Introduction - Swollen ankles
Ankle joints that swell and appear thicker due to increased fluid retention are referred to as swollen ankles. If not caused by an injury or infection, swelling in the ankles is technically referred to as "ankle edema". They appear as the first symptom of various diseases, some of which are harmless, while others can be potentially life-threatening and require therapy. The treatment is highly dependent on the cause, but in most cases it involves removing support stockings and elevating the legs.
Symptoms of swollen ankles
Swollen ankles can isolated or with other symptoms occur. In the context of chronic venous weakness, swelling often occurs in the area Pain or a Feeling of pressure on.
Over time, the water retention expands upwards and affects the entire lower leg. If the disease persists for a long time, step Skin changes on: the skin develops brownish and whitish discoloration, can harden and dilute.
Even minor injuries can develop deep, poorly healing wounds developed. If a weak heart is the cause of the swelling of the ankles, there is often water retention in other parts of the body.
For example, ascites can Gastrointestinal discomfort how Abdominal pain, nausea, bloating, and gas cause. If the heart is at an advanced stage, you can shortness of breath, Feeling weak, one Reduction in performance, Chest pain and dizziness occur.
When there is disruption in the outflow of lymphatic fluid from the leg, a swollen foot or ankle is often the only symptom at the beginning. Over time, pain can develop and hardening can form in the affected area due to the constant prevailing pressure.
If swollen ankles appear shortly after an infection of the neck, abdomen or urinary tract, this is an indication of the so-called "reactive arthritis"Or the"rheumatic fever". In the context of these disorders it can also be high fever, Complaints to heart and brain, Faults on eye as well as to Pain on other joints come.
Causes of swollen ankles
Swollen ankles without previous injury can be a symptom of many diseases. They are in the foreground especially in the case of "chronic venous insufficiency", which is also referred to as "venous congestion syndrome" or "chronic venous weakness", as well as right heart failure.
In chronic venous insufficiency, blood from the legs cannot be effectively directed to the heart due to damaged veins.
As a result, the blood sinks, its liquid components are pressed through the vein walls into the remaining tissue and cause swollen ankles.
If a right heart failure is the cause, blood can no longer be effectively pumped from the right part of the heart into the lungs.It accumulates in vascular sections in front of the right heart and leads, among other things, to ankle edema and water in the abdomen.
There are also a number of other diseases that can cause water retention on the ankles. Examples are diseases of the kidneys and the liver, in which the amount of protein in the blood decreases via various mechanisms such as impaired protein production.
Insufficient amount of protein in the blood leads to other symptoms and swollen ankles. In addition, if the lymphatic drainage is disturbed, injuries to the ankles, during or after various infections, and after taking medication, swollen ankles can occur.
Read more about this topic here: The causes of swollen ankles.
One possible side effect of various drugs used in chemotherapy is swelling of the ankles. Such swellings are caused, for example, by damage to blood vessels from the drug in question.
Such swellings usually do not last long and do not leave any lasting discomfort. Ankle swelling can usually be quickly brought under control by compression therapy with stockings, elevating the legs and using water-propelling medication.
Depending on the drug used, chemotherapy can also increase the risk of leg vein thrombosis. Such a leg vein thrombosis manifests itself in some cases as ankle edema. It is therefore advisable to discuss swelling that suddenly occurs after chemotherapy with the treating doctor.
Chemotherapy is usually carried out when a tumor is present. Many tumors can cause swelling of the ankles or legs regardless of therapy. Causes can be, for example, a protein deficiency caused by the tumor or the destruction of lymph vessels.
Surgery or radiation of the tumor can also lead to ankle edema. Chemotherapy is therefore only the most likely cause if it was carried out shortly before the swelling appeared.
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In the heat
The heat can be an important factor in the development of ankle edema. The water retention on the feet often results from an interplay of several factors. These often include a pressure load in the veins of the legs, favored by a weak vein or an incipient heart failure, provoked by strain on the muscles, warmth or long standing.
The heat can cause the venous blood vessels to relax considerably, which then dilate. As a result, more blood collects in the venous vessels, which disrupts the return transport of the blood to the heart. Due to the increased pressure load inside the veins, fluid escapes from the vessel into the surrounding tissue. The liquid typically first collects on the ankles of the lower leg in accordance with gravity. If there is a preexisting tendency to edema or a weak heart, strong heat influences or sauna visits should therefore be enjoyed with caution.
Many women experience swelling of their ankles, legs, and hands during pregnancy. Usually this is normal. This water retention can increase somewhat in the first few days after giving birth. The cause is the change in the maternal cycle, which has to get used to the new situation without a child. Edema can also develop in women who did not suffer from swollen ankles or feet before childbed. They usually go away without any consequences after a few days.
