Swelling in the ankles may be a symptom of several different conditions. It is a common condition that is typically seen among older people, although anyone can have ankle swelling. Gravity causes swelling in the ankles to be more severe than in swelling higher parts of the body.
Swelling in the ankles is called edema, and edema can be seen in any part of the body, although it is more commonly seen in the lower part of the body. A diet that is high in salt and carbohydrates may be a cause of edema. Laxatives, diuretics, birth control pills or hormone replacement pills, and other drugs can cause edema.
Common Causes of Swollen Ankles
The more common causes of swollen ankles include standing for extended periods of time, obesity, pregnancy (excess swelling can be a symptom of a serious condition known as toxemia and should be checked by a physician), injury to the ankle or foot, and menstrual periods.
In many cases, a traumatic injury is the cause of ankle swelling. This can be the result of a stress fracture or ankle sprain. In some cases the swelling will subside after the sprain heals, but for stress fractures or serious sprains, treatment may be needed.
Arthritis can cause ankle swelling and is a less common cause. Arthritis in the ankle joint is more common among those who have injured the joint previously, athletes, and those with rheumatoid arthritis.
Gout is another more common cause. Gout causes uric acid crystals to accumulate in the ankle fluid due to an increased production of uric acid. The increased uric acid crystals cause inflammation and swelling in the joints.
A less common cause of ankle swelling is infection. Infections may occur in the joint or in tissues around the joint and lead to swelling. Other causes may include burns, cellulitis, bug bites, congestive heart failure, kidney failure, scleroderma, fractures, tumors, medications, malnutrition, blisters, and others.
Swollen ankles may be the side effect of a medication or the result of a localized injection. Sodium retention can lead to edema in the ankles. Blockage of the lymph nodes in the legs can cause ankle or leg swelling. Allergic reactions can cause swelling, as well as some neuromuscular disorders.
Deep Venous Thrombosis (DVT)
A blood clot called a deep venous thrombosis (DVT) can cause ankle swelling. This is a blood clot that forms in a deep vein and commonly occurs in the leg. DVTs can be asymptomatic, but in many cases they display symptoms such as pain, swelling, and engorged veins.
DVTs are a medical emergency because at any time they can dislodge and travel to the lungs and cause a pulmonary embolism, since DVTs are potentially life threatening, swelling in the ankle should be tested for a DVT if there are no other known potential causes. Risk factors for DVTs include extended hospitalization, immobilization, surgery, smoking, obesity, certain drugs and others. A D-dimer blood test can diagnose a DVT as the cause of ankle swelling.
Symptoms of Swollen Ankles
Swelling in the ankles typically progressively gets worse throughout the day as a person stands for longer periods of time. Swelling that is not treated may result in skin ulcerations. To check for swelling, the swollen area can be pressed and an indentation can be seen, along with other visual signs.
Symptoms of swollen ankles or symptoms that may develop along with swollen ankles may include headaches, heart palpitations, puffy eyes, high blood pressure, weight gain, swollen wrists, and others.
Swollen Ankles During Pregnancy
Swelling or edema during pregnancy is commonly seen in pregnancy due to body fluids increasing in the pregnant mother for the development of the baby. Mild swelling in the ankles or other parts of the body during pregnancy is perfectly normal, and a large percentage of women don’t experience any swelling during pregnancy.
Swelling can be minimized during pregnancy by avoiding long periods sitting or standing by taking 5 minute breaks every hour of sitting or standing. If sitting, the legs should be elevated as much as possible to reduce fluid retention.
Elastic socks or stockings can increase swelling due to constricted blood flow so these should be avoided. Drinking water may help to reduce swelling, as it may reduce the levels of sodium in the body and waste products that may make swelling worse. Prolonged swelling that does not improve overnight or puffy hands and face should be seen by a doctor quickly, as these may be the signs of preeclampsia, a potentially serious condition.
Treatment of Swollen Ankles
The treatment of swollen ankles varies depending on the cause of the condition. A physician should be able to help determine what the cause of edema is and then treat the edema with medications or other treatments.
When a person is sitting, using a foot stool or anything to elevate the legs as much as possible should be used. Proper fitting shoes and socks should always be used, and new shoes with more space may need to be purchased so that swelling does not become constrictive. Leg wedges can be used to elevate the legs while the person is sleeping which helps to reduce fluid accumulated in the ankle region during the day.
If there are prescription drugs being taken such as hormones, blood pressure medications, steroids, anti-depressants, or others, a patient should consult with the doctor to determine whether or not ankle swelling is a side effect of a current medication. Diagnostic tests such as ECGs, x-rays, blood tests, urinalysis, and other tests can be used to determine the cause of the ankle swelling. A physician will ask a number of questions in order to narrow down the possible causes of the swelling.
There are also some steps that can be taken to prevent swollen ankles. Sodium intake should be limited, as high sodium diets may contribute to swelling. Excessive laxative usage may be a cause of swollen ankles and should be minimized. Long periods of driving should be broken up with regular breaks. Regular exercise may also reduce ankle swelling.