The Cause of Swollen Ankles in the Elderly And What You Can Do

Did you know that swollen ankles in the elderly are incredibly common? While a normal response to an injury, this health concern should not be ignored and could be a sign of a serious illness or even a life-threatening condition.

What Causes Swollen Ankles In The Elderly?

The medical term for swollen ankles is edema, which occurs when fluid builds up in an area of the body. Edema in elderly adults can occur throughout the body but most commonly affects the lower limbs, especially the ankles. The swelling may occur in both ankles or only one.

Various factors can cause cause of swollen ankles in elderly (edema), including lifestyle, illness, or medication.

Lifestyle Factors

Lifestyle causes may be the easiest to identify and address. Common causes of swollen ankles in the elderly include a lack of exercise or movement, a diet high in salt, and being overweight.

Additional causes are:

  • Ill-fitting shoes
  • Exposure to heat
  • Exposure to high altitudes
  • Poor nutrition and food allergies.

Medical Causes

variety of medical conditions – some more serious than others – can lead to swollen feet and ankles in the elderly. Some of the most common include:

  • A damaged lymphatic system
  • Allergies
  • Arthritis
  • Congestive heart failure
  • Diabetes
  • Liver disease
  • Lung disease
  • Kidney disease
  • Infection
  • Inflammation
  • Poor circulation
  • Sleep apnea
  • Thyroid conditions
  • Varicose veins.

This list might look extensive, but gout and cellulitis account for a large percentage of edema cases in the elderly.

Gout is a rheumatic disease caused by high levels of uric acid in the blood. Uric acid is produced during digestion and is passed through the body as waste.

But sometimes there is too much acid, and it forms crystals in joints or connective tissues like the feet and ankles.

If you think gout may be behind your swollen ankles, try to cut back on your protein and alcohol consumption. Eating high-protein foods, especially seafood, can cause your body to make more uric acid.

Cellulitis is a skin infection caused by bacteria. While typically treatable, cellulitis can be dangerous for people with weakened immune systems or diabetes. The infection can be caused when bacteria enter the skin through a cut or insect bite.

The legs, ankles, and feet are common places where cellulitis strikes, and symptoms often include swelling, redness, and pain.

If you suspect cellulitis is causing your swollen ankles, visit your doctor for treatment. It’s important to stop the infection from spreading.

You can learn a bit more in the following video:

Medication Side Effects

Swollen feet and ankles are a side effect of hundreds of medications. The common types of medication that may be behind edema include:

  • Adrenergic agonists
  • Anti-arrhythmics
  • Antidepressants, including MAO inhibitors and tricyclics
  • Antihypertensives
  • Anti-inflammatories like ibuprofen
  • Beta blockers
  • Blood pressure medicine, also called calcium channel blockers
  • Chemotherapeutic agents
  • Diabetes medications
  • Hormones, especially estrogen and testosterone
  • Hypertensives
  • Narcotic medications like morphine and Vicodin
  • Nitrates
  • Steroids, including cortisone and prednisone

Also, switching medications or even modifying a dosage can lead to swollen ankles. If you think your medication is to blame, talk to your doctor before you stop taking it. Your doctor can work with you to find a medication that doesn’t lead to swelling.

What Treatment Methods Are Available?

Depending on the cause of your swollen ankles, a variety of treatment options are available. If circulation is the root cause, you can raise your legs above your heart when lying down or sleeping. You can also wear compression stockings to increase blood flow.

If lack of mobility is a concern, try incorporating exercises for your hips and legs, like standing hip extensions, ankle circles, and calf raises. Also be sure to move around on a daily basis. A good rule of thumb is to stand up for five minutes after every hour of sitting.

For those whose swollen ankles are caused by diet, try reducing your salt intake. It is also important to eat a diet rich in vitamins and minerals to ensure your body is receiving the nutrition it needs.

Eating a proper diet and exercising more will also help you maintain a healthy weight.

How Can You Prevent Ankle Swelling?

One great way to prevent swollen ankles in the elderly is to drink plenty of water, since water is a natural diuretic.

If you do not have gout, make sure you are getting enough protein and B vitamins in your diet. Also, try to avoid processed food and fast food, as these tend to be higher in sodium.

You can also massage your ankles when you first notice swelling. By putting pressure on the swollen area, your lymphatic system will spring into action to drain the fluid.

Are There Any Risks To Be Aware Of?

You may be at risk for swollen ankles if you are experiencing heart failure, hypertension, liver disease, or kidney disease. In these cases, lifestyle and diet modifications may not be able to reverse the condition.

If you are in the early stages of heart failure or kidney disease, talk with your doctor about ways to prevent your swollen ankles from getting any worse.

Do You Need To Be Concerned?

While common in the elderly, swollen ankles should not be ignored, especially if the swelling becomes a recurring issue. If you experience any changes in swelling and if your ankles are also red and painful, visit your doctor.

There is a wide range of causes, so it is best to visit a doctor so he or she can determine the cause, diagnose any underlying health concerns, and identify the best course of treatment.

What Should You Expect At The Doctor?

Be prepared to discuss your medical history and your symptoms. Your doctor will ask questions about the swelling, such as the timing, if you notice any improvement at certain times of the day, and if you have ever had blood clots or varicose veins.

Your doctor may also schedule some tests, including blood tests, x-rays, and ultrasounds.

Remember, swollen ankles in the elderly may not always be a serious threat, but it is important to understand the risks and the steps you can take to prevent and treat this common health concern.

Sean Byers, MD

Sean Byers, MD

Sean Byers is currently a Resident in the Internal Medicine program at UTMB. He studied at the University of Queensland School of Medicine as well as received his Master’s in Public Health with a focus in epidemiology and biostatistics at the University of Southern California. His background is in biology, computer science, public health, and internal medicine.

Recommended Articles


  • Causes and signs of edema,

  • Swollen Ankles in the Elderly, Terry Hurley,
  • Swollen Feet,
  • Foot, leg, and ankle swelling, ADAM Health Solutions,

  • Pedal Edema in Older Adults, Jennifer M. Vesely, MD, Teresa Quinn, MD, and Donald Pine, MD, 2015