In some cases, normal ankle swelling after birth is difficult to distinguish from symptoms of leg vein thrombosis. Therefore, swelling of the ankles, especially if it is accompanied by pain, is only visible on one side or occurs after a long period of lying down, should be examined by a doctor.
If swelling on large parts of the skin, headaches or flickering eyes occur in addition to the swelling of the ankles, a doctor should also be informed due to the risk of "eclampsia".
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Swollen ankles during menopause are a typical and common symptom that can be attributed to various processes in the body. At the beginning of the menopause, the hormone progesterone may initially drop and the resulting excess estrogen may result. Estrogen causes the body to store more water, which in addition to swollen ankles can also appear as shiny and smooth skin. In the further course of the menopause, however, the estrogen levels decrease, which can also improve the water retention.
At the average age of menopause, many women also develop venous weaknesses, which in turn cause swollen ankles. Concomitant diseases of the heart or kidneys are also more likely after menopause and lead to leg edema.
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By the shield size
The thyroid produces the vital thyroid hormones and thus has a major influence on numerous body processes. Both overactive and underactive can be associated with numerous symptoms and swollen ankles. The typical water retention is described as a symptom of increased turnover during the overactive thyroid gland but also in the case of an underactive.
Another cause of swollen ankles is what is known as "myxedema", a typical symptom of hypothyroidism. Here, certain sugar molecules are deposited in the subcutaneous fat and cause swelling. It is typical that, unlike water retention, the swellings do not leave a dent after being pressed in. Initially, the swellings appear mainly in the eyes, hands and feet.
Here you can find out more about the topic: Water in the legs - where does it come from?
From an insect bite
Insect bites, for their part, can be accompanied by significant swellings and significant accompanying symptoms, including an anaphylactic reaction. Often there are no venous insufficiencies or organic concomitant diseases. The insect bite often transfers poisons, pathogens or other substances to the site of the puncture, which can lead to inflammation, irritation or allergic reactions. The localization on the ankle is typical as an often uncovered and exposed part of the body. The allergy-related swelling on the ankle can be accompanied by uncomfortable itching. Local antiallergic ointments or antiallergic medicinal products can reduce the swelling of the ankles.
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Through blood pressure medication
Various blood pressure medications can cause ankle swelling. The blood pressure medication often causes the blood vessels to relax, either directly or through several metabolic processes, in order to lower blood pressure throughout the body. This can also relax the leg veins, which means that the blood collects in these vessels according to the force of gravity and can lead to leg edema. In these cases, a combination of blood pressure medication with light diuretic, draining medication is common and useful.
Hiking puts a relatively heavy strain on the muscles of the legs over many hours. This increased activity can be the decisive factor in the development of swollen ankles. Often there is already a tendency to ankle edema with weak veins and possibly cardiac weakness.
As a result of the increased muscular activity and the subsequent increase in blood flow to the legs, the pressure in the veins can rise to such an extent that the fluid passes into the tissue. After a while, the swollen ankles often recede on their own if the legs are spared and raised.
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A swollen, painful ankle often occurs after an injury such as an twisting or bumping. Although most injuries will not cause permanent damage, if the swelling or pain is severe, see a doctor.
To be on the safe side, this should rule out a broken bone and torn ligament. If one or both ankles swell painfully without prior injury, a number of diseases can be the cause.
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Any sudden, severe swelling in the subcutaneous tissue or in the ankle can cause pain due to the increased pressure. A swelling in the joint leads to pain much faster than an edema in the skin.
Examples of possible diseases are chronic venous weakness and cardiac insufficiency. If, in addition to the pain, reddening or overheating of the ankle or skin is observed, an infection must be ruled out as soon as possible. Without adequate treatment, bacterial pathogens can cause blood poisoning or the destruction of the joint.
Diagnosis of swollen ankles
To diagnose swelling in one or both ankles for the first time In the first step a detailed anamnesis interview about possible injuries, previous illnesses, accompanying symptoms, taking medication and more.
Subsequently, due to the various causes, are common several examinations carried out. This includes the Examine the legs for varicose veins or swelling, the Checking the ankles for injuries, the Ultrasound examination of the legs, the Checking the leg pulses, one Blood pressure measurement, a detailed Heart and lung examination, the Examination of the urine as well as various Blood tests.
Therapy of swollen ankles
Treatment for swollen ankles depends on the underlying condition.
