Updated 23 August 2013

Why your ankles are swollen

It is the unusual accumulation of liquid/fluid in the ankles, feet and legs, which is known as peripheral oedema.



It is the unusual accumulation of liquid/fluid in the ankles, feet and legs, which is known as peripheral oedema.

Possible Causes

Common/benign factors for leg, ankle and feet swelling are as follows:
  • Age

  • Overweight

  • Pregnancy (excessive swelling, can be a sign of pre-eclampsia, which needs medical treatment immediately)

  • Menstruation

  • Standing for long periods

  • Lengthy airplane flights or motor travelling

  • Damage to leg, ankle or foot – consult your doctor when you are unable to walk more than three steps on your foot and if it is very tender over the swollen area.

Other more serious conditions that causes leg, ankle and foot swelling, are as follows:

1. Heart, kidney and liver failure
Leg swelling can be a sign of heart, kidney and liver failure, due to the fact that these conditions cause the body to retain too much fluid. You should contact your doctor immediately if your legs are swollen and you also have one or more of the following symptoms: shortness of breath, tight chest, abdominal swelling, severe nausea, vomiting, abdominal discomfort, decreased urine output and a fever.

2. Blood clot
This is known as deep vein thrombosis and causes oedema/swelling of one or both legs. It is usually seen in women who are on oral contraceptives and in people who have taken long flights. It is important to consult your doctor, to have a diagnosis made and to start with the correct treatment. The danger of a blood clot is that it can migrate to the lungs and cause a pulmonary embolism.

3. Surgery to your leg or foot
It is best to consult the surgeon if any complications arise from the surgery, such as infection.

4. Insect bite or sting
Insect bites can be treated at home by applying an antibiotic cream, as well as taking oral anti-histamines. If it is a very small bite, you can treat it with Anthisan cream. Sometimes a spider bite can lead to complications, for example a wound that does not want to heal and which is very red and painful. You should consult your doctor to start with the correct treatment. If you are allergic to bee stings, it may lead to severe anaphylaxis and you should urgently contact your doctor.

5. Starvation or malnutrition

6. Burns/sunburn
Sunburn can be treated at home with cold compress and after-sun lotions. Severe sunburn or burns should be examined by a doctor, in order for the patient to receive the correct treatment.

7. Varicose veins
Varicose veins can lead to swelling of the legs and can be very painful. You can elevate your legs and wear compression stockings (available at pharmacies), to reduce the symptoms. You can consult your doctor for sclerotherapy and surgical vein legation, with or without stripping the vein.

8. Venous insufficiency
This condition is defined by the pooling of lymph in the lower extremities or damage to or congenital absence of venous valves in the superficial and communicating veins. Pain is caused due to venous hypertension (increased pressure in the veins) from obstruction or valvular incompetence. Sometimes there are non-healing ulcers present. Varicose veins indicate venous hypertension.

You can elevate your legs for 30 minutes, wear compression stockings or alternate compression by means of elastic bandages (which are multi-layered), as this will reduce the oedema/swelling of the legs.

Diuretics and aspirin can also be used to alleviate your symptoms. Systemic antibiotics must be used in cases where there are unresponsive ulcers.

9. Leg Infection
Leg infection usually presents with redness, swelling/oedema and might have a puss discharge on the site of the infection. Pain, which can be throbbing, is also experienced.

Depending on the severity of the leg infection, especially with the formation of ulcers (in diabetics), it is important to consult your doctor regarding treatment.

10. Certain drugs
Oral contraceptives, hormone replacement therapy, a group of calcium channel blockers, steroids, antidepressants and MAO inhibitors, can cause oedema/leg swelling. If you experience side-effects (leg swelling) from your medication, you should consult your doctor to get a replacement prescription.

Written by Dr Anrich Burger, MB ChB (Stell)

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