12 health-related causes of swollen ankles and how to reduce them

Swollen ankles, also known as ankle edema, are a common issue that can range from mild discomfort to a sign of serious underlying health problems. Swelling occurs when excess fluid accumulates in the tissues, often in the lower legs, due to gravity or impaired circulation.

Causes can include lifestyle factors, injuries, pregnancy, or medical conditions affecting the heart, kidneys, liver, thyroid, or lymphatic system. Recognising the reason behind ankle swelling is essential for proper management. This guide explores 12 common causes of swollen ankles and offers practical tips on how to reduce swelling and support overall health.

Ankle swelling and health: 12 causes and effective treatments

Heart failure

In heart failure, the heart cannot pump blood efficiently. This causes blood to back up in the veins, leading to fluid accumulation in the ankles and legs. The condition also affects the kidneys’ ability to remove salt and water, worsening edema. According to a study published in AHA Scientific Journals when the heart's ability to pump blood is reduced, it can cause fluid to build up in the legs, ankles, and feet.

Pedal edema is often an early sign of heart failure. Symptoms may include fatigue, shortness of breath, and weight gain from fluid retention. Management typically involves medications to improve heart function, dietary changes to reduce salt intake, and regular monitoring by a healthcare professional.

Chronic venous insufficiency

Chronic venous insufficiency (CVI) occurs when the valves in the leg veins fail to function properly, allowing blood to pool in the lower legs.

Normally, these valves ensure blood flows toward the heart, but when they weaken, fluid and blood accumulate in the ankles and feet. Swelling may be accompanied by pain, heaviness, or skin changes such as discoloration or thickening. Managing CVI often involves wearing compression stockings, elevating the legs regularly, exercising to improve circulation, and in some cases, medical procedures to repair damaged veins.

Blood clots

Blood clots, or thromboses, can block the veins in the legs, preventing blood from returning to the heart. Deep vein thrombosis (DVT) is a serious condition that can be life-threatening if the clot travels to the lungs. DVT causes swelling, warmth, and pain in the affected leg. Smaller veins may gradually compensate, but if they fail to expand, persistent swelling can occur, known as post-thrombotic syndrome. Early diagnosis and treatment with blood thinners or medical interventions are crucial to prevent complications.

Pregnancy

During pregnancy, the body produces extra blood and bodily fluids to support the growing fetus. This often results in mild swelling of the ankles, feet, and sometimes hands, particularly in the third trimester. Hormonal changes and increased pressure on the veins in the pelvis can exacerbate swelling. While most swelling is harmless, sudden swelling in the face or hands may indicate preeclampsia, a serious condition that requires urgent medical care.

Simple measures such as elevating the feet and avoiding long periods of standing can help reduce discomfort.

Lymphedema

Lymphedema occurs when the lymphatic system, which helps remove excess fluid from tissues, becomes blocked or damaged. This can happen after infections, cancer treatments, or surgical removal of lymph nodes. Fluid buildup leads to swelling in the limbs, including the ankles, and may increase the risk of infections.

Treatment focuses on improving lymph drainage through compression therapy, manual lymphatic drainage, exercise, and skincare to prevent complications.

Chronic kidney disease

The kidneys help maintain fluid balance. In chronic kidney disease, they lose the ability to filter waste and remove excess fluid. Swelling often appears in the ankles first because fluid pools in the lower extremities due to gravity. Severe kidney disease, or end-stage renal disease, can lead to widespread edema.

Treatment focuses on managing kidney function, controlling blood pressure, reducing salt intake, and sometimes dialysis.

Liver disease

The liver produces albumin, a protein that keeps fluid inside blood vessels. Liver damage, from conditions like cirrhosis or hepatitis, can lower albumin levels, allowing fluid to leak into tissues. This can cause swelling in the ankles, legs, and abdomen. Managing liver disease through medication, diet, and avoiding alcohol can help reduce fluid buildup.

Hypothyroidism

An underactive thyroid slows metabolism, which can affect muscles and joints, leading to stiffness and swelling. Hypothyroidism may also increase fluid retention in tissues, causing puffy ankles. Treating the thyroid hormone deficiency usually alleviates edema, but additional lifestyle measures like reducing salt intake may also help.

Diabetes

High blood sugar levels can damage blood vessels and impair circulation, particularly in the lower extremities.

This can lead to fluid accumulation and swelling in the ankles. Uncontrolled swelling in diabetics may increase the risk of nerve damage, infections, or ulcers. Managing blood sugar levels, maintaining a healthy diet, and regular exercise are key to preventing complications.

Injury

Ankle injuries, including sprains, fractures, or ligament tears, often cause localized swelling due to inflammation. Immediate treatment with rest, ice, compression, and elevation (RICE) can reduce swelling.

Pain relievers such as NSAIDs and supportive braces or boots can also help speed recovery.

Cellulitis

Cellulitis is a bacterial skin infection that can cause rapid swelling, redness, warmth, and tenderness. People with diabetes or weakened immune systems are more prone to cellulitis. Prompt antibiotic treatment is necessary to prevent serious complications, and the affected limb should be monitored closely.

Arthritis

Certain types of arthritis, including gout and rheumatoid arthritis, can cause ankle swelling.

Gout results from uric acid crystal buildup in the joints, while RA is an autoimmune condition causing fluid accumulation in joint linings. Swelling may be accompanied by pain, redness, and stiffness. Treatment involves anti-inflammatory medications, lifestyle modifications, and managing underlying autoimmune conditions.Swollen ankles can result from simple lifestyle factors or serious medical conditions affecting the heart, kidneys, liver, or circulation. Identifying the cause is crucial for effective management. Seek immediate medical attention if swelling is sudden, painful, or accompanied by redness or warmth. For ongoing or chronic swelling, combining lifestyle adjustments with medical treatment can relieve discomfort and protect long-term health.Disclaimer: This article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider regarding any medical condition or lifestyle change.Also Read: Why some people eat chalk: Recognising pica, health risks and steps to overcome it