Varicose veins frequently cause swollen ankles, a condition medically known as edema. These enlarged, twisted veins, most often seen in the legs, develop when the small, one-way valves inside the vessels become weakened or damaged. This valve malfunction prevents blood from flowing efficiently back toward the heart, leading to blood pooling and increased pressure within the veins of the lower legs and feet. This increased pressure forces fluid out of the vessels and into the surrounding tissues, causing swelling, especially in the ankles where gravity’s effect is strongest. This localized fluid retention is often one of the first physical symptoms of underlying vein issues, causing discomfort, a feeling of heaviness, and visible puffiness in the lower extremities.
The Mechanism: Varicose Veins and Venous Insufficiency
The circulatory system relies on one-way valves within the leg veins to push deoxygenated blood upward, counteracting gravity. These valves open to allow blood flow toward the heart and then close immediately to prevent backflow, a process aided by the contraction of surrounding leg muscles. When these valves become incompetent, they fail to close completely, leading to chronic venous insufficiency (CVI). Blood begins to pool, or reflux, in the lower sections of the vein, causing the vessel to stretch and become varicose.
This pooling significantly increases the hydrostatic pressure inside the affected veins, particularly when standing for long periods. The sustained high pressure forces the liquid component of the blood to leak out of the capillaries and into the interstitial space—the tissue surrounding the veins. This accumulation of excess fluid outside the blood vessels causes the noticeable swelling, or peripheral edema, most commonly observed in the ankles and feet. The swelling is often worse at the end of the day because gravity has been pulling the fluid downward.
Immediate At-Home Relief for Swollen Ankles
Simple steps can provide immediate relief from the discomfort and puffiness of ankle swelling associated with varicose veins. Elevating the legs is one of the most effective methods, as it uses gravity to assist in draining pooled fluid back toward the trunk. Aim to raise your feet above the level of your heart for 15 to 30 minutes, several times throughout the day, which significantly reduces pressure within the leg veins.
Wearing compression garments is another self-care strategy, as these stockings apply external pressure to the legs, helping the veins and leg muscles push blood upward. Over-the-counter options offer mild pressure (e.g., 8–15 mmHg), but a healthcare provider can prescribe higher-pressure stockings (e.g., 20–30 mmHg) for more severe swelling. Regular, low-impact exercise, such as walking or calf raises, also helps by activating the calf muscles to encourage blood flow and prevent pooling. Reducing your daily intake of sodium can minimize fluid retention throughout the body, lessening the volume of fluid available to accumulate in the ankles.
When to Seek Professional Diagnosis and Treatment
While mild, symmetrical swelling that improves overnight is a typical symptom of varicose veins, certain signs indicate the need for prompt medical evaluation. Sudden, severe, or painful swelling, especially if it occurs only in one leg (unilateral), can signal a serious complication like Deep Vein Thrombosis (DVT). DVT involves a blood clot forming in a deep vein, and if accompanied by skin warmth, redness, or shortness of breath, requires immediate attention.
A healthcare provider will perform a physical examination and may order a venous Doppler ultrasound to assess blood flow in the leg veins. This non-invasive test confirms venous insufficiency and can detect any blood clots. If varicose veins cause persistent swelling and discomfort, definitive treatments are available to close or remove the faulty veins. Minimally invasive options include endovenous thermal ablation using laser or radiofrequency energy, and sclerotherapy, where a solution is injected to close the vein.