Venous insufficiency. Very common after 40, pregnancy, or family history. Valves in leg veins weaken, so blood falls back down. Swelling is usually both ankles, worse at night, better by morning, with aching or varicose veins.
Medications. Calcium-channel blockers (amlodipine, nifedipine), gabapentin, pregabalin, NSAIDs, steroids, and some diabetes drugs (pioglitazone) list ankle edema as a top side effect.
These patterns are usually symmetric, soft, painless, and gone after a night with legs up.
Red flags that mean don't wait until after the holidays
Get same-day care or go to urgent care/ER if you have any of these with the swelling:
One leg only, sudden, painful, warm, red — especially calf pain. Think deep vein thrombosis (DVT).
Shortness of breath, chest pain, or swelling with weight gain >3 lbs in 2 days. Think heart failure.
Swelling with fever, spreading redness, or open wound. Think cellulitis.
Swelling with very little urine, foamy urine, or around eyes in morning. Think kidney disease.
Swelling with yellow skin/eyes, abdominal swelling, or history of liver disease. Think cirrhosis.
Sudden swelling in pregnancy with headache, vision changes, upper belly pain. Think preeclampsia — go immediately.
Also worry if swelling is new, persistent in the morning, or accompanied by unexplained bruising like the faint discoloration near the heel in the photo (could be trauma, but also worth mentioning to your clinician).
What you can do safely while you wait
