Symptom - Foot, leg, and ankle swelling

Foot swelling

Lower leg edema

Definition:

Abnormal buildup of fluid in the ankles, feet, and legs is called peripheral edema.

Alternative Names:

Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral, Peripheral edema

Considerations:

Painless swelling of the feet and ankles is a common problem, particularly in older people. It may affect both legs and may include the calves or even the thighs. Because of the effect of gravity, swelling is particularly noticeable in these locations.

Common Causes:

Foot, leg, and ankle swelling is common with the following situations:

• Prolonged standing
• Long airplane flights or automobile rides
• Menstrual periods (for some women)
• Pregnancy -- excessive swelling may be a sign of pre-eclampsia (a serious condition that includes high blood pressure and swelling; sometimes called toxemia)
• Being overweight
• Increased age
• Injury or trauma to your ankle or foot

Swelling of the legs may be a sign of heart failure, kidney failure, or liver failure. In each of these conditions, there is too much fluid in your body.

Other conditions that can cause swelling to one or both legs include:

• Blood clot
• Infection of the leg
• Venous insufficiency (when the veins in your legs are unable to adequately pump blood back to the heart)
• Varicose veins
• Burns including sunburn
• Insect bite or sting
• Starvation or malnutrition
• Surgery to your leg or foot

Certain medications may also cause your legs to swell:

• Hormones like estrogen (in birth control pills or hormone replacement therapy) and testosterone
• A group of blood pressure lowering drugs called calcium channel blockers (especially nifedipine, but also amlodipine, diltiazem, felodipine, and verapamil)
• Steroids
• Certain antidepressants, namely MAO inhibitors (such as phenelzine and tranylcypromine) and tricyclics (including nortriptyline, desipramine, and amitriptyline)

Home Care:

• Elevate your legs above your heart while lying down.
• Exercise your legs. This helps pump fluid from your legs back to your heart.
• Wear support stockings (sold at most drug stores and medical supply stores). This can provide pressure to help pump fluid and reduce swelling.
• Try to follow a low-salt diet, which may help reduce fluid retention and decrease swelling.

Call If:

Call your local emergency number (such as 911) if:

• You feel short of breath.
• You have chest pain, especially if it feels like pressure or tightness.

Call your doctor right away if:

• You have decreased urine output.
• You have a history of liver disease and you have new swelling in your legs or abdomen.
• Your swollen foot or leg is red or warm to the touch.
• You have a fever.
• You are pregnant have more than just mild swelling or you have a sudden increase in swelling.

Also call your doctor if the self care measures do not help or your swelling worsens.

What To Expect:

Your doctor will take a medical history and conduct a thorough physical examination, with special attention to your heart, lungs, abdomen, legs, and feet.

Your doctor will ask questions like the following:

• What specific body parts swell? Your ankles, feet, legs? Above the knee or below?
• Do you have swelling at all times or is it worse in the morning or the evening?
• What makes your swelling better?
• What makes your swelling worse?
• Does the swelling get better when you elevate your legs?
• What other symptoms do you have?

Diagnostic tests that may be performed include the following:

• Blood tests such as a CBC or blood chemistry
• ECG
• Chest x-ray or extremity x-ray
• Urinalysis

Disclaimer:

Review Date: 9/21/2003
Reviewed By: Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma., and Senior Medical Editor, A.D.A.M., Inc. Previously reviewed by David Webner, M.D., Department of Family Medicine, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network (5/23/2003).