What Causes Swollen Ankles in Men?
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December 6, 2011, last updated March 7, 2013

By Alison Turner, Contributing Columnist
[Health and fitness articles are reviewed by our team of Registered
Nurses and other members of our Editorial Board]








In men, especially men who are active in sports,
occasionally swollen ankles are a fairly common occurrence.

But, once you've ruled out sports injuries as a cause, what
other medical conditions can cause swollen ankles in men?
In particular, are swollen ankles in men a sign of prostate
cancer?


Why Do My Ankles Swell At Night?

The National Institutes of Health explains that the answer
to this question is quite simple: gravity.   If there is extra
swelling or fluid in the body, by the end of the day it would
gather farther down rather than up.  Tricks to try to
prevent swelling include following a low-salt diet, wearing
compression socks, and exercising your legs to pump fluid
back to the heart (particularly during long periods of
sitting).  If you find that your ankles are particularly
swollen in the morning, try to keep your legs raised while
you sleep. (Read more about
causes of swollen ankles in
general and suggested remedies.)

If none of the above ideas deflates your swelling ankles to
their proper size, there may be something more serious
going on.  Check the list below for 10 possible causes of
ankle swelling in men.





























1.        
Prostate Cancer Can Cause Swollen Ankles.  

Prostate cancer offers an array of symptoms and
complications to its patients, one of which can cause
swelling in the ankle: lymphedema.  Lymphedema is the
build-up of fluid in fatty tissue just under the skin, resulting
in swelling, most often occurring in the arms or legs.  It
arises either directly after surgery, which usually goes
away after a few weeks, as well as from radiation
treatment, which is the more common method, and usually
does not show up for months to years after treatment for
prostate cancer.   

The American Cancer Society recommends that to lessen
the likelihood of lymphedema symptoms, people with
prostate cancer should avoid infections and burns, as these
events cause the body to make extra fluids. For lympedema
in the legs, including the ankles, well-fitting, close toed
shoes are advised rather than sandals and slippers, as well
as maintenance of the toe nails to avoid ingrown nails.  You
should also avoid pressure around the ankles and legs by
avoiding socks with tight elastic bands, not crossing your
legs when you sit, and wearing compression stockings
during long flights (or other lengthy periods of sitting).

In 2008 several doctors from the Irvine Vascular Lab in the
Department of Biomedical Sciences at Chieti-Pescara
University in Italy, including Dr. Gianni Belcaro,  evaluated
the long term effects on edema in patients with
lymphedema after tissue implants.  The patients relevant to
the study had been treated with a lymphatic tissue implant
from ten years prior to the study, which was harvested
from the same patient in an area unaffected by
lymphedema.  They found that the volume of limbs infected
with lymphedema that were treated with a tissue transplant
decreased nearly 80% over all after ten years.  They
conclude that their work “proposes a new, minimally
invasive method to improve lymphedema.” Perhaps swollen
ankles will soon be one less thing a prostate cancer patient
has to worry about.

2.        
High Blood Pressure Can Cause Swollen Ankles in
Men.  

If your blood pressure is high it means that your heart
works harder than it needs to in order to pump blood
throughout your body.  After several years this extra work
can lead to a thicker heart muscle, which is then even less
effective at pumping blood.  As a result, blood is allowed to
build up in lower legs and ankles, causing swelling.   While
this may seem like an inconvenience at first, ankle swelling
from high blood pressure could lead to more serious
problems, such as skin infections or ulcers on the outer
layers of the skin.

While there are several options available to try to treat high
blood pressure in general, including diuretics which may
help remove excess fluid, in 2010 several researchers at the
Department of Internal Medicine and Therapeutics at the
University of Pavia in Italy studied ways to alleviate ankle
swelling in particular.  

Led by Dr. Robert Fogari,  the study records the
effectiveness of three medications for high blood pressure,
valsartan, olmesartan, and amlodipine , on alleviating ankle
edema (swelling).  After testing 74 adult patients with high
blood pressure, they found that the combination of both
olesartan and amlodipine or valsartan and amlodipine
reduced ankle edema, but that the latter couple showed
positive results that were more ¨pronounced.¨ Good to
know that if nothing seems to relieve your high blood
pressure, you may nevertheless be able to relieve the fluid
that gathers in your ankles. (Read more about
natural
remedies for high blood pressure.)

3.        
Heart failure Can Make Your Ankles Swell.  

Heart failure is not necessarily as terrifying as it sounds,
which is relieving in that it affects an estimated 5.7 million
Americans.  

Rather than indicating that the heart has stopped, the term
"heart failure" indicates that either the left ventricle does
not pump with enough force (systolic heart failure), or that
the ventricles do not relax enough to allow proper filling
(diastolic heart failure).   In either case of heart failure,
blood moves too slowly to meet the body´s needs, and
sometimes the kidney responds by retaining fluid and
sodium.  When this happens, there may be swelling in the
ankles, as well as in the abdomen and legs.  

Other symptoms of heart failure may include
shortness of
breath, coughing and wheezing, confusion, and frequent
need to urinate at night – though sometimes people with
heart failure do not experience any symptoms. (Read other
causes for
shortness of breath.)

