This guide outlines the most common swollen ankle causes and how to reduce the swelling in your ankles.
Ankle swelling is common and most people have had it before because the ankles are regularly heavily used and sensitive areas of our body.
Swollen ankle causes: overview
Ankle swelling is a swelling with fluid accumulation, also known as ankle edema, in the upper part of the ankle. This often occurs with injuries and bruises in the ankle area.
Ankle swelling can be very painful and long-lasting. There are many swollen ankle causes. For example, the ankle can suddenly swell after twisting and walking for a long time, but sometimes ankle swelling occurs for no apparent reason.
Ankles that swell and appear thicker due to increased fluid retention are referred to as swollen ankles. If not caused by an injury or infection, swelling of the ankles is technically referred to as “ankle edema“. They appear as the first symptom of various diseases, some of which are harmless, while others can be potentially life-threatening and require therapy. Treatment depends heavily on the cause, but in most cases it involves removing support stockings and elevating the legs.
Symptoms of swollen ankles
Swollen ankles can appear in isolation or with other symptoms. In the context of chronic venous weakness, pain or a feeling of pressure often occur in the area of the swelling. Over time, the water retention expands upwards and affects the entire lower leg. If the disease persists for a long time, skin changes occur: the skin develops brownish and whitish discoloration , can harden and thin.
Even minor injuries can develop deep, poorly healing wounds. If a weak heart is the cause of the swelling of the ankles, there is often water retention in other parts of the body. For example, ascites can cause gastrointestinal discomfort such as abdominal pain, nausea, bloating and gas. If the heart is at an advanced stage, you may experience shortness of breath, a feeling of weakness, decreased performance, chest pain and dizziness.
When there is disruption in the outflow of lymphatic fluid from the leg, a swollen foot or ankle is often the only symptom at the beginning. Over time, pain can develop and hardening can form in the affected area due to the constant prevailing pressure.
If swollen ankles appear shortly after an infection of the neck, abdomen or urinary tract, this is an indication of so-called “reactive arthritis” or “rheumatic fever”. These diseases can also lead to a high fever , problems with the heart and brain, disorders of the eye and pain in other joints.
Swollen ankle causes: how to reduce swelling
The treatment of swollen ankles depends on the underlying disease. Here are some general suggestions for managing a swollen ankle. If you’re experiencing a swollen ankle, it’s important to consult a medical professional, especially if the swelling is severe, accompanied by severe pain, or if you’re unsure of the cause. Here are some steps you might consider:
If venous weakness is the reason for the ankle edema, there are several forms of therapy to choose from. Compression stockings, exercise and elevating the legs are among the most important building blocks. In addition, medication for flushing out water and cold water treatment can be helpful. Ointments and creams usually have no effect.
If there are varicose veins, they can be removed. In many cases, only a combination of different forms of therapy and consistent adherence to the therapy can lead to a satisfactory improvement in the swelling.
If there is heart failure, the first step must be to determine the cause and treat it. Common triggers are narrowing of the coronary arteries , a past heart attack, or a lung disease such as COPD.
In the case of cardiac insufficiency, various medications must also be used to make the cardiac output more efficient, lower blood pressure and increase the excretion of water via the kidneys. Examples are “ACE inhibitors” and “beta blockers”. If kidney or liver diseases are the cause, in addition to flushing out water through medication and the administration of proteins, usually only the treatment of the underlying disease helps .
In the case of swollen ankle causes from infections of the respiratory tract or the urinary tract, it is often not necessary to carry out specific therapy to swell the ankle – the ankle edema disappears on its own after a while.
Rest
Give your ankle ample rest by avoiding putting weight on it. Elevate your leg to help reduce swelling. Prop your ankle up on pillows or a cushion while lying down.
Cold and ice
Have you sprained your ankle while exercising, hiking or carelessly running? Then cold therapy can be helpful. To do this, the affected ankle is wrapped with a cooling pad. Depending on the personal injury, a gel cushion can be used that is placed in the freezer beforehand. (Here you should definitely place a cloth between the skin and the gel cushion to avoid frostbite.)
