Swollen Ankles and Feet (Oedema)
GP Review Primary Care Guidance
Swollen ankles or feet, known medically as oedema, are a common reason adults seek GP advice. Oedema can develop gradually or suddenly and may affect one or both legs. While many causes are straightforward, swelling can sometimes indicate an underlying medical condition that requires assessment. This page explains common reasons for ankle swelling, how GPs approach evaluation and when urgent review is needed.
These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.
What Oedema Is
Oedema refers to a build-up of extra fluid in the tissues, usually noticeable around the ankles, feet or lower legs. It may appear:
- Puffy or enlarged
- Worse by the end of the day
- Better after elevating the legs
- Indent (“pit”) when pressed, depending on the cause
Oedema itself is a symptom, not a diagnosis. Understanding the pattern helps guide what further checks may be needed.
Common Reasons for Swollen Ankles and Feet
1. Everyday or Positional Causes
These are common in healthy adults and often relate to reduced circulation in the legs:
- Standing for long periods
- Sitting for extended times (e.g. long car journeys, office work)
- Warm weather
- After long flights
- Mild venous insufficiency
You may also see dry, itchy or discoloured skin, sometimes called venous eczema, when swelling is related to vein issues.
2. Medication Side Effects
Several common medicines can cause ankle swelling:
- Calcium channel blockers (used for blood pressure)
- Some diabetes medications
- NSAIDs such as ibuprofen
- Steroids
- Hormone therapies or HRT
A GP can advise whether swelling may be linked to a medicine and discuss alternatives if needed.
3. Heart, Kidney or Liver Conditions
Oedema affecting both legs, especially when accompanied by symptoms such as breathlessness, fatigue or reduced urine output, may reflect a medical condition needing assessment, such as:
- Heart function problems
- Kidney disease
- Liver disease
- Low protein levels
These causes cannot be diagnosed at home and require GP evaluation.
4. Local Leg Conditions
Swelling may also result from:
- Varicose veins
- Lymphoedema (fluid build-up due to lymphatic system issues)
- Infection such as cellulitis
- Injury or inflammation around joints
- Blood clots
Severe Symptoms – Seek Urgent Help
Seek urgent same-day care or call emergency services if swelling occurs with any of the following:
- Sudden or severe breathlessness
- Chest pain or pressure
- A painful, red, hot or swollen calf (possible DVT)
- Rapidly increasing leg swelling
- Swelling with fever or signs of infection
- Swelling during pregnancy, especially with headache or visual disturbance
- Confusion, dizziness or feeling faint
- New swelling after a long flight or immobilisation
These symptoms may signal a serious condition and require immediate assessment.
When to Speak to a GP
You should book a GP review if you notice:
- New swelling without a clear explanation
- Swelling in both legs that is not improving
- Swelling that persists for more than a few days
- Swelling with breathlessness, reduced exercise tolerance or fatigue
- Swelling associated with a new medication
- Recurrent swelling, dry skin or a rash consistent with venous eczema
- Swelling that interferes with walking or daily life
Even if symptoms seem mild, a GP assessment can help clarify the cause and determine what tests may be helpful.
How GPs Assess Ankle Swelling
A GP will consider:
History:
- When the swelling started and how it fluctuates
- Whether one or both legs are affected
- Travel history, periods of immobility or heat exposure
- Medications, alcohol intake and medical history
- Presence of breathlessness, weight changes or urinary symptoms
Examination:
- Blood pressure and heart examination
- Lung examination
- Checking for pitting oedema, skin changes or venous eczema
- Assessing varicose veins
- Checking for signs of DVT or infection
Investigations (if needed):
- Blood tests (kidney, liver function, albumin, thyroid)
- Urine tests
- ECG
- BNP blood test if heart function is suspected
- Ultrasound or echocardiogram depending on symptoms
A tailored plan is then made based on the most likely cause.
Lifestyle Measures That May Help (Alongside GP Advice)
These are general measures and may or may not apply depending on the cause:
- Gentle walking or calf exercises
- Taking breaks from prolonged standing or sitting
- Elevating the legs
- Maintaining hydration
- Skin care for dryness or venous eczema
Further Reading and Hub Links
Visit our Heart Health hub or browse more health topics in the AccessGP Knowledge Base.
If you would like a GP review, you can book an online consultation at a time that suits you.
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Updated: 10 December 2025