Swollen feet and ankles may seem like a rather straightforward symptom that should be noticed quite easily. However, the signs and symptoms of oedema in the lower legs and feet tend to differ between individuals and will be dependent on the underlying cause. Some of the signs that characterise swelling include:
- Swelling that is a result of dependent oedema and swelling in both feet or ankles (i.e. bilateral swelling) that is caused by medications, pregnancy and the majority of medical conditions will normally begin as a soft, puffy enlargement of the skin that starts in the feet and rapidly spreads (normally within a few hours) to your ankles.
- Your skin will easily indent when you press down on it with a finger, this indentation will slowly disappear as the swelling reappears when you remove your finger. This is called pitting oedema and is characterised by the pits that are made when a finger is pressed on the area of swelling. Whether or not pitting occurs when pressure is applied to a swollen area is an important characteristic in determining the cause of the swelling. Swelling that does not result in indentation (referred to as non-pitting oedema) around the ankles and legs often has a unique cause that a doctor can start considering as a result of this observation. One example of a cause of this kind of swelling along the front area of the lower leg (pre-tibial oedema) is a condition related to an under-active thyroid (hypothyroidism) which is called myxoedema.
- Indentations that occur in swollen or puffy skin when socks or shoes are removed are characteristics signs of swelling.
- The skin colour associated with general swelling is usually normal ranging to slightly pale, indentation marks are typically darker than the surrounding puffy tissues. Elevation of the feet (higher than the chest) usually helps swelling to subside over a few hours.
- In more chronic cases of swelling, the skin may become red, rigid and discoloured in some way, these changes do not disappear when the feet are elevated. Examples of chronic swelling are sometimes seen in those with CHF (congestive heart failure) resulting in chronic bilateral swelling of both the feet and ankles, accompanied by skin changes.
When to see a doctor for swollen feet and ankles
It is generally advised that you seek immediate medical attention if1:
- You notice inexplicable and painful swelling of your legs, feet or ankles
- The affected area becomes red, warm or inflamed
- You are pregnant and notice new swelling of your legs, feet and ankles or if swelling suddenly becomes worse or affects new areas of the body (e.g. the hands and face)
- The swelling of your feet and ankles is accompanied by fever
- You feel short of breath
- You are suffering from chest pain that feels like tightness or pressure
- You have kidney or heart disease and notice swelling getting progressively worse
- You have liver disease and notice swelling in your abdomen or legs
- If the swelling you notice only involves one leg (i.e. is unilateral). This may or may not be accompanied by pain around the calf area of the affected leg.
1. University of Maryland Medical Center. 2017. Foot, leg, and ankle swelling. Available: http://www.umm.edu/health/medical/ency/articles/foot-leg-and-ankle-swelling [Accessed 30.10.2017]