If venous weakness is the reason for the ankle edema, there are several forms of therapy to choose from. Compression stockings, exercise and the elevation of the legs are among the most important basic building blocks. Medicines for flushing out water and cold water treatment according to Kneipp can also be helpful. Ointments and creams usually have no effect.
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If there are varicose veins, they can be removed. In many cases, only a combination of different forms of therapy and consistent adherence to the therapy can lead to a satisfactory improvement in the swelling.
If the heart is weak, the first step is to determine the cause and treat it. Common triggers are narrowing of the coronary arteries, a past heart attack, or a lung disease such as COPD.
In the case of cardiac insufficiency, various medications must also be used to make the cardiac output more efficient, lower blood pressure and increase the excretion of water via the kidneys. Examples are “ACE inhibitors” and “beta blockers”. If kidney or liver diseases are the cause, in addition to flushing out the water through medication and the administration of proteins, usually only the treatment of the underlying disease helps.
In the case of ankle swelling due to infections of the respiratory tract or urinary tract, it is often not necessary to carry out specific therapy to swell the ankle - the ankle edema disappears on its own after a while.
Swollen ankles as an indication of heart failure
Healthy people whose ankle edema occurs unexpectedly and only for a short time rarely suffer from cardiac insufficiency - usually another cause is present.
In people with previous illnesses such as high blood pressure, a past heart attack or the so-called "coronary heart disease", in which the coronary arteries are narrowed, swelling in the ankles can be the first indication of a weak heart.
Since these diseases are often present without the affected person being aware of them, people with occasional chest pain, shortness of breath or heart palpitations are advised to have the symptoms clarified by a doctor.
Ankle swelling occurs especially when the right part of the heart is damaged. Because chronic lung disease can lead to right heart failure, people with COPD, asthma, or similar illnesses should also see a doctor if they develop swollen ankles.
With cardiac insufficiency, swollen ankles usually do not appear in isolation, but are accompanied by symptoms such as occasional shortness of breath, heart stumbling, nocturnal urination, racing heart, a general reduction in performance or a feeling of weakness. They usually last for several weeks or recur over the course of months.
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Duration of ankle swelling
How long swollen ankles stay thick depends largely on the cause. A venous congestion syndrome can usually not be resolved causally - therefore, depending on the treatment and its consistent adherence to the treatment, swollen ankles can recur throughout your life Heart failure.
Ankle swelling after infections such as one Respiratory or urinary tract infection however, usually only last a few days to weeks on. Swell the ankle under a allergic reaction, they usually disappear faster.
Unilateral or bilateral swelling of the ankles
If edema and thickening only appear on one leg, this is often due to a disruption of the veins or lymphatic vessels.
Diseases of these 2 systems can affect the ankles, the foot, the lower leg or the entire leg. It is not important whether the right or left leg is swollen - both sides are equally affected.
A typical disease of the veins in long-standing swelling is chronic venous insufficiency, while sudden swelling is more likely caused by a leg vein thrombosis.
In addition, varicose veins can be the cause of ankle edema. Disorders of the lymph vessels are usually preceded by diseases such as tumors, injuries, infections of the legs, operations or radiation. If such a disease only affects the left or right leg, the swelling usually only occurs on the respective side.
Swelling around the ankles, which feels like normal fat tissue, can be congenital and caused by poor fat distribution. Such fat distribution patterns, known as “lipedema”, occur in women in particular. As a rule, they do not have a negative impact on health.
If redness is visible on the ankle in addition to the swelling, an infection of the skin and subcutaneous tissue must be ruled out. Such a skin infection - technically known as erysipelas - can spread quickly and, if left untreated, lead to blood poisoning.
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Swollen knuckles and hands / fingers
Simultaneous swelling of the ankles and joints of the hands can occur in various diseases.
For example, such symptoms occasionally occur in the context of an allergic reaction or in so-called "reactive arthritis". The latter arises due to an excessive immune response of the own body to an infection of the gastrointestinal tract or the urinary tract and usually lasts only a few days to weeks.
The situation is similar with "rheumatic fever": an infection by streptococci can cause swelling of various joints such as the wrists, fingers and ankles, as well as fever and disorders of the heart.
Rheumatoid arthritis is one of the most common conditions in the elderly with persistent swelling of the knuckles and fingers. It is mainly caused by an overreaction of the immune system in old age. Affected people suffer from swelling and pain in several joints, mainly the hands and fingers, but ankles, knees or cervical spine can also swell painfully.
Since all of the diseases mentioned can have serious consequences, swelling that has persisted for a long time on fingers, hands and ankles should be clarified by a doctor.