Swollen Ankles

If you have painful swollen ankles, see chart 31

Slight, painless swelling of the ankles is most often caused by fluid accumulating in the tissues after long periods of sitting or standing still, but it may be due to heart, liver, or kidney disorders. It is common in pregnancy. If swelling persists or if you have other symptoms, consult your doctor.

  • Are both ankles affected?

    • Both ankles

      Have you been suffering from increasing shortness of breath?

      • Shortness of breath
        • Possible cause Swelling of the ankles (due to fluid retention) and shortness of breath may be a result of chronic heart failure. Other possible causes of these symptoms are liver problems (see Cirrhosis) or kidney problems (see Nephrotic syndrome).

          Medical help See your doctor within 24 hours.

      • No shortness of breath

        Are you pregnant?

        • Pregnant

          Does either of the following apply?

          • Your face or fingers are swollen
            • Possible cause Retaining excessive amounts of fluid may be a sign of pre-eclampsia (see Pre-eclampsia and eclampsia).

              Medical help URGENT! Phone your doctor or midwife immediately!

          • You have gained over 2 kg (4.5 lb) in the past week
            • Possible cause Retaining excessive amounts of fluid may be a sign of pre-eclampsia (see Pre-eclampsia and eclampsia).

              Medical help URGENT! Phone your doctor or midwife immediately!

          • Neither
            • Possible cause Fluid retention, leading to swollen ankles, is common in pregnancy (see Common complaints of normal pregnancy).

              Self-help Avoid standing still for long periods and put your feet up whenever possible to reduce swelling. Consult your doctor if your face and/or fingers become swollen or if you start to put on weight rapidly.

        • Not pregnant

          Did your ankles become swollen after either of the following?

          • A long trip by car or train
            • Possible cause Several hours of inactivity can lead to accumulation of fluid in the ankles due to less efficient circulation. The decreased cabin pressure in a plane increases this tendency.

              Self-help Encourage the circulation by getting up and walking around at regular intervals during any long journey. When seated, keep your legs raised and take a brisk walk when you reach your destination.

          • An aeroplane flight
            • Possible cause Several hours of inactivity can lead to accumulation of fluid in the ankles due to less efficient circulation. The decreased cabin pressure in a plane increases this tendency.

              Self-help Encourage the circulation by getting up and walking around at regular intervals during any long journey. When seated, keep your legs raised and take a brisk walk when you reach your destination.

          • Neither

            Are you currently taking any medications or complementary remedies?

            • Yes
              • Possible cause Your symptom may be a side effect of the medication or remedy.

                Medical help Make an appointment to see your doctor. Continue to take prescribed medication unless advised to stop by your doctor but stop taking any other medications or complementary remedies.

            • No

              Do you have prominent veins in the leg or legs affected by swelling?

              • Prominent veins
                • Possible cause You may have varicose veins, which can cause fluid to accumulate in the ankles.

                  Self-help Avoid standing still for long periods. Walk as much as possible, and when sitting down try to keep your feet raised. Make an appointment to see your doctor if the swelling worsens or if other symptoms develop.

              • No prominent veins
                • If you cannot identify a possible cause for your swollen ankles from this chart, make an appointment to see your doctor.

    • One ankle

      Is the calf of the affected leg either of the following?

      • Swollen
        • Possible cause You may have a blood clot in a vein in your leg (see Deep vein thrombosis).

          Medical help URGENT! Phone your doctor immediately!

      • Tender
        • Possible cause You may have a blood clot in a vein in your leg (see Deep vein thrombosis).

          Medical help URGENT! Phone your doctor immediately!

      • Neither

        Have you injured your ankle within the past few weeks?

        • Recent injury
          • Possible cause Swelling can persist or recur for several weeks following an injury. This is unlikely to be a cause for concern.

            Self-help If the injury occurred within the past 48 hours, put a cold compress on your ankle, then bandage it firmly but not tightly, and rest it. For a less recent injury, try rest alone. Make an appointment to see your doctor if swelling persists for more than 24 hours despite rest or if the ankle is painful, tender, or inflamed.

        • No recent injury

          Are you currently taking any medications or complementary remedies?

          • Yes
            • Possible cause Your symptom may be a side effect of the medication or remedy.

              Medical help Make an appointment to see your doctor. Continue to take prescribed medication unless advised to stop by your doctor but stop taking any other medications or complementary remedies.

          • No

            Do you have prominent veins in the leg or legs affected by swelling?

            • Prominent veins
              • Possible cause You may have varicose veins, which can cause fluid to accumulate in the ankles.

                Self-help Avoid standing still for long periods. Walk as much as possible, and when sitting down try to keep your feet raised. Make an appointment to see your doctor if the swelling worsens or if other symptoms develop.

            • No prominent veins
              • If you cannot identify a possible cause for your swollen ankles from this chart, make an appointment to see your doctor.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

The subjects, conditions and treatments covered in this encyclopaedia are for information only and may not be covered by your insurance product should you make a claim.

Back to top