The Center for Podiatric Care and Sports Medicine

Ten Surprising Factors to Foot and Leg Swelling

Posted by on Friday, August 9th, 2013


Edema in feet and legs is one of the top reasons people seek the help of a NY podiatrist. Sometimes the cause of swelling is something as simple as an insect sting or remaining seated for a long period of time. As the day wears on, it’s common for the legs and feet to swell larger than they were in the morning. Often, elevating the legs and feet above heart level, exercise or wearing support stockings can help. Yet, in other instances, foot and leg swelling is indicative of a larger problem.

1. Venous Insufficiency

Venous insufficiency often begins with the swelling of varicose veins and progresses to fluid leakage in the skin and subcutaneous tissue (edema) as the vein valves weaken and the body struggles to pump blood from the feet back up to the heart. In the chronic stages, little brown freckles appear all over the front of the legs, revealing the overabundance of iron in the tissue. At this point, skin changes, ulcers and infections are possible, so it’s important to see a surgeon about vein stripping surgery.

2. Congestive Heart Failure

People who have had coronary artery disease, a heart attack or hypertension may suffer from a weakened heart muscle that cannot pump the normal amount of blood out with each beat. Fluid backs up into the veins, causing cardiac edema. These patients are often put on a diuretic drug to regulate the chronic swelling.

3. Lymphedema

While rare, lymphedema is caused by abnormal lymph vessel function. When the flow of lymph fluid is blocked, it slowly accumulates in the deep tissue of the legs, leaving the legs feeling like wooden blocks. The swelling is very hard and goes up to the knees. With normal edema, you will leave an imprint where your finger pressed, but with lymphedema, you can feel fibrous scarring in the tissue. Unfortunately, this condition is incurable. It is, however, treatable through compression stockings, physical therapy exercises and massage. If left untreated, it can impair wound healing, causing infection and deformity.

4. Medications

Medications that may cause lower leg swelling and foot swelling include:

– Calcium channel blocker blood pressure medications (diltiazem, amlodipine, verapamil, procardia, adalat,  plendil)

– Beta blockers (metoprolol, inderal, labetalol,pindolol, carvedilol)

–  Hormones (estrogen, testosterone, hormone replacement therapy, birth control pills)

– Steroids (corticosteroids, prednisone, anabolic steroids, androgenic steroids)

– Antidepressants (nortriptyline, desipramine, amitriptyline, monoamine oxidase inhibitors, tranylcypromine)

– Diabetes medications (rosiglitazone, Metformin, pioglitazone, exenatide)

5. Diabetes

High blood sugar is one of the common causes of leg swelling and swollen feet. Diabetes often leads to nerve and circulation damage, which could lead to amputation if left untreated. For diabetics, it’s especially important to wear the right type of shoes that will provide adequate padding and protect the wearer from blisters that could turn into festering ulcers.

6. Cellulitis Infection

Cellulitis is a bacterial infection of the skin and underlying tissues. It can be caused by staph, MRSA, clostridium or another type of microbe. Symptoms include tenderness, swelling and redness. Often, patients will develop a fever with chills and sweats.  Scaly red patches often develop on the shins as well, which may give the impression of dermatitis. People with diabetes, HIV/AIDS, chemotherapy or radiation therapy treatments, athlete’s foot, eczema or psoriasis are more at-risk for developing this type of infection. Usually, it corresponds with a cut or break in the skin — but not always.

7. Blood Clot

Blood clots can form in the veins of the legs and halt returning blood flow to the heart. They can be life-threatening if the clots break loose and travel to the heart and lungs. Blood clot warning signs include: swelling in one leg, pain (especially upon standing), low-grade fever, redness and heat. Treatment with blood thinners is necessary to resolve the condition before it progresses.

8. Kidney or Liver Failure

Kidney or liver disease can also cause foot and ankle swelling. When the liver and kidneys are routinely exposed to harmful substances, the organs can become scarred and have trouble working normally. Symptoms include: abdominal pain, confusion, nausea, vomiting, bloody stools, weight loss and jaundice. This damage can be done by alcohol, hepatitis C, metabolic disorders, a poor diet, and certain medications. Lifestyle changes like cessation of alcohol and a salt-restricted diet are often the first steps for treatment. Diuretics and restricted fluid intake are also recommended in most cases.

9. Traumatic Injury

Ankle sprains, torn tendons and fractures are the most common swollen feet and swollen legs causes. Bruising and pain accompany the injury and it’s usually easy to pinpoint how the trauma occurred. However, chronic stress and overuse can lead to bursitis, tendonitis and ligament or muscle strains that cause swelling as well. Recent increases in training or activity level often signify these injuries. Casting and surgery is not always needed. In some cases, a little rest, ice, compression and elevation can work wonders at home.

10. Gout Arthritis

Gout is a disease resulting from the build-up of uric acid in the body. Tiny crystals of urate form in the joints, causing redness, swelling and tremendous pain. Obesity, weight gain, alcohol intake, high blood pressure, high fructose corn syrup, certain medications and abnormal kidney function can all be triggers of a gout attack. Treatments may include cherry juice, diet modification and medication.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.