Applying ice to the swollen area can help reduce inflammation. Use a cold pack wrapped in a cloth or towel to prevent direct contact with the skin. Apply the ice for about 15-20 minutes every 1-2 hours during the first 24-48 hours.
Compression
Wearing a compression bandage can help control swelling. Make sure the bandage is snug but not too tight to avoid cutting off circulation. If necessary, you can regularly use compression stockings in certain situations. However, you should discuss this with a doctor or therapist you trust beforehand.
Elevation
As mentioned earlier, elevating your ankle above the level of your heart can help reduce swelling. This encourages fluids to drain away from the swollen area.
Pain relievers
Non-prescription anti-inflammatory medications like ibuprofen or naproxen might help reduce pain and swelling. However, consult a doctor before taking any medication, especially if you have underlying health conditions.
Avoiding heat and hot water
Heat can increase blood flow to the area and potentially worsen swelling. Avoid hot baths, saunas, and heating pads.
Gentle movement
Once the acute phase has passed, gentle range-of-motion exercises can help prevent stiffness from most swollen ankle causes. However, avoid putting too much strain on the swollen ankle.
Drink water
Sufficient fluids will help your body reduce swelling. Drink at least 8 glasses of water a day. Only when the organism can absorb sufficient fluid does it not try to hold it by storing it in the ankles, for example.
Take magnesium and potassium
The swollen ankle causes from the accumulation of water can also be due to a lack of magnesium. Eat foods that contain magnesium, such as almonds, cashew nuts, broccoli, or dark chocolate with no sugar. In general, a change in diet by avoiding sodium and too much salt can help with swelling of the ankles.
If there is a lack of potassium, this can lead to high blood pressure and water retention. Potassium-containing foods such as bananas, sweet potatoes and white beans can replenish the potassium stores and the swelling caused by potassium deficiency goes down.
Lose weight if you are overweight
Being overweight can lead to impaired blood flow, which can be accompanied by swelling of the lower extremities, such as the ankles. The reduction in weight can take the strain off the feet and permanently reduce the swelling in the ankles.
Massage
A massage is a relief for swollen feet and ankles. With firm movements and a lot of pressure, a massage can help the fluid to be removed more quickly.
Foot bath with cooling Epsom salt
Epsom salt and magnesium sulfate not only help you relieve pain in your muscles, it also helps your body reduce swelling. Epsom salt is said to draw toxins from your ankles and improve relaxation.
See a doctor
If the swelling persists, worsens, or is accompanied by severe pain, it’s important to consult a healthcare professional. They can assess the swollen ankle causes and recommend appropriate treatment.
Remember, these are general suggestions and might not be suitable for all situations. If you’re unsure about the severity of your swollen ankle or if it’s causing you significant pain, it’s best to seek medical attention. A healthcare provider can give you personalized advice and treatment based on your specific condition.
Top swollen ankle causes
Here are some common swollen ankle causes.
Injury
Ankle sprains, strains, or fractures can cause immediate swelling due to the body’s natural response to injury, which involves an increase in blood flow to the area.
Prolonged Standing or Sitting
Remaining in the same position for an extended period can lead to fluid accumulation in the lower extremities, including the ankles.
Overuse
Intense physical activity or overuse of the ankle joint can cause swelling due to inflammation in the area.
Venous Insufficiency
This one of the swollen ankle causes occurs when the veins in the legs have difficulty sending blood back up to the heart. Fluid can accumulate in the lower extremities, leading to swelling.
Lymphedema
This condition involves a blockage or damage to the lymphatic system, which can result in fluid retention and swelling in the affected area.
Pregnancy
Hormonal changes and increased pressure on blood vessels during pregnancy can lead to ankle swelling, especially in the third trimester.
