This article is for general information and is not a substitute for medical advice. Swelling can have serious causes, so a new or worsening swelling should be seen by a doctor and not treated with clothing alone.
A parent whose ankles are puffy by the evening, whose socks leave deep marks, or whose shoes suddenly feel tight, is dealing with something very common in older age. Swelling of the feet and legs is called oedema. It can be minor, or it can be a sign that the heart, kidneys, liver or veins are not coping. The first job is to find out why. The second is to dress the legs so that clothing helps and does not make things worse.
Why legs swell
There are several common causes, and a doctor needs to tell them apart:
- Heart: when the heart pumps less effectively, fluid collects in the feet, ankles and legs, often with breathlessness, especially on lying flat or on effort
- Kidneys or liver: these can cause fluid retention, sometimes with puffiness of the face as well
- Veins: weak veins let fluid pool in the legs, usually worse after standing or sitting for long, and better with the legs raised
- Medicines: some tablets for blood pressure and some painkillers can cause swelling
- Long sitting or immobility in an elderly or bedridden person
When to see a doctor, and when it is urgent
Book an appointment soon if swelling is new, increasing, or comes with weight gain over a few days or tiredness.
Get urgent medical help if swelling comes with breathlessness at rest or when lying flat, chest pain, or faintness, or if one leg is suddenly swollen, red, warm and painful, which can be a clot. Call 112 or your local ambulance number (102 or 108).
Clothing that helps
- Loose trousers. Swollen legs do not fit through narrow trouser legs. Side-opening pants and tearaway shorts open along the leg, so they go around a swollen limb without being pulled over it, and they can be loosened as the swelling changes during the day. A women's version is also available.
- Soft, wide waistbands that do not dig in at the waist or the groin
- Soft cotton socks with loose tops, or socks without tight elastic. Check the skin when socks come off: deep red grooves mean the band is too tight.
- Footwear a size larger or with velcro, because feet swell through the day. Choose shoes that are easy to put on and adjust.
What makes swelling worse
- Tight elastic at the ankle, calf or knee
- Narrow trouser legs or tight jeans
- Garters, tight stockings that were not prescribed, and tight waistbands
- Standing or sitting for long with the feet down
Compression stockings
Compression stockings are sometimes prescribed, but they are not suitable for everyone, and the wrong ones can do harm if the circulation to the legs is poor. Use them only on a doctor's advice, and have them fitted properly.
Other things that help
- Raise the legs when sitting or lying, as your doctor advises
- Walk regularly if able, since movement helps the fluid return
- Follow the doctor's advice about salt and fluids and take prescribed medicines as directed
- Weigh your parent regularly if the doctor asks you to, and note any sudden increase
- Check the skin daily for sores, redness or breaks
If swelling is in one arm or leg after lymph node surgery
That is a different condition called lymphoedema, and it has its own clothing needs. Read our guide to lymphedema clothing and dressing.
Frequently Asked Questions
Is swollen ankles in an elderly person always heart-related?
No. It can be due to the heart, kidneys, liver or veins, to medicines, or to long periods of sitting. A doctor has to decide which, so a new or worsening swelling should be checked.
Which socks are best for swollen feet?
Soft cotton socks with loose tops, or socks without tight elastic. If the top leaves a deep groove, it is too tight.
Should my parent wear compression stockings?
Only if a doctor prescribes them. They are useful for some causes of swelling and unsuitable or harmful for others, so they should be fitted properly.
Why do shoes feel tighter by evening?
Fluid collects in the feet during the day when they are down. Choose footwear with some room or with adjustable velcro, and try shoes on in the afternoon.