There are a number of factors that could damage the heart
muscle and lead to heart failure, such as coronary artery
disease, a heart attack, heart defects from birth, high blood
pressure and obesity.  Because there are so many different
causes, it is important to speak with your doctor about
your individual case in order to properly manage the
disease.  Treatment may include medications, diet and
lifestyle changes, depending on your particular situation.  
(Read more about the
signs of heart failure.)

4.        
Rheumatoid arthritis.  

Rheumatoid arthritis (RA) is a disease in which the immune
system attacks the body´s own tissues rather than viruses
and bacteria like it is supposed to.  These attacks cause
fluid build up in joints throughout the body, leading to pain
and inflammation.   

The most common symptoms of rheumatoid arthritis are
foot pain, swelling and stiffness:  The American Academy of
Orthopaedic Surgeons reports that nearly 90% of people
who have RA eventually develop symptoms in their ankles
or feet.

Unfortunately, rheumatoid arthritis is a disease whose both
cause and cure are currently unknown.  Some people
experience periods of intense symptoms, known as flares,
while others enjoy remission, a time with no disease
activity.   For some patients pain can be controlled through
medication, exercise, special shoes, various types of
crutches, and, in some cases, surgery.

Hope for a new medication for rheumatoid arthritis comes
from the labs of experts in various institutions throughout
Massachusetts, Arizona and Pennsylvania in 2008, including
Dr. A.B. Rogers with the Division of Comparative Medicine
at the Massachusetts Institute of Technology.   These
researchers analyzed the role of methionine
aminopeptidase type-2 (MetAP-2 for those of us who are
out of biological practice), a protein that is partially
responsible for the regulation of protein synthesis, among
other roles.   The team orally administered MetAP-2 to rats
that were previously induced with arthritis.  

Ankle swelling was ¨completely alleviated¨ in the rats with
arthritis, encouraging the researchers to propose that
MetAP-2 may be a future treatment for humans with
rheumatoid arthritis. (Read more about
foods that help
reduce the swelling and pain of arthritis.)

Other inflammatory types of arthritis that affect the foot
and ankle and may cause swelling are psoriatic arthritis,
ankylosing spondylitis and Reiter's syndrome.

5.       
 Thrombophlebitis.  

If our blood hardens into a solid somewhere in our body it
creates what is known as a  
blood clot, which, if left
untreated in a vein, may create swelling that is also known
as thrombophlebitis.   In addition to swelling, the affected
part of the body (including the ankle) may appear red, and
be tender and warm.

Thrombophlebitis can occur for a number of reasons,
including long terms of hospitalizaion, long periods of
sitting, and certain disorders that could make you more
susceptible.  Pain killers, antibiotics, blood thinners, anti-
inflammatory drugs, stockings or wraps to alleviate
discomfort, and keeping pressure off of the affected area
are all treatment options.

One of the above risk factors listed above may apply to
many of us: long period of sitting could be, say, an
overseas flight.  In 2005 a study by several Italian experts
including Dr. M. Cesarone with the Department of
Biomedical Sciences at L´Aguila University,  studied a
possible prevention of precisely this situation.  Using data
from 211 long distance flyers, they found that those who
orally consumed Pycnogenol, an anti-edema drug produced
by Horphag in Geneva, experienced significantly less
swelling than those who did not ingest the drug.  The team
concludes that Pycnogenol creates a ¨positive effect¨ an
ankle swelling during long flights, without producing any
recorded side effects. (Read more about
deep vein
thrombosis.)

6.        
Ankylosing Spondylitis Causes Swollen Ankles
Predominantly in Men.
 

This is a long-term disease resulting in inflammation in the
joints between the spinal bones, eventually causing the
spinal bones to join together.  It usually affects people
between 20 and 40, and is more common in men; while
genes seem to play a role, the cause is unknown. Though
the disease begins with intermittent lower back pain, you
may also experience fatigue, heel and/or hip pain, loss of
appetite, fever, and joint swelling and pain in the shoulder
knees and ankle .  

Treatment for ankylosing spondylitis may include anti-
inflammatory drugs, corticosteroid therapy, or drugs that
block cell growth, exercises that improve posture and
breathing, and surgery in cases of severe damage.  

There is some encouraging news coming from a 2008 study
on long-term effects of adalimumab, a medication used to
relieve symptoms of diseases in which the immune system
attacks healthy parts of the body, causing pain, swelling
and damage (i.e. autoimmune disorders).   Dr. D. van der
Heijde with the Department of Rheumatology at the Leiden
University Medical Center in The Netherlands led the study
on 311 patients  with ankylosing spondylitis.  They found
that “Adalimumab reduced the signs and symptoms of AS
and induced partial remission for up to 2 years.”  With such
a long list of potentially unpredictable medication options
out there, it might be worth it to ask your physician about
adalimumab.

