, warmth and redness. Contact a medical professional for unexplained foot swelling.

• Heart failure: When your heart is not working as well to pump blood, blood and fluids back up in your legs and abdomen. Congestive heart failure can also cause pulmonary edema. If you notice unexplained foot swelling and you are short of breath, seek medical help immediately. Heart medicines, diuretics, and a low-salt diet can help prevent edema.

• Kidney damage or disease: Your kidneys are responsible for filtering your blood and excreting excess fluid. When the kidneys are not working well, fluid accumulates and it is noticeable in your feet and ankles. Puffiness around the eyes is another sign of edema.

• Chronic venous insufficiency: Damaged valves in your leg veins make it difficult for blood to return to the heart from the legs. This leads to blood pooling in the veins, which in turn increases leakage and edema. Foot and ankle swelling, leg achiness, and new varicose veins are signs of venous insufficiency. Treatment measures include not standing for long periods, compression stockings, and possibly taking medicine to improve blood flow.

• Lymphedema: Your lymphatic system is a series of vessels that help your body get rid of excess fluid. Lymphedema is edema caused by damage to the lymph system, of which cancer surgery is a common cause.

Inflammatory causes of foot swelling

Inflammation can cause foot swelling restricted to one foot or even a specific location on one foot. Examples of inflammatory causes include:

• Allergic reactions, such as a bee sting

• Arthritis, including gout, pseudogout, osteoarthritis, and rheumatoid arthritis

• Bursitis (inflammation of a bursa sac that cushions a joint)

• Gout (a type of arthritis caused by a buildup of uric acid in the joints)

• Ingrown toenail

• Lyme disease

• Osteoarthritis (wearing down of cartilage in the joints)

• Osteomyelitis (bone infection)

• Plantar wart

• Plantar fasciitis (inflammation of the thick, fibrous tissue on the bottom of the foot)

• Rheumatoid arthritis (chronic autoimmune disease characterized by joint inflammation)

• Skin ulceration

• Tendonitis (inflammation of a tendon)

• Vasculitis (inflammation of the blood vessels)

Serious or life-threatening causes of foot swelling

Although life-threatening causes of foot symptoms are rare, all serious foot injuries should be evaluated immediately in an emergency setting.

In some cases, foot swelling that is accompanied by serious symptoms, such as a high fever (higher than 101 degrees Fahrenheit) or loss of consciousness may be caused by a serious infection. Sudden swelling of the face, lips or tongue may be anaphylaxis, a severe allergic reaction.

These life-threatening conditions should be evaluated immediately in an emergency setting.

Itchiness can be the result of stretched skin due to swelling. Itchy feet with swelling can also be due to dermatitis or an allergic reaction. An oral or topical antihistamine can help reduce itching. An over-the-counter corticosteroid cream may help as well.

Risk factors for swelling of the feet include:

• Advanced age

• Injury to the leg, foot or ankle

• Organ failure (heart, kidney or liver)

• Overweight and obesity

• Pregnancy

• Sedentary lifestyle

• Surgery involving the leg, foot or ankle

• Vascular condition, such as atherosclerosis, chronic venous insufficiency, and deep vein thrombosis

How do you prevent feet from swelling?

If you are prone to foot swelling (edema) due to a medical condition, such as cardiovascular disease, try these techniques:

• Avoid being in very warm temperatures, which can make edema more likely.

• Elevate your legs on a stool or above the level of your heart when you are sitting.

• Increase your activity level.

• Lose weight if you are overweight or obese.

• Reduce your salt intake, but check with a healthcare provider first to make sure you are getting enough sodium in your diet. (Sodium deficiency can lead to hyponatremia, which is a life-threatening condition left untreated.)

• Wear compression stockings, especially if you will be standing for any length of time. Moderate compression will reduce the amount of fluid that collects in your lower extremities.

Treatments for swollen feet depend on the cause.

