13 Causes of Swollen Feet and Ankles

Your feet support your body weight and let you walk, run, jump, and stand. All of that foot action adds to a lot of wear and tear. One of people's biggest complaints is swollen feet and ankles. Some of the most common causes include standing for long periods, excess salt intake, and pregnancy. This swelling, also known as edema, happens if fluid builds up in your tissues.

Swollen feet have other severe causes, some of which may be red flags for other health issues. Read on to learn what causes swollen feet and ankles and treatments.

What Happens When Feet Swell

What exactly happens when feet swell? Fluid builds up in your feet, ankles, and legs from standing, inactivity, injury, or some other cause, resulting in edema.

Gravity helps that fluid build up. Blood gathers in the veins of your legs because of gravity. Fluid from the blood begins to pool into the tissues of your legs, feet, and ankles. You may notice that your shoes feel tighter than normal.

1. Standing for Hours at a Time

You may feel like your shoes are too tight at the end of the day if you work on your feet. Edema is common in people who stand for long periods. This kind of end-of-the-day swelling usually does not indicate a health problem and goes away once you rest your feet.

Try sitting for five minutes every hour that you are standing. Prop your legs up to keep blood from gathering in the veins of your legs. Compression stockings may be helpful if the swelling persists or you cannot take breaks from standing or walking.

2. Salt

The sodium that partly makes up salt (sodium chloride) is one of the biggest dietary culprits of fluid retention. The American Heart Association (AHA) recommends that adults consume no more than 2,300 milligrams (mg), about one teaspoon, of sodium per day.

Sodium can hide among a list of ingredients in processed and take-out foods, including:

• Bread
• Cheese
• Deli meat
• Eggs
• Pizza
• Snacks (e.g., chips, popcorn, and crackers)
• Soups
• Tacos and burritos

Try limiting your intake and swapping these foods for sodium-free or low-sodium items. You can monitor the sodium content in food by looking at the nutrition facts labels.

3. Pregnancy

Swollen feet and ankles are an inevitable part of pregnancy for many people. The fetus presses on the pelvic veins, compromising circulation as it grows. Foot swelling can make pregnancy uncomfortable and worsens as the due date approaches.

Lying on your back compresses the blood vessels if you have a big belly from pregnancy. This position makes it difficult for blood to flow back to your heart and will sometimes cause some of the fluid in the veins to seep out.

This swelling is usually nothing to worry about. Try some of the following tips to ease swollen feet and ankles during pregnancy:

• Ask a healthcare provider about support hose or compression stockings.
• Do not drink caffeine or eat salty foods.
• Drink eight to 10 glasses of fluids daily.
• Rest and elevate your feet.

Call a healthcare provider if swelling comes on quickly, especially in your hands and face. Rapid swelling may be a sign of preeclampsia, which leads to dangerous, rapid-onset high blood pressure.

4. Obesity

Obesity is an excess accumulation of body fat, which may cause health concerns. Body mass index (BMI) determines whether a person has obesity, though it remains a biased and outdated metric. A person with a BMI over 30 is considered to have obesity.

A person with a BMI exceeding 50 may develop lower extremity swelling. Weight loss may not reverse the swelling. It's essential to discuss treatment for foot swelling with a healthcare provider before reaching a BMI of 50. 

5. Injury

Maybe you sprained your ankle during a gym workout, had a stress fracture of the leg or toe, or had surgery on your leg, ankle, or foot. Injuries like these may cause swelling in and around your feet and ankles. Inflammation is your body's response to an acute injury. Blood flows to the injured area, bringing cells and fluid that cause swelling.

Use the RICE method to relieve pain and inflammation and speed healing for minor injuries. The RICE method includes:

• Rest: Limit activities for at least one or two days. Avoid putting weight on or using the injured joint or limb.
• Ice: Apply an ice pack to the injured area for 20 minutes, four to eight times per day. Do not apply ice directly to the skin of an injured area, open wound, or surgical incision. Use a thin cloth to protect the skin.
• Compression: Keep pressure on the injured area. An elastic bandage works well. Do not wrap the bandage so tightly that it cuts off circulation.
• Elevation: Elevate the injured body part on a pillow above heart level.

Do not immediately use heat after an injury. Heat tends to increase internal bleeding and swelling. You can use heat later to relieve and relax tense muscles. See a healthcare provider if pain or other symptoms persist or worsen.

6. Premenstrual Syndrome (PMS)

Some people feel bloated during the week leading up to their period. This feeling is the normal result of sodium and water retention after ovulation, or when one of the ovaries releases an egg.

The time after ovulation and before your period is when premenstrual syndrome (PMS) symptoms begin. Swollen feet and ankles are another possible PMS symptom. A study published in 2015 found that 65% of women studied had swelling leading up to their period.

7. Medication

Certain medications have side effects of swelling in feet and ankles. Vasodilators, for example, help open up the blood vessels to make blood flow more freely than usual.

These heart medications increase the risk of leakage from the blood vessels to the surrounding tissue, which causes swelling. Calcium channel blockers similarly cause leakage from the blood vessels into the tissue and result in swollen feet and ankles. Other drugs that can cause swelling include chemotherapy drugs like Taxotere (docetaxel).

8. Infection

Skin infections can cause painful, swollen feet and ankles. Cellulitis, for example, is a bacterial infection of the skin that causes pain, swelling, and redness in the affected area.