Medications
Certain medications, such as those used for blood pressure, pain relief (NSAIDs), or hormone therapy, can cause fluid retention and ankle swelling as a side effect.
Medical Conditions
Various medical conditions can be swollen ankle causes, including heart disease, kidney disease, liver disease, diabetes, and thyroid disorders.
Infections
Infections in the lower extremities, such as cellulitis, can cause localized swelling.
Blood Clots
Deep vein thrombosis (DVT), a blood clot in a deep vein, can lead to ankle swelling, often accompanied by pain and redness.
Inflammatory Conditions
Inflammatory disorders like arthritis, gout, and lupus can cause joint inflammation and swelling, including in the ankles.
Allergic Reactions
An allergic reaction to certain foods, medications, or insect stings can cause generalized swelling, including in the ankles.
High Altitude
Traveling to high altitudes can cause fluid to accumulate in the lower extremities due to changes in atmospheric pressure.
Malnutrition
Severe protein deficiency (malnutrition) is one of the swollen ankle causes because it can result in a lack of protein in the blood, leading to fluid accumulation in tissues, including the ankles.
Hot weather
The heat can be an important factor in swollen ankle causes and the development of ankle edema. The water retention on the feet often results from an interplay of several factors. These often include a pressure load in the veins of the legs, favored by a weak vein or an incipient heart failure , provoked by strain on the muscles, warmth or long standing.
The heat can cause the venous blood vessels to relax considerably, which then dilate. As a result, more blood collects in the venous vessels, which disrupts the return transport of the blood to the heart. Due to the increased pressure load inside the veins, fluid escapes from the vessel into the surrounding tissue.
The liquid typically first collects on the ankles of the lower leg in accordance with the force of gravity. If there is a preexisting tendency to edema or a weak heart , strong heat influences or visits to the sauna should therefore be treated with caution.
After birth
Many women experience swelling of their ankles, legs, and hands during pregnancy. Usually this is normal. In the first few days after giving birth, this water retention can increase somewhat and thus is one of the common swollen ankle causes.
The cause is the change in the maternal cycle , which has to get used to the new situation without a child. Even in women who before childbirth have not suffered from swollen ankles or feet, can in the days after birth edema form. They usually go away without any consequences after a few days.
In some cases, normal postpartum ankle swelling is difficult to distinguish from symptoms of leg vein thrombosis . Therefore, swelling of the ankles, especially if it is accompanied by pain, is only visible on one side , or occurs after a long period of lying down , should be examined by a doctor.
If swelling of large parts of the skin, headaches or flickering eyes occur in addition to the swelling of the ankles , a doctor should also be informed because of the risk of eclampsia.
Menopause
Swollen ankles during menopause are a typical and common symptom that can be attributed to various processes in the body. At the beginning of the menopause, the hormone progesterone may initially drop and the resulting excess estrogen may arise.
Estrogen causes the body to store more water , which can appear as shiny and smooth skin in addition to swollen ankles. In the further course of the menopause, however, the estrogen levels decrease, which can also improve the water retention.
At the average age of menopause, many women also develop venous weaknesses, which in turn cause swollen ankles. Concomitant diseases of the heart or kidneys are also more likely after menopause and lead to leg edema .
Thyroid
The thyroid produces the vital thyroid hormones and thus has a major influence on numerous body processes. Both overactive and underactive can be associated with numerous symptoms and swollen ankles. The typical water retention is described as a symptom of an increased turnover during the overactive thyroid gland but also with an underactive.
Another cause of swollen ankles is what is known as “myxedema”, a typical symptom of hypothyroidism . Certain sugar molecules are deposited in the subcutaneous fatty tissue and cause swelling. It is typical that, in contrast to water retention, the swellings do not leave a dent after being pressed in. Initially, the swelling occurs mainly in the eyes, hands and feet.
