People ask at the Clinic all the time…what is causing my feet or ankles to swell? This is a common condition often caused by fluid retention, or oedema. It can be due to a medical condition or injury. The range of contributory issues can be endless; however, the main ones would be highlighted below.
Liver, heart or kidney disease
Sometimes swelling can indicate a problem such as heart, liver or kidney disease. Ankles that swell, could be a sign of heart failure. Kidney disease can also cause foot and ankle swelling. When kidneys are not functioning properly, fluid can build up in the body. Liver disease can affect the liver’s production of a protein called albumin, which keeps the blood from leaking out of the blood vessels into the surrounding tissues. Gravity causes fluid to accumulate more in the feet and ankles.
Swollen ankles or feet often suggest symptoms of venous insufficiency. This is where there is inadequate blood flow up the veins, from the legs and feet, back to the heart. Normally, the veins keep blood flowing in the correct direction with the help of one-way valves. Chronic venous insufficiency can lead to skin changes, skin ulcers and infection.
Blood clots that form in the veins of the legs, can stop the return flow of blood from the legs, back to the heart, causing swelling in the ankles and feet. The clots can be either superficial (occurring in the veins just beneath the skin), or deep (a condition known as deep vein thrombosis). Deep clots can be life-threatening if they break loose and travel to the heart and lungs. If you have swelling in one leg, along with pain, a slight fever, and possibly a change in colour of the affected leg, seek medical advice immediately. Treatment with blood thinners may be necessary.
Medication side effects
Many medicines can cause swelling in the feet and ankles as a possible side effect. They include:
• Hormones such as oestrogen and testosterone
• Calcium channel blockers, a type of blood pressure medication
• Steroids and corticosteroids such as prednisolone
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Diabetes medications
Foot or ankle injury
A sprained ankle which occurs with an injury or misstep, can cause the ligaments that hold the ankle in place, to be stretched beyond their normal range. You should wrap the foot or ankle with a compression bandage and elevate the foot on a stool or pillow.
This is a collection of lymphatic fluid in the tissues that can develop because of the absence of or problems with the lymph vessels, or after the removal of lymph nodes. Lymph is a protein-rich fluid that normally travels along an extensive network of vessels and capillaries. It is filtered through the lymph nodes, which trap and destroy unwanted substances such as bacteria.
However, when there is a problem with the vessels or lymph nodes, the fluid’s movement can be blocked. Untreated, lymph build-up can impair wound healing and lead to infection and deformity. Lymphoedema is common following radiotherapy or removal of the lymph nodes in patients with cancer.
Swelling in the feet and ankles can be a sign of infection. People with diabetic neuropathy or other nerve problems of the feet are at greater risk of foot infections. If you have diabetes, it is important to inspect your feet daily for blisters and sores, since nerve damage can blunt the pain sensation and foot problems can progress quickly. If you notice a swollen foot or blister that appears to be infected, seek medical advice straight away.
As was identified earlier, there are varied reasons for swelling, if you suspect swelling may be related to a medication you are taking, speak to your doctor. Although the benefits of the medication may be worth enduring some swelling, more severe swelling could make it necessary to change the medication or its dosage.
Your feet mirror your general health . . . cherish them!