Swollen Feet

Swelling or edema of feet and ankles is caused by the accumulation of fluid in the spaces between the cells. The buildup of fluid in body parts is not painful unless caused by an injury.

Swollen feet is not a disease in itself, but a symptom of an underlying condition. Swelling can occur in any of the body parts and it is a very frequent symptom seen in many people. It is more commonly noted in elderly people.

The swelling may be noted on either side or only on one side. In most cases, swollen feet is not a serious condition and does not pose a serious risk. But when accompanied by symptoms, it could be a warning signal of a serious health issue.

Swelling of feet can occur due to a variety of reasons. Lifestyle factors like being overweight or sitting and standing for a long duration may cause swollen feet and ankle. Certain medications are also known to cause edema of feet.

This includes steroids, some antidepressants, non-steroidal anti-inflammatory drugs, and estrogen. Natural hormonal changes, blood clots in legs, infection, injury, pericarditis, lymphedema, cirrhosis, and venous insufficiency are some of the other causes of feet edema.

Symptoms of swollen foot depend on the actual cause of swelling. It may range from a painless increase in the size of the foot to changes in skin color of the foot, and changes in texture. The skin may become warm and may become ulcerated with pus in some other cases.

Swollen feet is not of concern in most of the cases, but may indicate serious health issue in some cases if: 

• patient has kidney, liver, or heart disease
• swelling is reddish and is warm to touch
• the patient has a temperature
• the swelling does not reduce with home remedies
• swelling worsens with time

Some of the other symptoms along with foot swelling that needs medical attention are:

• Tightness in chest area
• Lightheadedness
• Dizziness
• Shortness of breath
• Confusion

The actual cause of swelling is diagnosed based on physical examination, medical history, and other tests. Treatment also depends on the underlying cause of swelling. In most of the cases, the swelling may resolve without any specific treatment.

Those with an underlying medical condition may need specific treatment to alleviate swelling of feet. Swollen feet may remain uncomplicated in many cases, depending on the cause of edema. In some cases, ulcerations and pus formation can be seen as complications of swelling.

Swollen feet can be prevented and controlled by simple methods. Prevention and control of swelling may be more complex if the underlying condition is progressive and complicated.

Keeping the legs in a raised position, wearing support stockings, and losing weight and having regular physical activity are some of the methods to control swelling in feet. Prognosis of swollen feet may range from poor to good depending on the response to medication and lifestyle changes.

In most of the cases, the swelling may affect ankles too and hence both the conditions are considered together. Swollen feet is often a symptom of an underlying condition, which may or may not is a serious issue.

Some of the common causes of feet edema include: 

Complications in pregnancy – pregnancy is characterized by some amount of swelling in feet and ankles. Sudden and excessive swelling in the feet may indicate preeclampsia, a condition in which the blood pressure increases and protein are excreted in urine.

This may be usually accompanied by abdominal pain, headaches, nausea, and vomiting. Preeclampsia requires immediate medical attention.

Injury to foot or ankle – sprain in the ankle or foot injury is a common cause of swelling in the feet. Common home remedies are usefully helpful in relieving swelling.

Lymphedema – issues in lymph vessels or removal of lymph nodes may result in the collection of lymphatic fluid. Accumulation of lymph fluid may result in infection and deformity. It is commonly seen in a patient who undergoes radiation therapy for the treatment of cancer.

Venous insufficiency – this is a condition in which the blood flow to the heart from the legs and feet is inadequate. In such case, the blood is retained in the lower legs, particularly feet and ankles. A chronic condition may lead to ulcers and infection.

Infection – foot infection is yet another cause of swollen feet. Diabetic neuropathy increases the risk of infection and thus feet edema.

Blood clot – clots in the blood vessels of leg prevents the blood flow back to the heart, leading to build up in the tissues. This leads to swelling of foot and ankle.

Clots may be formed superficially in the veins just beneath the skin, or in deep veins. These clots are potentially life-threatening if the clot moves through the blood vessels to heart or lungs.

Heart, liver or kidney disease – Improper functioning of the heart, kidney and liver lead to fluid buildup in the body. Due to gravity, the fluid accumulates more in the feet.

When accompanied by other symptoms like fatigue, loss of appetite, or shortness of breath, this needs medical attention. Liver cirrhosis resulting from alcohol abuse or hepatitis infection may also cause poor circulation in the feet and edema.

Side effects of medication – certain medications have swollen feet as a side effect. This includes hormones like estrogen, calcium channel blockers, steroids, antidepressants, non-steroidal anti-inflammatory drugs, and medications for diabetes.

Certain factors increase the risk of edema in feet. People who stand or walk for a long duration have an increased risk of developing swelling in feet. This includes salespersons, construction workers, and mothers with children.

Pregnant women also have a high risk of developing swollen feet, particularly in the last trimester. People who take certain medications that have feet edema has a side effect are also at a risk of this condition.

The benefit of medication might be more than the risk of swollen feet, and hence the dosage is often adjusted accordingly. Many diseases and conditions that have feet edema as a symptoms are risk factors.

Swollen feet is diagnosed by physical examination. Doctors will analyze the medical history of the person along with the signs and symptoms to identify the underlying cause of edema.

They may evaluate the functioning of organs like kidney, lymph nodes, heart, lungs, and legs to assess the cause of the condition. This is often done with the help of questions.

The doctor may try to understand whether swelling occurs above knee level and whether the swelling worsens during a particular time of the day. Things that make swelling better or worse are also noted. It is important to know whether the swelling worsens when the leg is raised.

Medical history of the person including episodes of clot formation in heart or lungs also helps in identifying the cause. Other symptoms associated with swollen feet is also included in the evaluation.

Further tests and examinations are suggested based on the probable cause of edema in feet. Other tests suggested include blood tests, imaging techniques like x-ray, ECG, and ultrasound scan.

ECG is used to assess the functioning of the heart, while x-ray helps in visualizing bones and other tissues. Ultrasound provides a better picture of organs, blood vessels, and other tissues.

CT scan and MRI are useful in detecting damages in tissues.Mild cases of foot swelling may resolve without any specific treatment. These cases can be treated by primary care doctors.

Depending on the underlying cause of feet edema, specialist consultation may be required. The simplest method of treating swollen feet is raising the feet above their heart while lying down or sitting.

Thus sitting on a reclining chair with legs raised is a good way to control swelling. There are many ways of reducing or preventing swollen feet, depending on the underlying cause of the condition.

Some other home remedies that help in alleviating this symptom include: 

• Stretching the legs often to prevent building up of fluid in tissues
• Staying active to improve circulation
• Reducing salt intake to prevent fluid accumulation in tissues
• Maintaining a healthy body weight
• Avoiding tight clothing around thighs
• Using supportive materials like stockings and compression socks
• Moving or standing periodically, if the work involves long duration of standing or sitting
• Regularly exercising to maintain good circulation
• Avoiding smoking, alcohol, and other substances

Swollen feet may result in some complications like discomfort or pain during activities. Chronic swelling may lead to color changes in the skin. In some rare cases, ulcers may develop on the feet.

Infections of skin in this region may lead to complications like abscesses, cellulitis, and necrotizing fasciitis. For many others, treatment depends on the underlying cause of swelling.

The outcome of treatment depends on the actual cause of swelling. In the majority of cases, feet edema has a good prognosis. Swelling of feet and ankle is usually reversible. Complications are seen only in few cases.

The prognosis may range from good to poor in cases where edema is caused by chronic conditions. This is particularly true of diseases that are refractory to treatment. It also depends on the response of the patient to medications and lifestyle modifications.