After a lengthy run, a long shift on your feet or a hot day, it's not uncommon to encounter a little swelling in your lower limbs. But if your tootsies tend to swell more regularly, it might be a red flag for a more serious issue or chronic health condition.
Here, Nelya Lobkova, DPM, a New York City-based podiatrist at Step Up Footcare, explains why your feet may balloon plus ways to soothe the swelling.
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1. You Have an Injury
Twist your foot the wrong way or accidentally roll your ankle? An injury can instigate swelling in your feet.
The most common causes include:
- Ankle sprains, which happens when you stretch or tear a ligament, i.e., the fibrous tissue that connects bone to bone
- Tendinitis, which occurs when your tendon — the thick tissue connecting muscle to bone — becomes inflamed
- Stress fractures, which happen when repeated stress or force causes a tiny crack in a bone
Each injury might present accompanying puffiness in different ways, Dr. Lobkova says:
- Ankle sprains — swelling will occur around the ankle
- Tendonitis — swelling will appear along the path of the affected tendon
- Stress fractures — a slight swelling will surface on the top of the foot, close to the toes
“If these occur, or if there's an onset of pain with the swelling, it is advised to stop all high impact activities, then rest, ice and elevate the feet for at least 24 hours,” Dr. Lobkova says.
When elevating the feet, lie down with your dogs above heart level, which helps fluid drain back with gravity, she says.
Epsom salt soaks of the feet and legs can help decrease swelling after an injury as well, Dr. Lobkova adds.
If home remedies don’t resolve the injury and swelling or pain persists, seek medical attention from a foot and ankle specialist, Dr. Lobkova says.
2. You’re Standing (or Sitting) Too Much
When you stand or sit for long periods of time, gravity takes its course and causes pooling of blood in the lower extremities, Dr. Lobkova says.
This means more fluid leaves the blood and travels into the tissues, which results in edema (a type of swelling that happens when fluids accumulate and become trapped in your body's tissues).
People who work on their feet all day may develop edema but those who sit at a desk for extended stints can experience foot swelling too.
In addition to puffy ankles, feet or legs, other symptoms of edema may include, per the National Health Service (NHS):
- Shiny or stretched skin
- Changes in skin color
- Discomfort, stiffness and dents when you press on the skin
Swelling related to sitting also commonly occurs on long airplane flights when the muscles in our legs aren't working. In this scenario, the "veins in our lower body need to work harder to get the blood back towards the heart," Dr. Lobkova says.
If you’re sitting too much:
To resolve this swelling, break up long bouts of sitting by getting up and walking, even for short spurts. “When we walk, we use the muscles in the legs that help pump blood back towards the heart in the veins,” Dr. Lobkova says. This will help keep blood from pooling in the lower extremities.
Another smart strategy is doing exercises for swollen feet. Specifically, “calf exercises throughout the day will help,” she says. You can even do these without leaving your chair. For instance, in a seated position, extend your legs in front of you. Point and flex each foot 12 times. Repeat for three sets with a 10 second break.
If you’re standing too much:
When standing for prolonged periods, wearing compression socks can help slash swelling in the feet. “Compression socks are special socks meant to deliver a level of compression to the lower extremities,” Dr. Lobkova says.
They’re measured in units of pressure of mm of Hg (millimeters of mercury). “The higher the mm of Hg, the more compression delivered to the legs and feet,” she says.
For most people, compression socks in the 15-20 mm of Hg range are sufficient to prevent leg swelling. “But if you have a history of venous insufficiency, at least 30 mm of Hg is recommended,” Dr. Lobkova says.
When buying compression socks, Dr. Lobkova suggests starting with knee-length (they also come in ankle length and thigh highs too). Also, make sure they fit your calf circumference.
Not sure where to purchase compression socks? Discount Surgical is a reputable retailer of medical grade compression wear, she adds.
3. You’re Dealing With Obesity
With obesity, "there is excess weight on the tendons and muscles of the body, specifically the lower extremities," Dr. Lobkova says. "This strain on the muscles can cause a buildup of fluid in the lower legs, leading to swelling in the feet and ankles," she says.
“The best way to manage this is to increase mobility, perform foot stretches and walk every day,” Dr. Lobkova says. “Walking alone contracts the calf muscle, which helps pump the fluid in the legs back up towards the heart,” she says.
