By the end of a long shift, your shoes feel a size too small and your socks leave deep grooves above your ankles. In the morning, everything looks normal again. Sound familiar?
The most common swollen ankles and feet causes are everyday ones: standing or sitting for a long time, hot weather, salty meals, pregnancy, extra weight, and some medicines, including certain blood pressure drugs. Less often, swelling signals a problem with the heart, kidneys, liver, or leg veins, and swelling with pain in only one leg can be a blood clot that needs prompt care.
Doctors call this swelling edema: extra fluid trapped in the body’s tissues. Gravity pulls that fluid toward your feet, which is why ankles are usually the first place you notice it. Most of the time it’s a nuisance rather than a danger. The trick is knowing which patterns are worth a closer look.
The press test: what pitting edema looks like
You can do this quick check at home. Press your thumb firmly but gently into the swollen area, such as the top of your foot or just above the ankle bone, for about five seconds. Then let go and watch.
- If a dent stays for a few seconds, that’s called pitting edema. It means there is extra fluid in the tissue.
- If the skin springs right back, the swelling may be from something else, or there may be little extra fluid.
Pitting doesn’t tell you the cause. It shows up with harmless swelling and with heart, kidney, liver, or vein problems. But it’s a useful detail to mention to your doctor, along with how long the dent lasts and how high up the leg the swelling goes.
Everyday causes of swollen ankles and feet
MedlinePlus and Mayo Clinic list these common, often harmless causes:
- Standing or sitting for long periods, including long flights and car rides
- Hot weather, which widens blood vessels and lets fluid collect
- Eating a lot of salt (sodium), which makes the body hold on to water
- Pregnancy, especially later on, as the growing uterus presses on veins
- Being overweight
- Getting older
- Hormone changes, such as before a menstrual period
- An injury to the foot or ankle, such as a sprain
Medicines that can make ankles swell
MedlinePlus and Mayo Clinic note that some medicines can cause swelling in the legs and feet, including:
- Certain blood pressure medicines, such as calcium channel blockers
- Steroids
- Hormones such as estrogen and testosterone
- Some antidepressants
- Certain diabetes medicines
- Some anti-inflammatory pain relievers (NSAIDs)
If your ankles started swelling after a new prescription, don’t stop the medicine on your own. Call your doctor or pharmacist. There may be a different option or a simple adjustment.
When swollen ankles point to the heart, kidneys, liver, or veins
Swelling that keeps coming back, doesn’t go down overnight, or comes with other symptoms can be a clue to a medical condition.
Heart failure
When the heart doesn’t pump as well as it should, blood can back up in the veins and fluid can leak into the tissues. NHLBI lists swelling in the feet, ankles, legs, or belly as a symptom of heart failure, along with shortness of breath, tiredness, and sudden weight gain from fluid. Trouble breathing when lying flat is another clue.
Kidney disease
Healthy kidneys remove extra fluid and salt. When they don’t work well, fluid can build up in the legs and around the eyes.
Liver disease
Liver problems can lower the level of a protein that keeps fluid inside blood vessels, so fluid leaks into the legs and belly.
Weak leg veins (venous insufficiency)
Valves in the leg veins normally keep blood moving up toward the heart. When they weaken, blood pools in the lower legs. Swelling is often worse at the end of the day, and you may see varicose veins or skin changes around the ankles.
A blood clot (DVT)
A deep vein thrombosis (DVT) is a blood clot in a deep vein, usually in the leg. NHLBI describes symptoms such as swelling, pain or tenderness, warmth, and red or discolored skin, often in just one leg. A DVT needs prompt care, because part of the clot can break off and travel to the lungs (a pulmonary embolism), which is an emergency.
Symptom, possible cause, next step
Use this table to sort out what you’re seeing. It’s a guide for your next step, not a diagnosis.
| What you notice | Possible cause | Next step |
|---|---|---|
| Both ankles puffy after a long day or flight, gone by morning | Standing, sitting, heat, salt | Move more, put your feet up, watch salt; mention it at your next checkup |
| Swelling started after a new medicine | Medicine side effect | Call your doctor or pharmacist; don’t stop the medicine on your own |
| Mild swelling in both feet during pregnancy | Normal pregnancy change | Mention it at your prenatal visit |
| Sudden swelling of face, hands, or feet in pregnancy, with headache or vision changes | Possible preeclampsia | Call your provider right away |
| One leg swollen, painful, warm, or red | Possible blood clot (DVT) | See a doctor the same day or go to urgent care |
| Swelling with shortness of breath, tiredness, or trouble breathing lying down | Possible heart failure | Call your doctor promptly; call 911 if breathing is hard |
| Swelling with foamy urine or puffy eyes | Possible kidney problem | Make a doctor’s appointment soon |
| Swelling with a swollen belly or yellow skin or eyes | Possible liver problem | Make a doctor’s appointment soon |
| Swelling worse at night, with varicose veins or skin changes | Weak leg veins | See your doctor about vein care |
Swollen ankles paths by situation
If you’re on your feet all day
Take short walking breaks, flex your ankles often, and put your feet up above heart level when you get home. Ask your doctor whether compression stockings are right for you.
If you’re pregnant
Some ankle swelling is common, especially late in pregnancy and in hot weather. Lying on your side and resting with your feet up may help. Sudden swelling of the face or hands, a bad headache, or vision changes need a call to your provider right away.
If you have high blood pressure
Swelling may be a medicine side effect or a sign that your heart is under strain. Bring it up with your doctor, and keep your blood pressure in check. Our guide to high blood pressure symptoms explains why many people have none.
If you have a heart rhythm problem or heart disease
New or worsening swelling, along with sudden weight gain, breathlessness, or a resting heart rate that is higher than your usual, is worth a call to your care team. If you have atrial fibrillation, our guide to AFib symptoms lists the warning signs to watch for.
Easing everyday ankle swelling at home
For swelling from harmless causes, MedlinePlus and Mayo Clinic suggest:
- Raise your legs above heart level while lying down, a few times a day
- Move. Walking and ankle exercises help pump fluid back toward the heart
- Cut back on salt, especially from packaged and restaurant foods
- Avoid sitting with your legs crossed or in one position for a long time
- On long trips, get up and walk every so often, or flex your ankles in your seat
- Avoid tight clothing around your thighs
If swelling doesn’t improve with these steps, see your doctor.
Swelling that needs a doctor now
Call 911 if swelling in your legs comes with:
- Chest pain or pressure
- Trouble breathing or sudden shortness of breath
- Coughing up blood
- Fainting
These can be signs of a blood clot in the lungs or a serious heart problem.
See a doctor the same day if:
- Only one leg is swollen, especially with pain, warmth, or redness
- Swelling came on suddenly
- You’re pregnant and have sudden swelling with headache or vision changes
- The swollen area is red, hot, and you have a fever, which can mean an infection
Make an appointment if swelling keeps coming back, doesn’t go down overnight, or you have heart, kidney, or liver disease and it’s getting worse.
Try the ankle check tonight
Before bed, take off your socks, do the press test on both ankles, and look at both legs side by side. Write down what you see. Tomorrow evening, do it again. If one leg looks different, or the dent lingers night after night, call your doctor and bring your notes.
Because high blood pressure and some of its medicines are closely tied to swelling, a good next read is our guide to high blood pressure symptoms.