People with diabetes are more prone to skin infections. Diabetes may cause peripheral vascular issues, which decreases a person's ability to heal cuts, sores, or infections. Peripheral neuropathy may occur with diabetes. The nerve disorder decreases your ability to feel a cut, sore, injury, or infection. 

Wounds can become infected if untreated, causing the feet and ankles to swell. Experts advise annual foot exams for people with diabetes to prevent infections. Clean and cover all open sores and cuts with a bandage. Antibiotics usually clear up bacterial infections, and antifungal drugs treat fungal infections.

9. Lymphedema

Lymphedema is a type of swelling. Lymph is fluid that carries infection-fighting white blood cells to different body parts. Clusters of lymph nodes throughout your body control the travel of that fluid.

Lymph will not drain properly if your lymph nodes become damaged or removed, say, during surgery for cancer. Lymphedema may also be idiopathic, meaning there's no underlying cause. Swelling in the feet and ankles happens if the pelvic lymph nodes become injured or removed. These glands control lymph movement in your legs and feet.

Check in with a healthcare provider if you suspect lymphedema is the cause of your swelling. Wearing compression stockings and moving around as much as possible can help in the meantime.

10. Heart Failure

Heart failure is when your heart is not pumping enough blood. Blood will back up in the veins, leading to fluid build-up. Swollen feet and ankles are one of the common signs of heart failure. This swelling often points to right-sided heart failure.

Other heart failure symptoms include:

• Abdominal pain
• Swelling of the neck, legs, or abdomen
• Nausea
• Weight gain

Get medical attention right away if you develop heart failure symptoms. A healthcare provider will need to monitor your symptoms and make sure they do not worsen. You may develop complications if symptoms persist, including breathing problems.

11. Blood Clots

Your legs can develop swelling and pain sitting for a long time without moving. These may be symptoms of a blood clot, or deep vein thrombosis (DVT). The blood causes increased pressure, which pushes fluids and blood out of the veins and into the tissues.

Anyone who sits for long periods can develop a blood clot. Certain factors can increase your risk, including:

• A previous blood clot
• Birth control pills
• Cancer
• Heart disease
• High blood pressure
• Kidney problems
• Pregnancy
• Smoking
• Stroke

A blood clot that causes foot and ankle swelling does not always have other symptoms, but you'll typically feel pain in your leg. A healthcare provider can treat blood clots if you catch them early enough. The blood clot can break off and travel to the lungs, where it may cut off oxygen supply and become fatal if untreated.

Get immediate medical attention if these symptoms strike without explanation. You can prevent blood clots by staying active and taking breaks to move around if you sit for long periods.

12. Kidney Failure

Your kidneys balance fluids in your body and move fluid you do not need out of your system. You might end up with swelling if one or both kidneys are not functioning properly. Your feet and ankles may puff up if your body retains extra salt and produces more fluid.

Your body normally reabsorbs extra fluid, and the kidneys get rid of it. The kidneys may have trouble getting rid of the fluid, however, if you have kidney failure. Swelling from kidney failure is typically severe. You may also develop swollen hands and face.

Medications can help with kidney problems. Diuretics, for example, help get rid of kidney fluid, which may alleviate swelling in your feet and ankles.

13. Liver Disease

Cirrhosis happens if the liver develops permanent scarring from disease or damage. Scarring interferes with blood flow through the liver. This causes portal hypertension, or high blood pressure in the veins that go into the liver. Portal hypertension causes swelling in the legs, feet, and abdomen.

Other signs of cirrhosis include:

• Bleeding and bruising easily
• Bloating
• Feeling tired
• Nausea and vomiting
• Unintentional weight loss
• Yellow-tinted skin and eyes

A healthcare provider usually focuses on treating the disease that causes cirrhosis. Treatments depend on the cause. Medications, weight loss, or recommendations to stop drinking alcohol may help. Taking diuretics and limiting salt intake can help with foot and ankle swelling.

Treatment

Do not stop taking medicines that may be the cause of your swelling before speaking to a healthcare provider. You can instead reduce swelling of the feet and ankles at home by:

• Eating a low-sodium diet
• Exercising regularly, which keeps fluid from building up in your legs
• Managing or losing weight.
• Not wearing tight clothing around your thighs.
• Propping your legs on a pillow so they are raised above heart level when lying down
• Wearing compression stocks, which are sold at many drugstores.

When To Contact a Healthcare Provider

You can usually treat swelling at home. You'll want to contact a healthcare provider if home remedies do not work or swelling worsens. Seek emergency medical attention if you have swelling, as well as chest pain and shortness of breath.

Talk to a healthcare provider right away if you:

• Are pregnant and have severe or sudden swelling
• Currently have or have had heart, liver, or kidney disease and develop worsening swelling
• Have a fever
• Have swollen feet and ankles that are warm to the touch
• Notice new or worsening swelling in one leg

A Quick Review

Several causes of swollen feet and ankles exist. You may just need to give your feet and ankles a break after a long day. Swelling, also known as edema, may be a sign of a severe health condition, such as diabetes, heart or kidney failure, blood clots, and liver disease. Other causes include having too much salt in your diet or being pregnant.

Discuss your symptoms with a healthcare provider to determine the cause and best course of treatment. Treatment can range from rest and a low-sodium diet to addressing the underlying disease.