Swollen Ankles in the Elderly

Reviewed by Terri Forehand RN
Swollen ankle

Although swollen ankles in senior citizens are considered a common problem, it should never be taken lightly as it could be a sign of a life-threatening illness. Make sure you are aware of some of the most common causes and treatment available for swollen ankles.

Swollen Ankles: A Common Occurrence in the Elderly

Many older seniors experience swollen ankles. The swelling can occur in both ankles or just one and is caused by fluid that accumulates in the soft tissues surrounding the ankle or in the joint of the ankle itself. The swelling is often caused when an individual stands for too long, eats too much salty food or sits for extended periods without exercising the legs, such as when traveling in an airplane or car. Although swollen ankles are common in older people, it is very important to have a medical professional determine the cause of the swelling.

Edema: The Most Common Cause

In the general population, swollen ankles are often caused by edema, which is the most common cause in elderly individuals. Edema simply means that excess water accumulation in the body causes swelling of the soft tissues under the skin. When the swelling is of the extremities, such as the ankles or feet, it is called peripheral edema.

Edema is classified as either pitting or non-pitting. In pitting edema, an indentation remains in the area of the swollen ankle when light pressure is applied with a finger. The pitting can occur from other things such as wearing socks with elastic. If the edema is non-pitting, a depression does not remain in the skin when light pressure is applied with a finger.

There are more than a hundred medical conditions that can cause swollen ankles in elderly people. Some of the causes are much more serious than others. The following is a list of some of the more common medical conditions that can cause peripheral edema:

  • Congestive heart failure
  • Cirrhosis of the liver
  • Kidney disease
  • Poor circulation
  • Varicose veins
  • Inflammation of the deep veins called thrombophlebitis
  • A damaged lymphatic system
  • Thyroid conditions

Many types of medications can also cause Edema. In fact, the number of medications that can cause this problem is well over 1,000. Swollen ankles often result from an individual changing from one kind of medication to another or from changing the dosage amount of a medication.

The following are some of the medication categories that can cause swollen ankles:

  • Calcium channel blockers
  • Beta-blockers
  • Nitrates
  • Antihypertensives
  • Anti-arrhythmics
  • Diabetes medications
  • Hypertensives
  • Adrenergic agonists
  • Anti-inflammatories
  • Narcotic medications
  • Chemotherapeutic agents

More Causes of Swollen Ankles in the Elderly

There are several other issues that could potentially cause swollen ankles.

Gout

Gout is a rheumatic disease that occurs when uric acid forms into tiny needlelike crystals in joint spaces and/or connective tissue. When the crystal deposits form in the ankle joints or the soft tissue around the ankle, pain, stiffness and swelling occur.

Injuries to an Ankle

Elderly individuals that injure their ankle in some way often have swelling. This occurs with the following types of ankle injuries:

  • Broken ankle
  • Sprained ankle
  • Ankle strain
  • A fractured ankle that is not detected
  • Reinjuring a previous ankle injury

Cellulitis

Caused by a bacterial infection such as staphylococcus or streptococcus, cellulitis is generally a treatable condition. However, it can also be very dangerous, especially for people with a compromised immune system or those who have diabetes. It is very important to get prompt treatment to stop the spread of infection as soon as possible. Common locations for cellulitis to occur are the legs, ankles and feet. Symptoms include swelling, redness and pain.

Additional Possible Causes

  • Wearing shoes that do not fit properly
  • Anemia
  • Improper diet
  • Insect sting or bite
  • Tendinitis in the ankle
  • A blood clot or other vascular obstruction

Possible Treatment

The type of treatment that is best for swollen ankles is dependent on the illness or cause of the swelling. However, some of the ways you can try to alleviate the swelling include:

  • Elevate the legs when lying down
  • Reduce salt intake
  • Wear support stockings
  • Increased exercise and activity
  • Medication prescribed by a Physician

Be Cautious

Although swollen ankles in the elderly occur often, the problem should never be ignored. It is best to be cautious and have a medical professional diagnose the underlying cause of the swelling. Once the cause is known, the senior can begin proper treatment for the condition, whether that means treating a medical condition of which the swelling is a symptom, or simply reducing time spent standing or sitting without intermission.

Swollen Ankles in the Elderly