Ask The Doctor

Swollen Feet Have Different Causes

April 15, 2015

Dear Dr. Garner,

My ankles and feet have been swelling each night. It seems to have gotten worse lately. I can’t fit in my shoes, and when I press on my ankles, it leaves a mark.

I am a healthy 78-year-old. I do have thyroid problems, and I take several blood pressure medications.

I have occasionally had swollen feet, but this is the worst it has ever been. I’m grateful that it doesn’t hurt, but it is annoying not to be able to wear my shoes.

What do you think I can do to alleviate this problem?

Swollen Feet and Ankles

In Astoria

 

Dear Swollen,

Your problem is not an uncommon one. There are many different causes for the condition, and treatment is aimed at correcting the underlying cause. Therefore, one-size treatment will not fit all.

Swelling of the ankles and feet is usually not serious. It may be caused by prolonged standing, hot weather, vein problems, hormones and medications, such as blood pressure pills, antidepressants and Motrin-like medication.

On occasion, it may be a sign of a serious underlying condition, such as heart, liver or kidney disease.

Here are some of the more common causes of swollen feet and ankles:

  • Pregnancy – The uterus can block some of the blood vessels causing the blood to stay in the area of the feet and ankles within the veins. Usually wearing compression stockings and drinking fluids is helpful. It is also good to lie on your left side as this speeds blood flow back to the heart.
  •  Injuries – A sprained ankle is one of the most common causes of swelling. It usually responds to elevation of the foot and ankle, compression, bandaging, ice and avoidance of walking. If swelling persists for more than a day, see your doctor.
  • Lymphedema – This occurs because of problems within the lymph vessels, which carry the fluid that helps to fight infection in the body. Due to infection or cancer surgery, lymph vessels can become swollen and cause build-up of fluid in the feet and ankles. You should notify your doctor if you notice swelling of your extremities after cancer surgery.
  • Venous insufficiency – The veins normally help keep blood moving upward from the feet to the heart. When the veins are damaged, the blood stays in the foot and ankle veins and causes swelling.
  • Infection – Swelling of the feet and ankles can be related to an underlying infection. This is most common in people with diabetes who have nerve problems.

If you have diabetes, or have nerve problems with your feet, see your doctor immediately if your feet or ankles swell.

  • Blood clots – Blood clots in the veins of the leg can block blood flow from the legs back to the heart. It is important to have your doctor check for possible clots that can extend into the lungs and can be deadly.

Swollen ankles and feet can range from being very serious and even life threatening to being a benign nuisance-type condition.

It is always a good idea to limit salt intake, exercise, drink fluids and avoid water pills, especially if not prescribed by your doctor.

I suggest you visit your doctor to rule out any serious underlying causes for the swelling. Please let me know of your progress.

Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET TV, Tuesdays at 8 p.m. on Time Warner Channel 97, Cablevision Channel 30 and Verizon FiOS on Demand.