The ankle is that part of the body where the leg and the foot meet. It consists of three joints namely- talocrural, inferior tibiofibular joint, and subtalar joint. The functions involve dorsiflex (i.e. flexing up toward the body), plantarflex (flex down with toes pointing down), eversion (slight outward movement), and inversion (slight inward movement).
The ankle joint consists of three bones and plays an important part in human gait. Swollen ankles affect standing and walking as it gives rise to pain and difficulty in tolerating the weight. With various causes to address, the solution depends on underlying causes.
1.Pregnancy
Swollen ankles are normal during pregnancy as, during this period, the body starts accumulating fluids and fluctuating hormones. Simultaneously the developing uterus adds pressure on the veins going from the lower body to the heart.
Solutions involve using compression stalking, loose clothing, and sleeping on your left side to ease the pressure on the veins going to the heart. Majorly, pregnant women must reduce using their feet altogether.
2.Preeclampsia
Again, this occurs during pregnancy and is characterized by high blood pressure which causes higher protein retention in the urine, leading to swollen feet, ankles, arms, and legs. It mainly occurs in the later semesters of pregnancy and if left untreated can lead to a more serious condition called eclampsia.
Eclampsia involves seizures and can sometimes be fatal to both, the mother and child. The cause of preeclampsia and eclampsia is unknown but it is suspected that it is the consequence of a poor functioning placenta, poor nutrition, high body fat, and genetics.
3.Trauma
Ankle swelling is caused by injury or trauma to the foot or ankle, mainly sprained ankle. When certain ligaments that are supposed to stabilize the ankle are stretched more than their normal range, it causes trauma to the ankle. This can also lead to tearing of the ligament.
To help reduce this discomfort and swelling, one must rest, apply ice, use compression bandages, and elevation. Together, it is known as the ‘RICE’ regime. If no improvement is noticed or the pain becomes severe, medical attention is advised in order to stop the condition from getting worse.
4.Lymphedema
When the lymph vessels are hindered, the lymphatic fluids collect in tissues causing Lymphedema. The lymphatic fluid is rich in protein and the vessels are found all over the body.
The lymphatic fluid is filtered through the lymph nodes which trap and destroy foreign or unwanted substances like harmful bacteria. If either of these nodes or vessels are damaged, the fluid movement gets blocked. If and when left untreated, the accumulation of the lymphatic fluid will lead to impaired wound healing. Lymphedema is commonly found after radiation therapy or surgery involving the removal of lymphatic nodes.
5.Venous insufficiency
When the blood faces difficulty in flowing back to the heart, the condition that arises is called venous insufficiency. Valves in veins that are meant to stop the back-flow of blood when it moves upward, but in this condition the phenomenon doesn’t occur efficiently, leading to pooling of blood in the lower body. Thus, it arises swollen feet, ankles, and legs. A condition known as Varicose Veins where the veins get enlarged and filled with blood can also cause this ailment.
6.Clots
Clots lead to blockage of blood flow in veins. This prevents the blood from returning to the heart, causing swelling in the lower parts of the feet and ankles. In deeper veins, clots are known as deep vein thrombosis. Nevertheless, clots can also occur in superficial veins.
Blood clots can break, dislodge, and shift to major organs like lungs and heart as well. Swelling, pain, redness, warmth, and tenderness calls for medical attention at the latest.
7.Infection
A wound in or around the ankle area can lead to an infection. This is most common in diabetic patients with neuropathy (damage to nerves) who have a greater risk of infections.
Diabetics must practice foot care by addressing small wounds, blisters, or sores because due to nerve damage some sensations can go unnoticed until the infection spreads. If found, medical attention must be immediate.
8.Heart disease
It is understood that due to a weak heart, the blood does not get pumped effectively. The flow of blood is slow and the blood which needs to get to the heart also does not reach on time. This delay causes swelling in the ankles, legs, and feet. This phenomenon is called as the pooling of blood.
The second reason is water retention. Due to the inability of the heart to pump blood effectively, a counter mechanism of kidneys to filtrate sodium and water is challenged. This inability of the kidneys causes fluid retention and swelling.
9.Kidney disease
The kidney’s function is to excrete excess fluid and sodium from the body. When a kidney gets diseased, the retention of fluid and sodium increases, leading to swelling of the feet, ankles, legs, and even area around the eyes.
When the kidney gets damaged the nephrons and blood vessels get affected, causing leakage which causes fluid retention, Edema, and decreasing levels of proteins.
10.Iatrogenic
Iatrogenesis refers to any effect due to an activity, product, or service of a healthcare professional. Swollen ankles are caused by the side effect of medications that are found in hormone replacement therapy and oral contraceptives. Also, some types of blood pressure medications known as calcium channel blockers which include Nifedipine, Amlodipine, Felodipine, and Verapamil.
Other medications that can lead to feet and ankle swelling are steroids9 prednisone), antidepressants (tricyclics and monoamine oxidase inhibitors), non-steroidal anti-inflammatory drugs (NSAIDs) and diabetic medication If you suspect that medication is causing ankle selling, discuss alternatives and change in dosage with your doctor
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