Swollen Ankles After 60: What to Notice and When to Get Help

When to get help for swollen ankles

Call 911 if you have leg or ankle swelling along with shortness of breath, chest pain, coughing up blood, or fainting. These can be signs of a blood clot in the lungs.

Get medical care right away for new or worsening swelling in just one leg, sudden unexplained swelling, or swelling with redness, warmth, significant pain, or a fever. MedlinePlus guidance on ankle and leg swelling also advises contacting your care team right away if swelling worsens with known heart or kidney disease, or if you have liver disease and develop swelling in your legs or belly. If you cannot reach your care team promptly, seek in-person medical care.

Call your care team if swelling keeps coming back, persists, or gets worse. A familiar pattern is still worth bringing up. Keep notes if you can, and seek care right away if any of the warning signs above are present.

Is it one leg or both?

Swelling can come from extra fluid in the tissues, called edema. When you call, start with where you see the swelling. Is it around one ankle, both feet, or farther up a calf? Is one side noticeably different from the other?

When one leg is newly swollen, a clinician may check for an injury, an infection, or a blood clot in a deep leg vein. When both legs are swollen, the clinician may consider how the leg veins are working, whether a medicine could be involved, and whether a heart, kidney, or liver condition needs attention. The two patterns overlap. Where you see swelling is one clue alongside how it started, other symptoms, and an exam.

Does it change from morning to evening?

Maybe your shoes fit in the morning and feel tight after dinner. Prolonged standing or sitting can contribute to ankle and foot swelling. Problems with the leg veins can also make swelling more noticeable after time spent standing. Tell your care team if the swelling eases overnight, stays about the same, or extends farther up the leg.

Evening swelling can have several causes. A dent that stays after pressure on the skin is called pitting edema. If you have already noticed a dent, mention it. The time of day and the presence of a dent are details to report. A clinician can interpret them along with your other symptoms and health history.

Did a medicine change around the same time?

Write down when you started a medicine or changed the dose, and when you first noticed the swelling. Include over-the-counter products and supplements when you share your list. MedlinePlus lists medicines that can contribute to swelling, including some blood pressure medicines and anti-inflammatory pain relievers.

Ask the prescriber or pharmacist whether the timing matters and what else should be checked. Keep taking prescribed medicine as directed unless your prescriber tells you to change it. If urgent signs are present, get help right away even if a medicine changed recently.

A checklist for your call or visit

Save a screenshot, copy the list into your phone, or print it. Bring what you have. If you need urgent care, go ahead and get help.

• Where it is. Left, right, or both. Foot, ankle, calf, or farther up.
• When it started. Date if you remember. Sudden or gradual.
• What changes. Morning versus evening. What you were doing before it appeared and when it eases.
• What else you notice. Pain, warmth, skin color changes, or other new symptoms.
• What changed recently. A fall or injury, surgery, a long trip, or more time sitting or standing.
• What you take. Prescriptions, over-the-counter medicines, and supplements. Note any recent starts or dose changes.

MedlinePlus tips for preparing for a medical visit also suggest writing down your questions. You could start with “What should I watch for while you look into this?”

Watch the episode on swollen ankles

The episode walks through how clinicians use these clues and what to bring to your appointment. Watch the episode with chapters, or jump to the one-leg-versus-both chapter on YouTube.

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Frequently asked questions

Is it normal for ankles to swell as you get older?

Ankle swelling is common in older adults. Age alone tells you little about why it is happening. Call your care team if it persists, keeps returning, or gets worse.

Why would only one ankle swell?

An injury, infection, or vein problem can cause swelling on one side. Get medical care right away for new or worsening swelling in one leg. Call 911 if you also have trouble breathing or chest pain.

Why are my ankles more swollen at the end of the day?

Time spent on your feet or sitting for long stretches can affect when swelling is most noticeable. Let your care team know if it eases overnight and whether one side is more swollen. The pattern is a clue your clinician can use.

Can swollen ankles be a sign of heart failure?

Yes. Heart failure can cause swelling in the ankles, feet, and legs. Swelling has several possible causes, and an exam can help sort them out. If you already have heart disease and the swelling is getting worse, contact your care team right away. Call 911 if you also have shortness of breath or chest pain.

What is pitting edema in the legs?

Pitting edema is swelling that leaves a temporary dent where pressure was applied. It can occur for different reasons. If you notice it, tell your clinician where it happens and when you first saw it.