The ankles and legs are common sites of swelling because of gravity’s effect on the fluids in the human body. However, fluid retention from gravity is not the only cause of a swollen ankle or leg. Injuries and subsequent inflammation can also cause fluid retention and swelling. A swollen ankle or leg can cause the lower part of the leg to appear larger than normal. The swelling can make it difficult to walk. It may be painful, with the skin over the leg feeling tight and stretched out. While the condition is not always a reason for concern, knowing its cause can help rule out a more serious problem.
Signs & symptoms
Swelling in the ankles & feet
Difficulty to walk
Ankle joint pain
Causes
- Foot or ankle injury
- Cellulitis
- Side effect of certain medications
- Chronic venous insufficiency
- Blood clots
- Pregnancy
- Preeclampsia
- Lymphoedema
- Obesity
- Heart failure
- Kidney failure
- Venous insufficiency
- Leg infection
- Liver failure
- Gout
- Arthritis
Pathophysiology
Oedema results from increased movement of fluid from the intravascular to the interstitial space or decreased movement of water from the interstitium into the capillaries or lymphatic vessels. The mechanism involves increased capillary hydrostatic pressure.
Physical examination
Medical history
Blood examination
Urine examination
X ray
Treatments
Mild swelling from pregnancy or a mild injury usually goes away on its own after delivery of the baby or with sufficient rest.
Diuretics are used in congestive heart failure, which affect the kidneys and stimulate them to release fluids.
Symptomatic treatment is needed in rheumatoid arthritis.
Bone resetting, a cast, or surgical repair is needed in injury.
Anti-inflammatory medication, such as ibuprofen (Advil) or naproxen sodium (Aleve) are used in swelling with pain.
Prognosis
Prognosis depends upon the cause. Swollen ankles can develop due to long time sitting etc, but they can also indicate a potentially serious disorder, such as congestive heart failure, deep vein thrombosis, and liver failure. So, it is important to get a proper diagnosis.
Complications
- skin ulcers and infection.
- Deep vein thrombosis,
- increased swelling
- redness or warmth
- sudden and severe pain
- chest pain lasting for more than one to three minutes
- fainting or dizziness
- confusion
Disease & Ayurveda
Paadasopha/gulphasopha
Nidana
Causative factors for the vitiation of Vaata and Kapha
Chronic systemic diseases or Fasting can cause ksheena in a person.
This tired/emaciated person when subjected to –
- Excessive usage of Guru, amla, snigdha, seta, lavana, kshaara, teekshna, ushna
- Saaka (leafy vegetables)
- Ambu (water intake)
- Swapna-jaagaram (sleep and wake up schedule)
- Mrith (soil)
- Graamyamaamsam (meat of domestic animals)
- Vallooram (dried meat)
- Ajeerna (indigestion)
- Sramam (exertion)
- Maithunam (sex)
- Padaathe margagamanam kshobhinaa yaanena vaa (pedestral travelling or travelling by shaky vehicles)
- Swaasakaasaathisaararsojatharapradarajwaraa: – asthma & other breathing disorders, cough, diarrhoea, piles, ascites, leucorrhoea or other bleeding disorders, and fever
- Vishoochika-alasaka chardi garbha visarpa paanduta – (disorders of delayed digestion, vomiting, pregnancy, herpes, and anaemia)
Purvaaroopa
Not mentioned separately
Samprapti
Due to the causative factors, the vitiated doshas travel along the channels in the body. When they get lodged in the ankle joint, they produce oedema there.
Lakshana
Sopha in gulpha – oedema of ankles
Divisions
- Nija
- Aagantu
- Sarvangajam
- Ekangajam
- Prithu
- Unnatam
- Grathitam
- Vaatika
- Paittika
- Kaphaja
- Samsargaja
- Sannipaataja
- Abhighaataja
- Vishaja
Prognosis
Saadhya in new cases without complications
Chikithsa
In oedema other than that due to an injury, fasting should be observed according to the strength of the patient. Then after light food intake, pratisarana choornas should be given in warm water. If the doshas are highly vitiated, gomootrahareetaki should be given for cleansing the body. After proper cleansing and enhancing digestion, medications are given for rakta suddhi and srotovisodhana.
In oedema due to injury, raktamoksha, ghritapaana, lepana with cold potency drugs, and virechana should be administered.
Samana
Lepanam with Rookshana dravyas
Swedanam
Sodhana
Virechanam
Raktamoksham
Commonly used medicines
Punarnavasavam
Chandraprabhavati
Gokshuradi guggulu
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
To treat a swollen ankle or leg at home, remember the acronym RICE:
- Rest. Stay off your ankle or leg until you can get to the doctor or until the swelling goes away.
- Ice. Put ice on the swollen area as soon as you can for 15 to 20 minutes. Then repeat every three to four hours.
- Compression. Wrap your ankle or leg snugly, but be sure not to cut off circulation. Support stockings may be an option.
- Elevation. Raise your ankle or leg above your heart (or as far above your heart as possible). Two pillows will usually give you the correct elevation. This encourages fluid to move away from your leg.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Drink enough liquids
Light meals and easily digestible foods
Green gram, soups, honey
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active. Avoid continuous standing,
Yoga
Regular stretching and mild cardio exercises are advised in cases of mild swelling with no restriction of movements. Proper circulation of body fluids is very important in the management of oedema. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Yoga for swelling in feet
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://www.ncbi.nlm.nih.gov/books/NBK53445/
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
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