From an insect bite
Insect bites, for their part, can be accompanied by significant swellings and significant accompanying symptoms, including an anaphylactic reaction that is one of the swollen ankle causes. Often there are no venous insufficiencies or organic concomitant diseases. The insect bite often transfers poisons, pathogens or other substances to the site of the puncture, which can lead to inflammation, irritation or allergic reactions.
The localization on the ankle is typical as an often uncovered and exposed part of the body. The allergic swelling on the ankle can be accompanied by unpleasant itching . Local antiallergic ointments or antiallergic medicinal products can reduce the swelling of the ankles.
Bood pressure medication
Various blood pressure medications can cause swelling of the ankles. The blood pressure medication often causes the blood vessels to relax, either directly or through several metabolic processes, in order to lower the blood pressure throughout the body. This can also relax the leg veins, which means that the blood collects in these vessels according to the force of gravity and can lead to leg edema. In these cases, a combination of blood pressure medication with light diuretic, draining medication is common and useful.
After hiking
Hiking puts a relatively strong strain on the muscles of the legs over many hours, and is one of the most common swollen ankle causes. This increased activity can be the decisive factor in the development of swollen ankles. Often there is already a tendency to advance ankle edema with venous insufficiency and possibly a weak heart .
As a result of the increased muscular activity and the subsequent increase in blood flow to the legs, the pressure in the veins can rise so that the fluid passes into the tissue. After a while, the swollen ankles often recede on their own if the legs are spared and raised.
These are just a few potential causes of ankle swelling. It’s essential to consult a healthcare professional if you’re experiencing persistent or severe swelling, especially if it’s accompanied by pain, redness, warmth, or difficulty breathing. Proper diagnosis and treatment are important to address the underlying cause and ensure your overall health and well-being.
Diagnosing swollen ankles
To diagnose swelling on one or both ankles for the first time, the first step is to carry out a detailed anamnesis discussion about possible injuries, previous illnesses, accompanying symptoms, taking medication and more.
Subsequently, due to the various causes, several examinations are often carried out. These include the study of legs on varicose veins or swelling, the control of ankle injuries that ultrasound of the legs, the review of the leg pulses, a blood pressure measurement, a detailed heart and lung examination, the examination of the urine and various blood tests.
A swollen, painful ankle often occurs after an injury such as an twisting or bumping . Although most injuries will not cause permanent damage, if the swelling or pain is severe, see a doctor.
To be on the safe side, this should rule out a broken bone and torn ligament. If one or both ankles swell painfully without prior injury, a number of diseases can be the cause.
Any sudden, severe swelling in the subcutaneous tissue or in the ankle can cause pain due to the increased pressure . A swelling in the joint leads to pain much faster than an edema in the skin.
Examples of possible diseases are chronic venous insufficiency and cardiac insufficiency . If, in addition to the pain, reddening or overheating of the ankle or the skin is observed, an infection must be ruled out as soon as possible. If left untreated, bacterial pathogens can cause blood poisoning or the destruction of the join.
Swollen ankles as an indication of heart failure
Healthy people in whom ankle edema is unexpected and occurs only briefly, only to suffer rarely at a heart failure – usually is already signalled by at least one other cause before the swelling.
In people with previous illnesses such as high blood pressure, a past heart attack or so-called “coronary heart disease”, in which the coronary arteries are narrowed, swelling in the ankles can be the first indication of cardiac insufficiency.
Since the diseases mentioned are often present without the affected person being aware of them, people with occasional chest pain , shortness of breath or heart palpitations are advised to have the symptoms clarified by a doctor.
Ankle swelling occurs especially when the right part of the heart is damaged. Since chronic lung disease can lead to right heart failure, people with COPD, asthma, or similar illnesses should also see a doctor if they develop swollen ankles.
With cardiac insufficiency, swollen ankles usually do not appear in isolation, but are accompanied by symptoms such as occasional shortness of breath, heart stumbling, nocturnal urination, racing heart, a general reduction in performance or a feeling of weakness. They usually last for several weeks or recur over the course of months.