7.        
Dermatitis Can Make Ankles Swell.  

For those of us who grew up hiking or playing in the
woods or fields, we know that sometimes rashes happen.  
What we might not have known is that the scientific word
for these rashes is ¨dermatitis,¨ referring more specifically
to an inflammation of the skin arising from direct contact
with an irritating substance.   Along with the red, itchy
rash, the area affected by
dermatitis may also be tender,
inflamed, or even have blisters that ooze.

Dermatitis may arise with exposure to something to which
we are allergic, such as nickel or other metals, rubber or
latex, certain detergents or fabrics, certain medications
such as topical antibiotics or, perhaps the most familiar,
poison ivy or oak.  It can also flare up due to over-use of a
topical medication for a different problem.  Some products
may create a rash only when exposed to the sun, such as
shaving lotions, sunscreen or perfumes.  

One type of dermatitis that could particularly appear as
swelling around the ankles is ¨shoe dermatitis,¨ caused by
contact with parts of the shoe.   In 2007 Drs. Sanjib
Chowdhuri and Sanjay Ghosh with the Institute of Allergic
and Immunologic Skin Diseases in Kolkata, India, detected
the patterns of the types of footwear that cause shoe
dermatitis.   

Evaluating 155 cases in people from 8 to 75 years old, they
found that the footwear leading to the highest numbers of
shoe dermatitis -- nearly 62% of all cases -- was leather
¨and leather related chemicals.¨ After leather footwear,
metal buckles and black dyes of shoes or socks are the
leading culprits for shoe dermatitis. (Read more about
natural remedies for dermatitis.)

8.        
Erythema nodosum.  

This is an inflammatory disorder that is most common on
the shins, but also occurs on the buttocks, calves, thighs,
arms and ankles.  It is characterized by tender and red
raised bumps from under the skin, which begin as flat, firm,
painful red lumps, then change to a purlish color in a few
days, and finally to a brownish hue over several weeks.  In
addition to pain and swelling, symptoms include fever and
redness.

Nearly fifty percent of erthema nodosum cases occur
without a known cause.  The other half may be associated
with different types of infections such as streptococcus, cat
scratch disease, Heptatis B and others, pregnancy,
sensitivity to certain medications such as antibiotics, and
other disorders such as leukemia and rheumatic fever.  For
those cases in which there is an associated cause, that
drug, disease or infection should be identified and treated.  
For all cases, anti-inflammatory medications or oral
potassium iodide may reduce symptoms.

9.        
Gout Causes Swollen Ankles.  

Also known as “the king of diseases and the disease of
kings,” some of us may associate gout with old Europe –
but it continues to infect people today.  Gout is a type of
arthritis that occurs when uric acid (a type of chemical
created by the body to help with the break down of certain
foods) builds up in the blood, causing joint inflammation.  
Gout typically affects one joint at a time, and the ankle is
one that is  most often affected.  The pain in the affected
joint starts suddenly, and the joint becomes warm, red,
and tender.  For some people the attacks subside in a few
days, but then return sporadically – half of gout patients
have a second attack after the first.  

The precise cause of gout is not currently known, though
there is some evidence that it may run in families, is more
common in men and in those who drink alcohol, and in
people with other diseases such as diabetes, obesity, sickle
cell anemia or leukemia.  Available treatments include anti-
inflammatory drugs, painkillers, and corticosteroid
injections.

A review of literature conducted in 2011, led by Dr.
Jasvinder Singh with the Birmingham Medical Center in
Alabama analyzed the data on 53 patients with gout.  They
found several dietary factors in correlation with gout,
including alcohol (especially beer and hard liquor), meat
intake, sugar-sweetened soft drinks, and foods high in
fructose.  

On the other hand, dairy and coffee consumption was
linked to a lower risk of gout.  The researchers conclude
that “several dietary risk factors for incident gout and gout
flares are modifiable”: good news, especially if you can
convince yourself to prefer milk over beer.

10.
Certain Blood Pressure Medicines and Other Drugs Can
Cause Swollen Ankles
.  

While drugs have frequently been listed above as treatment
options to reduce ankle swelling, some drugs can,
paradoxically, be the cause of ankle swelling.  

A report led by Dr. John Ely with the Department of Family
Medicine at the University of Iowa  lists several drugs that
may lead to leg edema (swelling), the most common of
which are calcium channel blockers and nonsteroidal anti-
inflammatory drugs.  

Calcium channel blockers are used by millions of Americans
to treat high blood pressure, angina, and some
abnormalities affecting heart rhythm:  yet 50% of patients
who take these drugs experience leg edema.

Less severely, there is a 5% rate of leg edema in patients
taking nonsteroidal anti-flammatory drugs, which are
meant to reduce pain and stiffness because of inflammation
of joints without using steroids.

While this information may be frustrating (why would you
treat ankle swelling with a drug that may cause ankle
swelling?) it is important to remember that every body is
different.  If certain drugs do not work for you, be sure to
consult your physician, as there may be other options.





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Phlebitis -Causes and Top 10 Natural Remedies

Too Tight Shoes -Top 10 Health Dangers

Top 10 Health Benefits of Nuts

Night Cramps-Why Your Legs Seize Up At Night


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Exercises to Strengthen Your Ankles
Other than sports injuries, there are
many other more serious causes of
swollen ankles in men.