Having swollen feet is not necessarily alarming and can be due to entirely benign causes. However, in some cases, this symptom should raise concern and warrant a medical consultation. Discover here the main reasons explaining foot swelling and the warning symptoms to monitor.
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Swollen Foot: What are the Reasons?
- Swelling of both feet: the causes
- How can we explain the swelling of just one foot?
- Other causes of swelling in one or both feet
- Swelling in the foot or feet: a summary of causes
- Sources
Swelling of both feet: the causes.
Most commonly, we observe a similar swelling of both feet that can interfere with daily life. There are quite a few reasons that can explain this:
Sedentariness : Most commonly, foot edema is due to a lack of physical activity. When one remains seated or in a static position for extended periods, blood and lymph tend to accumulate in the lower limbs of the body. Conversely, when the leg muscles are active, they contract and relax, acting like a pump that pushes fluids towards the heart, thereby reducing the risk of swelling.
Obesity : Similarly, obesity can cause or contribute to swelling of the feet. The veins in the lower limbs, whose role is to transport blood back to the heart, are no longer as efficient due to the additional weight pressing on them from the abdomen.
Hormonal fluctuations : Hormonal changes during pregnancy or throughout the menstrual cycle can also be responsible for edema in the feet. Indeed, estrogen, a hormone whose synthesis greatly increases during pregnancy and whose quantity varies throughout the menstrual cycle, acts primarily by binding to nuclear receptors ER-α and ER-β. In doing so, it triggers a cascade of reactions involving the intensification of the production of intracellular cyclic adenosine monophosphate (cAMP). This, in turn, plays a role in the regulation of nitric oxide (NO) synthesis, a vasodilator.
An Endocrine System Disorder : An overactive or underactive thyroid gland can cause swelling or thickening of the skin on the shins and ankles, often hard and waxy in appearance. As a reminder, this organ located in the neck produces the thyroid hormones thyroxine and triiodothyronine, which play a role in regulating calcium metabolism. Found in the blood, calcium is necessary for the proper functioning of blood circulation.
Cushing's Syndrome : This disease, in which the adrenal gland produces an excess of steroid hormones, can be responsible for swelling in both feet. Besides this swelling, patients with Cushing's Syndrome typically exhibit other characteristics of the condition, such as changes in skin texture, facial roundness, and the appearance of a hump of tissue at the back of the neck.
Heart Failure : When the heart is weakened, it fails to pump enough blood. This causes the blood to back up into the veins, leading to an increase in pressure that pushes fluid into the tissues. The blood then tends to pool in the lower extremities, particularly in the feet, resulting in edema. In addition to swelling, patients suffering from heart failure typically experience rapid shortness of breath during exertion.
The use of certain medications : Medications are another common cause of swelling in the feet and legs. This discomfort can be observed with calcium channel blockers, such as amlodipine or nifedipine, non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, gabapentin, oral contraceptives, prednisone, or with medications used to combat diabetes like thiazolidinediones.
Heat : It is more common to observe swelling of the feet during the summer period. Indeed, when it is hot, the blood vessels expand to help dissipate body heat, which increases blood flow to the extremities and results in an accumulation of blood and fluids in the feet and ankles. This vasodilation, although necessary for the regulation of body temperature, directly contributes to the swelling of the feet. Moreover, high temperatures increase the permeability of the capillaries, allowing more fluids to escape from the blood vessels into the surrounding tissues.
The wearing of narrow shoes : By exerting constant pressure on the feet, narrow shoes can cause local inflammation, resulting in swelling of this part of the body. Moreover, ill-fitting shoes can compress the feet and toes, thereby limiting blood flow to and from the feet. This compression of the blood vessels impedes normal circulation, which can lead to an accumulation of blood and fluids in the feet, exacerbating the swelling.
How can we explain the swelling of just one foot?
Less commonly, swelling may affect only one of the two feet. The causes of this peculiarity are then different:
Venous Thrombosis : The presence of a blood clot in the veins of the ankle leads to swelling of the foot. This swelling appears quickly, within a few hours to a few days, and causes the patient severe pain and intense redness. Venous thrombosis is caused by a combination of factors: stagnation of blood flow, vein injuries, genetic predispositions... It is most often observed in patients who have undergone major surgery or significant foot trauma. Urgent medical attention is necessary as soon as a blood clot is suspected.
Infectious Cellulitis : Not to be confused with adipose, aqueous, and fibrous cellulitis, infectious cellulitis is an acute bacterial infection of the skin and subcutaneous tissues caused by streptococci or staphylococci. It is recognized by the erythema, edema, and pain it causes. Infectious cellulitis is more commonly found in individuals suffering from diabetes or other chronic diseases, but it can also occur in healthy individuals if a cut or scrape allows bacteria to penetrate the tissues. It is treated with antibiotics.
A Sprain : More benign, a sprained ankle can also cause swelling of the foot. From a biological perspective, a sprain is due to trauma to the ligaments supporting a joint. It is caused by a sudden and violent movement, accompanied by a twist. Resting the foot for a few weeks is usually enough to completely heal the sprain.
Other causes of swelling in one or both feet.
Depending on the situation, certain factors may cause swelling in one or both feet:
Venous Hypertension : This issue arises when the veins widen and the valves that prevent blood reflux can no longer close properly. The blood can then no longer return to the heart and stagnates in the legs and feet. The excess blood causes high pressure in the veins, which in turn causes fluid to leak into the tissues. Patients suffering from venous hypertension frequently develop varicose veins, that is, bulging and twisted veins appearing blue-purple. To control the swelling, wearing compression stockings may be sufficient, although outpatient care is sometimes necessary.
Lymphedema : Another vascular cause of foot swelling, lymphedema results from a deterioration of the lymphatic vessels. These vessels normally aim to absorb excess fluid trapped in the tissues. They are also involved in the body's functions to fight against infections. As soon as the first signs of lymphedema appear, it is necessary to implement a treatment to prevent it from becoming chronic. The most common treatments are lymphatic drainage and the wearing of compression socks.
Swelling in the foot or feet: a summary of causes.
Swelling of both feet | Swelling of a single foot | Swelling of one or both feet |
---|---|---|
Sedentary Lifestyle | Venous Thrombosis | Venous Hypertension |
Obesity | Infectious Cellulite | Lymphedema |
Hormonal Fluctuations | Sprain | |
Endocrine System Disorder | ||
Cushing's Syndrome | ||
Heart Failure | ||
Medication Intake | ||
Heat | ||
Wearing narrow shoes |
When the cause is benign, fortunately there are several tricks that can help reduce foot swelling.
Sources
WOLFE J. & al. The Swollen Leg. ABC of Vascular Diseases (1991).
EBELL M. & al. Approach to Leg Swelling of Uncertain Cause. The Journal of the American Board of Family Medicine (2006).
RATCHFORD E. & al. The Swollen Leg. Society for Vascular Medicine (2016).
YANAGISAWA N. & al. Treatment of Leg and Foot Swelling in Women. Women's Health Open Journal (2017).
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