By Medicover Hospitals
What is Swollen Ankle?
Swollen ankles, also known as ankle edema, occur when there is fluid accumulation or inflammation in the joints and tissues of the ankle. While slight swelling after prolonged rest is common, persistent swelling can indicate various underlying health issues.
Causes of Swollen Ankles
Swollen ankles can stem from various factors, including:
- Injury: Sprains or fractures in the ankle can lead to inflammation and swelling. Immediate treatment involves rest, icing, compression, and elevation.
- Cellulitis: Bacterial skin infections like cellulitis can cause rapid swelling, particularly in individuals with diabetes. Treatment involves antibiotics and close monitoring.
- Medication Side Effects: Certain drugs like antidepressants, steroids, and calcium channel blockers may induce ankle swelling. Consulting a doctor for potential alternatives or management strategies is advised.
- Chronic Venous Insufficiency (CVI): Dysfunction in leg vein valves can cause blood to accumulate, leading to swelling. Treatment includes compression stockings, elevation, and sometimes surgical interventions.
- Blood Clots: Deep vein thrombosis (DVT) can obstruct blood flow, resulting in persistent swelling. Urgent medical attention is necessary to prevent complications like post-thrombotic syndrome.
- Pregnancy: Increased fluid retention during pregnancy can cause swelling, particularly in the later stages. Management involves lifestyle adjustments and monitoring for conditions like preeclampsia.
- Other Conditions: Lymphedema, heart failure, chronic kidney disease, liver disease, and hypothyroidism can all contribute to ankle swelling through various mechanisms. Treatment depends on addressing the underlying condition.
- Preeclampsia: A life-threatening condition in pregnancy characterized by high blood pressure and proteinuria, necessitating prompt medical intervention to safeguard maternal and fetal health.
- Lymphedema: Blockage or damage to the lymphatic system results in fluid accumulation, requiring lifelong management through compression therapy, exercise, and massage.
- Heart Failure: Reduced cardiac function leads to fluid buildup in tissues, particularly in the legs and ankles. Treatment involves medication management, fluid restriction, and lifestyle modifications.
- Chronic Kidney Disease (CKD): Impaired kidney function results in fluid retention and electrolyte imbalance, necessitating dietary changes, medication, and regular monitoring.
- Liver Disease: Liver dysfunction affects protein production, leading to fluid accumulation in the abdomen and extremities. Lifestyle modifications and medical management aim to slow disease progression.
- Hypothyroidism: Thyroid hormone imbalance can cause muscle and joint swelling, requiring hormone replacement therapy for symptom management.
Cellulite
- Bacterial infections of the skin are called cellulitis. People with diabetes are particularly susceptible to this type of infection.
- Cellulite can cause a range of symptoms, including redness, warm skin, and swelling that spreads quickly. In rare cases, cellulite can be life-threatening without treatment.
- People with cellulitis need to take antibiotics. It is essential to tell a doctor if the swelling does not decrease or gets worse after a few days of treatment.
Side effect of drugs:
- Some medications can cause ankle swelling as a side effect. These drugs include:
- antidepressants
- birth control pills and others containing estrogen
- testosterone pills
- calcium channel blockers for high blood pressure
- steroids
- People who suspect that their ankles are swollen as a side effect of the medication may want to talk to their doctor.
- A doctor may prescribe diuretic medication or suggest methods to reduce the swelling if it is uncomfortable.
Chronic venous insufficiency:
- The most common type of edema is chronic venous insufficiency (CVI). CVI is a condition that affects the valves in the veins of the legs.
- These valves generally ensure that blood flows to the heart. In CVI, however, the valves malfunction and allow some blood to flow back and collect in the legs and ankles.
- Although CVI doesn't have serious complications, it can be painful and uncomfortable. It can also lead to noticeable changes in the skin.
- A doctor can help a person with a CVI develop a personalized treatment plan.
- Some treatment options include:
- keeping the legs elevated to improve blood circulation
- wearing compression stockings to reduce swelling
- taking medications, such as aspirin
- undergoing radiofrequency ablation, which uses heat to close the affected vein
Blood clots
- Sometimes a blood clot, or thrombosis, occurs in one of the veins of the arm or leg. It is called deep vein thrombosis (DVT) and requires urgent medical attention.
- DVT blocks the flow of blood to the heart, causing it to build up in the affected limb.
- Sometimes the body can compensate for the blockage by gradually diverting blood to nearby small veins. Over time, these veins grow larger and can drain blood from the limb.
- If these veins are not raised, the limb may remain swollen. Persistent pain and swelling after DVT is called post-thrombotic syndrome.
- People who are having DVT should consider:
- elevate the affected limb
- wear compression stockings to promote blood circulation
- take blood thinners or blood thinners
- undergo a stent procedure, in which a surgeon inserts a tube called a stent into the vein to keep it open
Pregnancy
- During pregnancy, the body produces more blood and bodily fluids to support the development of the fetus.
- Swelling is a common side effect of pregnancy, particularly in the third trimester. swelling can affect the ankles, feet, legs, face, and hands.
- Slight swelling is normal and usually harmless. However, sudden swelling of the hands and face could be a sign of a life-threatening condition called preeclampsia.
