About this symptom
Swollen legs, ankles and feet happen when fluid builds up in the tissues. Doctors call this oedema. If you press the swollen skin with a finger, it may leave a dent that slowly fills again.
Mild swelling in both legs is common after standing or sitting for long, in hot weather, after salty food, and in pregnancy. It can also be a sign of a problem with the heart, kidneys, liver or thyroid, a blood clot, an infection, or a medicine.
Possible causes
This is not a diagnosis. These are the causes doctors think about, with the ones that are most urgent to rule out first.
- Deep vein thrombosisThrobbing pain and swelling, usually in one leg, with red, blue or darkened skin. Breathlessness or chest pain with it can mean the clot has reached the lung.Read about it
- Heart failureSwelling in both feet, ankles and legs, sometimes the tummy, with breathlessness (often worse lying down), tiredness and sudden weight gain.Read about it
- Pre-eclampsiaIn pregnancy, sudden swelling of the face, hands or feet with a severe headache, vision problems or pain below the ribs. It needs checking at once.Read about it
- Cellulitis (skin infection)A swollen area that is red, hot and painful, sometimes with a high temperature or shivering.
- Chronic kidney diseaseKidney problems can leave fluid in both legs, and sometimes elsewhere. Blood tests for kidney function and a urine test help to check.Read about it
- CirrhosisLong-term liver damage can cause fluid to collect in both legs and the tummy.Read about it
- Varicose veinsTwisted, bulging veins you can see under the skin of the legs. They can cause swollen ankles, especially after long spells of standing.Read about it
- Some medicinesSome blood pressure medicines, steroids and contraceptive pills can cause swollen ankles. Do not stop a medicine yourself: ask your doctor.
- Standing or sitting for longSwelling in both feet that builds up with long spells on your feet, in hot weather or after salty food, and eases with rest.
When to get help
Also get emergency care for:
- Blue, pale or grey lips or skin with the swelling
- Someone who has passed out and is not responding normally
See a doctor the same day if you have:
- Swelling in one leg only, or a swollen leg that is painful, red or hot
- Swelling that came on suddenly, is severe or is getting worse
- Swelling of the face or tummy as well, or sudden weight gain
- Swelling with a high temperature or shivering
- Sudden swelling of the face, hands or feet in pregnancy or after a recent birth, especially with a severe headache or blurred vision
See a doctor within a few days if you have:
- Swelling in both legs that has not gone down after a few days at home, or swelling if you have diabetes or a heart, kidney or leg vein condition
Mild swelling in both ankles after a hot day, or after standing or sitting for long, that goes down with rest and raised legs can wait.
What you can do at home
If the swelling is mild, in both legs, and none of the signs above apply, these steps can help while it settles.
Do
- Raise your legs on a chair or pillows when you sit or lie down
- Walk about and do gentle activity to keep the blood moving
- Wear wide, comfortable, low-heeled shoes with soft soles
- Eat less salt, and keep your feet clean, dry and moisturised
Do not
- Do not stand or sit for long spells without moving
- Do not wear tight clothes, socks or shoes
- Do not raise your legs if you are breathless: see a doctor instead
- Do not stop or change a medicine yourself if you think it is causing the swelling
What the doctor will do
The doctor will ask when the swelling began, whether it is in one leg or both, whether it is anywhere else, what you have tried, and which medicines you take. They will press on the swelling and examine your legs and the rest of your body.
Tests depend on the likely cause. They may include:
- Blood tests, including kidney and liver function and albumin, a blood protein
- A urine test
- An , or an (an scan of the heart)
- A chest X-ray
Treatment depends on the cause. It may include eating less salt, water tablets (diuretics), support stockings, or treating the heart, kidney, liver or vein problem behind the swelling.
Myths and facts
Things people often say about this. Open each one to see what is true.
Myth“Swollen feet are just water, so there is nothing to worry about.”What is true?
Fact
Swelling is often harmless, but it can also come from the heart, kidneys, liver, thyroid or a blood clot. If it is in one leg, comes on suddenly, comes with breathlessness, or does not go down in a few days, it needs checking.
Myth“A painful swollen calf is only a pulled muscle.”What is true?
Fact
Pain and swelling in one leg can be a blood clot, which needs to be checked the same day. If you are also breathless or have chest pain, the clot may have reached the lung, and that is an emergency.
Myth“Swollen feet always mean the kidneys have failed.”What is true?
Fact
Kidney problems can cause swelling, but so can standing for long, salt, heat, medicines, leg veins, the heart and the liver. A doctor can tell which with an examination and a few tests.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
Why do my feet swell in hot weather or at the end of the day?
Mild swelling in the lower legs is common in warm weather and after standing or walking for long periods. Raising your legs, moving about and eating less salt can help. If it has not gone down after a few days, or is getting worse, see a doctor.
Which medicines can make my ankles swell?
Some medicines for blood pressure, diabetes and heart disease, steroids, and contraceptive pills can do this. Do not stop a medicine yourself. Tell your doctor, who can decide whether to change it.
Is swelling in one leg more serious than in both?
It can be. Swelling in only one leg with no clear cause, or with pain, redness or heat, can be a blood clot or an infection, so see a doctor the same day. If you are also breathless or have chest pain, get emergency care.
Do I need to cut down on salt?
Too much salt makes the body hold on to fluid, and eating less is part of the treatment for several causes of swelling. Ask your doctor how much is right for you, especially if you have heart, kidney or liver disease.
