12 reasons you have swollen ankles, according to doctors

Swollen ankles can be totally harmless, but may also signal a serious health condition or injury.

Known in the medical world as edema, swelling can be incredibly annoying and alarming – and it’s particularly common in the ankles. When left untreated, your swollen ankles can become painful, make it difficult to walk, cause stiff joints, and stretch out the skin.

To add to the frustration, all sorts of things can cause ankle swelling – from the not-so-concerning to the life-threatening. Here, the experts break down why your ankles have swollen up like balloons.

1. You’ve been sitting (or standing) all day

If you work a job that involves standing or sitting in one place for long periods of time, you’ve probably experienced some swelling in your ankles as a result. “When you move around, the muscles involved in that movement actually help pump fluid and blood to and from your limbs,” explains Steven Weinfeld, MD, chief of foot and ankle surgery at New York City’s Mount Sinai Health System. Without that extra help from moving muscles, though, blood and fluid can pool in the feet and ankles.

2. Your weight could be to blame

Overweight and obese people may experience swelling around the ankles for two reasons, says Dr. Weinfeld. First, the stress extra weight puts on joints can trigger fluid retention around those joints. Plus, storage of excess hormones in extra fat cells can contribute to hormonal shifts that also trigger fluid retention, he says.

3. An injury put you out

Whether you walked into the coffee table or sprained your ankle running, injury is perhaps the most common cause of swollen ankles doctors see. When you hurt your ankle, your body sends extra blood to the area, explains Dr. Weinfeld. “Not only does this bring healing cells, but also contributes to swelling in order to stiffen and immobilize the injured joint.” In the case of injury, swelling may also be accompanied by redness or bruising.

4. Certain medications can trigger swelling

Because of their complex interactions with the body, a number of medicines (including OTCs) can contribute to swollen ankles. “Certain medications can cause fluid retention,” explains Dr. Weinfeld. “Some blood pressure medications, anti-inflammatory steroids, and even NSAIDs like Advil may have that effect.” Hormones like estrogen and some antidepressants can also leave you with balloon ankles.

5. It may be a sign that your veins aren’t working effectively

Veinous insufficiency, a state in which your veins don’t function normally, can impact the circulation of blood back towards your heart and leave it pooling in your feet and ankles, says Dr. Weinfeld. “Veins have one-way valves that can basically stretch out over time and allow fluid to leak out,” he explains.

This happens when these valves become damaged or weak – say, due to aging or extended sitting. Much more common in people over 50, veinous insufficiency slowly develops over time and is more common in women than men.

6. You might have lymphedema

Our lymphatic system transports fluid called lymph (which contains white blood cells and waste products) throughout the body. In lymphedema, though, a damaged or blocked lymphatic system leaves fluid to pool in the extremities, The U.S. National Library of Medicine says. Though certain cancers (and cancer treatments) can cause lymphedema, infections can also spur the swelling. Signs of lymphedema also include a heavy or tight feeling in the arms or legs, not being able to move properly, recurring infections, hardening or thickening of the skin, and trouble sleeping.

7. You could be dealing with arthritis

Arthritis, which includes a number of specific diseases, refers a condition in which joints become swollen, painful, stiff, and difficult to move. Incredibly common among older adults, it can affect joints all over the body, including the ankles. “When I get an X-ray back and see that someone has bad ankle arthritis, it can certainly explain any swelling in the area,” Dr. Weinfeld says, adding that inflammation related to the arthritis causes the joint to swell.

8.  It could be a sign of a blood clot

One of the most alarming causes of swelling around the ankle (which often spreads further up the leg) is a blood clot, says Dan Paull, MD, founder and CEO of Easy Orthopedics.

“If you have swelling on one side that continues to rise up your leg, you need to get it checked out,” Dr. Paull says. In some cases, blood clots can move into the lungs and cause a potentially life-threatening pulmonary embolism (a.k.a. blocked lung artery). If you notice other signs of a blood clot – like pain, shortness of breath, feeling lightheaded, red or discolored skin, and warmth in the area – in addition to your swelling, head to the emergency room ASAP.

9. It could be a symptom of other heart problems

In congestive heart failure – a result of coronary artery disease or high blood pressure – at least one of the heart’s chambers can no longer pump blood properly. “If the heart can’t pump enough fluid, that fluid can back up,” Dr. Paull explains.

Often, this occurs in the feet and ankles, leading to swelling. In more severe cases, it can progress up the legs. Other signs of a heart failure include shortness of breath, rapid or irregular heartbeat, persistent cough, concentration problems, and chest pain if it’s caused by a heart attack.

10. It’s a side effect of pregnancy

Among the many changes the body undergoes during pregnancy, swollen feet and ankles are perhaps the most common. This is mainly due to all of the extra blood and fluid a woman produces when expecting, which soften the body and help it expand as the baby grows, according to the American Pregnancy Association. Hormonal changes and extra pressure on the veins can also contribute to swollen ankles during pregnancy.

11. You may have an infection brewing

Though an untreated wound around the ankle joint can infect the inside of the joint itself, any bacteria that gets into your bloodstream can end up in one of your joints. One of the crystal-clear signs of an infection? Swelling, as well as tenderness, warmth, and redness.

Infants and older adults are particularly susceptible to septic arthritis, in which a bacterial or fungal infection causes joint inflammation, along with redness, pain, and fevers. Skin conditions, like cellulitis – a fast-spreading bacterial infection that gives skin a red, blistery appearance – can also cause the ankle area to look swollen, since it often shows up on the lower leg in adults, per the American Academy of Dermatology.

12. Liver or kidney issues could be the problem

Dysfunction of the kidneys and liver, which impact the amount of fluid in the body, can both also contribute to fluid retention that causes swollen ankles.

In the case of kidney damage or disease, the kidneys leave either too much fluid and sodium or not enough protein in the blood, which can lead to accumulation throughout the body – especially in the lower extremities, according to the Mayo Clinic. “At the point of kidney failure, swelling and tenderness can affect the entire leg below the knee,” Dr. Weinfeld notes.

Liver disease also involves low levels of protein in the blood that can make fluid “leaky” and cause swelling in the lower body, he says.

Source: Prevention

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