- Women who experience mild swelling during pregnancy can get relief from home remedies such as:
- eating foods high in potassium
- reduce salt intake
- avoid caffeine
- wear comfortable shoes
- wear support stockings
- avoiding standing for long periods of time
- elevate feet at rest
- apply cold compresses
- wear loose clothing
- limit time outdoors in hot weather
- rest in a swimming pool
Preeclampsia
- Preeclampsia is a life-threatening condition that can occur in the second or third trimester of pregnancy, or up to 6 weeks after giving birth.
- It is characterized by dangerous blood pressure and proteins in urine. It can cause a variety of symptoms, including headaches, vision changes, weight gain, and edema.
- Preeclampsia that happens during pregnancy may also affect the unborn baby.
- It requires urgent medical treatment. Treatment may include drugs to prevent seizures and lower blood pressure.
- Childbirth is the most effective treatment, although some women may experience worsening symptoms before they recover.
Lymphedema
- Lymphedema is a type of swelling that affects the soft tissues of the arms or legs, including the ankles. This is due to a buildup of a fluid called lymph. This is mainly made up of white blood cells, which help fight infection.
- Lymphedema occurs when there is a blockage or other damage to the lymphatic system. The lymphatic system is a network of tissues and organs that help rid the body of infection and maintain fluid balance.
- Lymphedema may be caused by infections, cancers, and surgical removal of lymph nodes. Certain inherited conditions can also cause lymphedema.
- Damage to the lymphatic system is irreversible, so treatment is aimed at reducing swelling and preventing other symptoms.
- Potential treatments include:
- wearing compression garments and bandages
- increased heart and respiratory rate through exercise
- get a gentle massage from a therapist trained in the treatment of lymphedema
Heart failure
- Heart failure occurs when the heart can no longer pump blood as efficiently as it should. There are three different types of heart failure: left, right, and congestive heart failure.
- In the right and congestive heart failure, there is reduced blood flow out of the heart, which causes blood to flow back up through the veins. This can cause fluid to build up in tissues, including the legs and ankles.
- Heart failure also affects the kidneys, reducing their capacity to eliminate salt and water from the body. This further contributes to edema.
- Although there is no cure for heart failure, there are many treatment options.
- A doctor may prescribe diuretics and suggest monitoring and reducing fluid intake. These two treatments can help reduce swelling in your ankles and legs.
Chronic kidney disease
- Chronic kidney disease refers to permanent kidney damage, which can get worse over time.
- A person may not have any symptoms until they are in the later stages of the disease called kidney disease or end-stage renal disease (ESRD).
- During ESRD, the kidneys have a hard time removing waste and excess fluid from the body. This may result in a variety of symptoms, including swelling of the ankles.
- The following lifestyle factors can also assist in maintaining renal function for as long as possible:
- reduce salt and fat in the diet
- maintain a healthy weight
- maintain healthy blood pressure
- Minimum 30 minutes of exercises are needed every day
- stop smoking
- limit alcohol
- control blood sugar levels
Liver disease
- A healthy liver produces a protein called albumin. Albumin prevents fluid from escaping blood vessels and surrounding tissue.
- Very low levels of albumin due to liver disease can cause fluid to build up in the legs, ankles, and abdomen.
- A doctor can prescribe medications and offer advice on certain lifestyle factors that might help prevent or slow further damage to the liver. Examples include:
- exercise regularly
- eat healthy food
- limit salt intake
- avoid alcohol
Hypothyroidism
- Hypothyroidism can affect a person's muscles and joints in many ways, causing aches, pain, stiffness, and swelling.
- If a person suffers from hypothyroidism or hypothyroidism, it means that their thyroid gland is producing too little hormone.
- A 2017 study suggests there may be a link between thyroid disorders and rheumatoid arthritis, which can also cause painful swelling in the joints.
- A doctor may perform a blood test to check a person's thyroid hormone levels and treatment is by taking synthetic thyroid hormones.
Diagnosis and Treatment
To help diagnose the cause of the swelling, your physician may order one or more of the following tests:
- Diagnosis involves a combination of physical examination and diagnostic tests such as blood tests, X-rays, ultrasound, or electrocardiogram.
- Treatment focuses on addressing the underlying cause, which may include lifestyle changes, medication, or surgical interventions.
When to Seek Medical Attention?
Immediate medical attention is necessary if swelling is accompanied by symptoms like chest pain, difficulty breathing, dizziness, or confusion. Additionally, individuals with pre-existing cardiac, renal, or liver conditions should promptly consult a healthcare provider if swelling occurs or worsens.
When to see a Doctor?
A sore throat caused by a viral infection usually improves on its own within two to seven days. Still, some causes of sore throat need to be treated. You should consult the physician as soon as possible if:
- you have cardiac or renal disease and have swelling
- you have liver disease and swelling of the legs
- swollen areas are red and are warm to the touch
- your body temperature is higher than normal
- You are pregnant with sudden or serious swelling
- you have tried home remedies but they did not work
- your swelling gets worse
You should call for an emergency immediately if you experience any of the following symptoms along with swelling of the feet, legs, and ankles:
- pain, pressure, or tightness in the chest region
- dizziness
- confusion
- feeling dizzy or faint
- difficulty breathing or shortness of breath
Home Remedies
Home remedies for managing swollen ankles include elevating the legs above heart level, periodic leg movements, wearing compression stockings, and maintaining a healthy lifestyle. These measures can help alleviate discomfort and promote circulation.