To reduce foot swelling from an injury, doctors recommend you rest your foot and:

• Ice your foot 20 minutes, then wait 15 to 20 minutes before icing again. Alternate ice with warm compresses after swelling peaks.

• Elevate your foot.

• Wrap your feet and ankle in a compression bandage in between ice.

• Take an antihistamine if the injury is from a sting or bite (even if you have no known allergy).

To reduce foot swelling from arthritis or other inflammatory conditions, take a nonsteroidal anti-inflammatory drug (ibuprofen) and apply warm compresses for 20 minutes at a time. Your doctor may prescribe more powerful medicine if your foot swelling is due to chronic inflammation.

For systemic conditions like heart failure, medical treatment depends on the cause. It may involve prescription medicine to improve blood flow, reduce blood clot formation, or make it easier for your heart, kidneys or liver to function. Diuretics (so-called “water pills”) are a common treatment to help your kidneys remove excess fluid into the urine. In some cases, surgery may be necessary to improve blood flow to the legs. Compression stockings can help prevent fluid from accumulating in your feet.

For chronic foot swelling, lifestyle changes may be part of an overall treatment plan. Lifestyle changes include:

• Limiting your salt intake, as directed by your doctor

• Increased activity level

• Increased water intake

• Moving around in between periods of standing

A licensed healthcare provider should evaluate all serious injuries causing foot swelling. A professional can evaluate the severity of the damage and treat it accordingly. Even if you can treat your injury at home, a medical evaluation can offer peace of mind that you are doing what is necessary for proper healing.

Foot injuries include:

• Ankle sprain

• Broken foot or toe

• Burns

• Wounds

• Sports injuries

• Stress fractures

Contact a doctor for unexplained foot edema or when:

• You have heart, liver or kidney disease and swelling is worsening or spreading.

• You are pregnant and the swelling is sudden or more than usual.

• You have a fever.

• Your foot is red and warm (and probably painful).

• Your self-care measures to reduce swelling do not help.

Seek immediate medical care (call 911 for assistance) if you experience foot swelling with any of these symptoms or other concerning symptoms:

• Change in mental status, such as confusion or lethargy

• Chest pain or heart palpitations

• High fever (higher than 101 degrees Fahrenheit)

• Inability to feel or move your foot

• Difficult breathing, including wheezing and shortness of breath

• Sudden swelling of the face, lips or tongue

• Worst headache of your life

Questions for diagnosing the cause of foot swelling

To diagnose your condition, your doctor or the healthcare provider will ask you several questions related to your foot swelling.

Your provider may ask you:

• How long has your foot been swollen?

• Does the problem involve one or both feet?

• Did you injure your foot?

• What other health conditions do you have? (Unless you are visiting with a provider who knows your health history, mention other conditions you have been diagnosed with or sought care for in the past.)

• Are you experiencing any other symptoms, such as pain or loss of sensation in the foot?

• When do your symptoms occur?

• Are your symptoms worsened or relieved by movement or specific activities? For example, does elevating your leg reduce swelling?

• Do you take medications, vitamins or supplements?

Questions to ask your doctor about foot swelling:

• What is causing swelling in my feet?

• Could swollen feet be due to a medicine I’m taking? (Show your doctor a list of the medicines, vitamins and supplements you take.)

• What can I do to reduce swelling in my feet?

• How much sodium (salt) should I have in my diet, based on my overall health?

• Should I wear compression socks to reduce and prevent foot swelling?

• How long will it take for the swelling to go away with the treatment you suggest?

• When should I contact you about my symptoms if they happen again or don’t go away?

Because foot swelling can be due to serious diseases, getting an accurate diagnosis helps you avoid serious complications and permanent damage. Once you know the underlying cause, it is important for you to follow the treatment plan you and your healthcare professional design to reduce the risk of potential complications, including:

• Amputation

• Deformity

• Difficulty walking

• Heart failure

• Loss of mobility

• Paralysis

• Permanent disability

• Serious infections and gangrene

• Severe discomfort or pain

• Spread of infection