Easing summer swelling

Tips to help you reduce puffiness in your feet and ankles and learn to recognize when it might be a sign of something more serious.

It’s hot, you’ve been on your feet all day, and you know what’s coming — uncomfortably swollen feet and ankles. This common problem is not unexpected if you spend a lot of time on your feet, particularly during the summer months.

"It becomes more common as you age because some of the conditions that cause it tend to occur as you get older," says Dr. Jennifer Cluett, a doctor of internal medicine at ­Harvard-affiliated Beth Israel Deaconess Hospital.

Understanding edema

Lower leg and foot swelling is most often the result of an abnormal fluid buildup. Doctors call it edema. Because fluid flows downhill, it pools in the lowest parts of your body.

Excess fluid retention can be triggered by many things, including eating too much salt, heat, drinking alcohol, or standing for a long period of time.

You might be more prone to swelling if you are older, overweight, or have a condition that is increasingly common with age, called venous insufficiency, in which the veins in your leg have difficulty pushing blood against gravity back toward your heart.

Certain medications may also cause edema. The more common culprits are antidepressants, steroids, some types of blood pressure medications, and hormones, like those found in postmenopausal hormone therapy or birth control pills. Medications are a common cause, says Dr. Cluett, an assistant professor at Harvard Medical School.

"Medication-associated swelling usually goes away when the medicine is stopped or the dose is lowered," she says.

 But even if you suspect that a drug you are taking is at the root of your edema, always consult your doctor before you stop taking it.

Swelling is sometimes triggered by a medical problem, such as a blood clot in your leg, an infection, an injury, or — less commonly — heart, kidney, or liver failure.

Signs of trouble

While in most instances, swelling has a harmless cause, signs that it should be brought to the attention of your doctor include the following:

Swelling develops in only one leg. "In general, asymmetric swelling is often a red flag that there is something more going on," says Dr. Cluett. "Certainly, serious things can cause swelling in both legs, but when a single leg swells, it really suggests something local affecting only one leg, such as an infection, a blood clot, or an injury."

The change is sudden. Another thing to look out for is if the change in swelling is abrupt or different from what you typically experience.

Swelling is accompanied by other symptoms. You should also call your doctor if in addition to swelling you have redness and pain, a fever, shortness of breath, chest pain, or pressure.

Treating edema

If your edema is not caused by a medical problem, there are some at-home strategies that you can use to get some relief.

Cut down on your salt intake. Sodium can cause your body to retain water, so focus on eating less of it. You can achieve this both by putting away the salt shaker and by carefully reading labels to avoid high-sodium foods.

Put your feet up. If you have a few minutes, elevate your feet above your heart when you are seated or lying down. This can help reduce swelling, as can putting a pillow under your feet at night while you sleep.

Wear support stockings. If you have venous insufficiency, wearing support stockings, which provide pressure to the veins in your legs to help move blood back up toward the heart, can help reduce swelling.

Get moving. Exercises such as walking, moving your ankles, and stretching can also reduce swelling by helping to push blood back toward your heart.

Prevent related problems. Chronic swelling leads to skin problems in some instances. "Taking good care of your skin will reduce your risk of infection. Use moisturizers to prevent dry, cracked skin that can be a portal for infection," says Dr. Cluett.