Swelling of the feet, which is very common in older adults, can be a warning sign but most often is due to garden-variety aging of the leg veins. Whether to
worry generally depends on:
Whether the swelling is a brand-new problem.
Whether the person is known to have certain medical problems.
Whether there's any pain associated with the swelling.
If the swelling is new:
It's important to get a medical evaluation promptly. Swelling in just one lower leg can be a sign of a blood clot in the deep leg veins (called a deep vein thrombosis, or DVT); if a piece of the clot breaks off, it can move to the lung (called pulmonary embolism), where it can cause shortness of breath, palpitations, and in some cases even cardiac arrest.
Swelling due to DVT may be painful or painless.
Older people at particular risk for DVT include those with cancer and those who have had recent knee or hip surgery. Taking a long plane flight can also raise the risk of DVT.
New swelling in both legs can be a sign of a new problem affecting the heart, liver, or kidney -- so, again, a prompt medical evaluation is important.
If the person has known heart, liver, or kidney problems:
Swelling of the lower legs can also be a warning sign of decline in people who have heart failure, liver failure, or kidney failure. Here the swelling usually affects both legs, although people may notice that one leg tends to puff up a bit more than the other. Heart failure and chronic liver disease are particularly associated with swelling of the lower legs, which often gets worse if a person eats too much salt or forgets to take his diuretic pills. The swelling is usually painless. In someone who is known to have a medical condition associated with swelling, worsening swelling should be taken as a sign to call the doctor for advice.
If there's pain:
It's also possible for a skin infection to cause swelling in the foot or lower leg. In this case the swelling is usually painful, the leg is tender, and the skin may become red.
But most swelling of the feet is just due to aging of the leg veins that bring blood from the legs back to the heart, a condition called venous insufficiency. Over time, this type of swelling can cause the skin to become brownish, and sometimes the swelling feels tender. Elevating the feet for 20 minutes three times daily is usually helpful, as are support stockings. Diuretic pills are also sometimes prescribed, although they tend to not work very well for this type of leg swelling.
Lower leg swelling can also be a side effect of certain medications given for high blood pressure or for diabetes.