Maintaining a healthy weight for you will also help reduce your risk of regular foot swelling.
4. You Have Arthritis
Your puffy feet may be associated with arthritis, a condition that creates swelling and tenderness in the joints.
One type of arthritis, called osteoarthritis, is a common culprit. "This form involves the denuding [or stripping] of the cartilage covering the bone, leading to bone-on-bone motion that can result in loose bone fragments or bone spurs," Dr. Lobkova says. Ouch.
"These patients present with a generalized puffiness overlying the affected joints," most commonly impacting the midfoot, tarsal or ankle joints, she says.
Another form of arthritis, known as inflammatory arthritis, causes swelling in the feet as well. "One example is gout, which stems from excess uric acid in the blood," Dr. Lobkova says. "Gouty arthritis causes redness, pain, stiffness and swelling in the affected joint, frequently the big toe joint," she says.
When it comes to treating osteoarthritis, compression wear, physical therapy and supportive orthotics are helpful. “However, osteoarthritis is a progressive disease,” Dr. Lobkova says. In other words, in many cases, your condition and accompanying symptoms may worsen with time.
“When conservative care fails, we consider surgical options to remove bone spurs or fuse the impacted joints,” she says.
To treat inflammatory arthritis like gout, your doctor may prescribe an oral medication to lower the uric acid in the blood, as well as strong anti-inflammatory medicine such as corticosteroids, Dr. Lobkova says.
5. You Have an Ingrown Toenail
Ingrown toenails are another common condition that can cause swollen feet. This happens when the nail grows into the soft, fleshy skin and typically affects the big toe.
"The resultant swelling is usually in one foot only, instead of both, and is very tender to the touch," Dr. Lobkova says.
Sometimes, an ingrown nail can even become infected. When there is a localized infection of the soft issue (known as cellulitis), you may experience edema, warmth, pain and redness in the affected area, Dr. Lobkova says.
To help prevent ingrown toenails, don't wear shoes that crowd the toenails and don't trim your toenails too short or in a curved shape (snipping straight across is best), according to the Mayo Clinic.
For milder cases, home remedies can help resolve ingrown toenails and subsequent swelling. For example, try taping the skin away from the nail border’s edge (which will help keep the nail separated from the skin) or soaking your feet it in Epsom salt and warm water.
If these conservative treatments haven’t helped, or if your nail is infected, consult with your doctor. “The infection must be addressed with targeted antibiotics and wound care if necessary,” Dr. Lobkova says.
6. You’re Taking Certain Medications
The source of your swollen feet may be found in your pillbox. Yep, certain medications can cause fluid retention and raise your risk for swelling in the feet, Dr. Lobkov says. Some of the most common offenders include, per Dr. Lobkova:
- Blood pressure medications
- Steroids and corticosteroids
- Nonsteroidal anti-inflammatory medications (NSAIDs)
- Neuropathy medications (such as Gabapentin and Lyrica)
"Approximately 10 percent of people who take these medications exhibit localized foot and leg swelling," Dr. Lobkova says.
Additionally, antidepressants and hormones like estrogen (in birth control pills or hormone replacement therapy) and testosterone may produce puffiness in your feet as well, according to Mount Sinai.
If your doctor determines that a drug is causing the swelling, it’s usually safe to continue taking it, Dr. Lobkova says. Often, the benefit of the medication outweighs the pesky side effect.
In other cases, your healthcare provider might be able to prescribe an alternative medicine altogether.
7. You’re Eating Too Much Salty Food
You can develop edema due to your dietary choices, specifically your salt intake.
"Fluid goes back and forth between blood and our tissues with the help of sodium in a delicate balance of fluid maintenance," Dr. Lobkova says. But a high sodium eating pattern can throw off this equilibrium.
When there's an excess of sodium in your system from salty foods, your body will retain more water, which is why your feet become swollen.
Not to mention, eating too much sodium can produce more serious problems than puffy feet. "A high salt diet is also linked to developing high blood pressure and elevated cholesterol," Dr. Lobkova adds.
“We get enough salt by eating a natural diet, and we do not need to add much salt to our meals,” Dr. Lobkova says.
To avoid excessive sodium, limit processed foods, which have a lot of hidden salt, she says. That's why it's important to always read food labels and scan the nutritional info for sodium content. Anything with 20 percent or more of your daily value (DV) is considered a high sodium food
Additionally, you can also snack on certain foods to reduce swelling in the feet such as those rich in water and electrolytes like magnesium potassium and calcium.
8. You Have Compartment Syndrome
"Another cause of swollen feet is compartment syndrome," Dr. Lobkova says.
This rare condition happens when there are dangerous levels of pressure within the muscles, according to the American Academy of Orthopaedic Surgeons (AAOS).
This increased pressure can reduce blood flow, cutting off essential nutrients and oxygen from nerve and muscle cells, per the AAOS.
While compartment syndrome can strike many areas of the body, it usually appears in the lower leg and can occur from overuse of the foot tendons, Dr. Lobkova says. With chronic overexertion, tendons in the feet can expand and push up against nerves and veins, she says. And this can cause swelling and, sometimes, numbness.
Compartment syndrome can also result from a severe injury (like a broken bone) and may present other symptoms including pain, muscle tightness, tingling or burning sensations, according to the AAOS.
To get relief and reduce swelling, avoid physical activity and seek medical care immediately.
“If the swelling does not resolve, the compartment pressure may be too high and require emergency surgery to release the pressure,” Dr. Lobkova says.
9. You’re Pregnant
Puffy feet are particularly prevalent in pregnancy.
That's because the growing uterus compresses the veins in the abdomen, according to Keck Medicine of USC. Making matters worse, hormonal shifts can affect your vascular system during pregnancy, and this can cause foot swelling too.
Fortunately, foot swelling in pregnancy is temporary and should subside once you give birth.
If you’re pregnant and experiencing excessive swelling along with additional symptoms such as a severe headache, blurred vision, abdominal pain or less frequent urination, consult your doctor right away as these may be indications of preeclampsia, a potentially serious condition characterized by dangerously high blood pressure, per Keck Medicine of USC.
10. You Have Another Underlying Health Condition
"Swollen feet may be a sign of a systemic disease involving the essential organs," Dr. Lobkova says. For instance, heart, kidney or liver problems are prone to produce puffiness in your feet.
Heart Problems: If your heart doesn't work effectively, the veins in your lower limbs won't be able to pump blood back to your ticker. This is true of conditions like congestive heart failure (CHF), which happens when the lower heart chambers don't pump properly, Dr. Lobkoka says. With CHF, the failing heart can't do its job, causing blood to pool in the legs, feet and ankles, she says.
Kidney Problems: "Nephrotic syndrome is a kidney condition that stems from damage to the kidney's filtration vessels," Dr. Lobkova says. This damage decreases your kidney's ability to filter protein and water into urine, leading to fluid buildup in the feet. "Those with diabetes or autoimmune disorders are at greater risk for developing nephrotic syndrome," she says.
Liver Problems: "The liver is also involved in fluid maintenance in the body," Dr. Lobkova says. Liver disease, such as cirrhosis and nonalcoholic fatty liver disease, can create excessive pressure in the portal vein (the vein leaving the liver), which can trigger the legs to swell, she says.
“In the case where the heart, kidneys or liver is causing the swelling in the feet, the systemic issues need to be addressed to eliminate the edema,” Dr. Lobkova says. See your doctor who can properly evaluate you or refer you to a specialist for additional testing, diagnosis and treatment.
When to See a Doctor
"Foot swelling that persists despite efforts to reduce or resolve it should be taken seriously and evaluated by a medical specialist," Dr. Lobkova says.
Specifically, if you find that one foot starts to swell suddenly, seek immediate care as this could be a sign of a serious issue called deep vein thrombosis (DVT), she says.
DVT happens when blood clots form in the leg veins, preventing the return of blood to the heart, according to Harvard Health Publishing. If these blood clots dislodge and travel to the lungs, they can cause a serious, potentially life-threatening pulmonary embolism.
Other warning signs of a blood clot to watch out for include breathlessness and/or pain with breathing, per Harvard Health Publishing.
- Mayo Clinic: “Ingrown toenails”
- Mount Sinai: “Foot, leg, and ankle swelling”
- American Academy of Orthopaedic Surgeons: “Compartment Syndrome”
- National Health Service: “Swollen ankles, feet and legs (oedema)”
- Keck Medicine of USC: “6 Possible Reasons Why You Have Swollen Feet, Ankles or Legs”
- Harvard Health Publishing: “What’s causing those swollen feet?”
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.