How to reduce swelling in your feet, ankles and legs fast

Before you start: check for warning signs

Home care is for everyday swelling in both feet, the kind that builds through the day and goes down overnight. Don’t wait to see if it improves if you have:

• sudden swelling in one leg, especially with calf pain, warmth or redness (possible blood clot)
• swelling with chest pain or trouble breathing (call 911)
• swelling that’s red, hot and painful, or comes with a fever
• sudden or severe swelling during pregnancy

Our guide to what causes swollen feet and ankles explains these warning signs and the conditions behind them.

Fast relief at home

These steps work best together. Try two or three at once.

1. Raise your feet above your heart

Lie down and prop your legs on two or three firm pillows, a wedge or the arm of the couch so your ankles are higher than your heart. Stay there for 15 to 30 minutes, two or three times a day, especially after work and before bed. Sitting with your feet on a low stool helps less, because your ankles are still below your heart.

2. Get your calf muscles pumping

Every time your calf muscles tighten, they squeeze the veins and push fluid back up your legs. Try:

• Ankle pumps: point your toes away, then pull them toward you, 20 to 30 times.
• Ankle circles: 20 slow circles in each direction with each foot.
• Calf raises: stand holding a counter, rise onto your toes and lower slowly, 10 to 15 times.
• A short walk: even 5 to 10 minutes helps.

You can do ankle pumps at your desk, on a plane or in bed.

3. Take off anything tight

Take off tight shoes, socks with elastic bands and clothing that squeezes your legs or waist. Tight bands trap fluid below them.

4. Use cold if it’s sore

If your ankle is warm, sore or swollen from an injury, hold a cold pack wrapped in a thin towel on it for 10 to 15 minutes. Avoid heat on a swollen ankle.

5. Put on compression socks

Compression socks squeeze hardest at the ankle and less further up, helping fluid move back toward your heart. Put them on in the morning, before swelling builds. For everyday swelling, 15 to 20 mmHg is a good starting strength. Ask your doctor first if you have diabetes, numb feet, poor circulation or heart failure.

6. Cut back on salt and drink water

Salt makes your body hold on to water. Cutting back for a few days often makes a visible difference. Choose water over salty or sugary drinks, but drinking extra water won’t take swelling down on its own. Our guide to foods and drinks that reduce swelling goes into detail. If your doctor has limited your fluids, follow that limit.

7. Try gentle massage

Light strokes from your toes up toward your knee, for 5 to 10 minutes, can help move fluid. Don’t massage a leg that could have a blood clot: one that’s suddenly swollen, painful, warm or red.

A 15-minute routine after work

1. Take off your shoes and socks as soon as you get home.
2. Lie down with your feet above your heart.
3. While you’re there, do 30 ankle pumps and 20 ankle circles each way.
4. If your ankles are sore, add a wrapped cold pack for 10 minutes.
5. Get up slowly and change into loose clothes.

How to wake up with less swelling

• Raise your legs overnight. Put a pillow or wedge under your lower legs, or raise the foot of the bed a few inches.
• Take compression socks off at night, unless your doctor tells you otherwise.
• Go easy on salt at dinner, and take a short walk in the evening.
• Do ankle pumps before you get up in the morning.

If you’re pregnant, lie on your side with your legs on pillows rather than flat on your back. If you get short of breath lying flat, don’t raise your legs at night until you’ve talked to your doctor.

On flights and long drives

• Wear compression socks, if they’re safe for you.
• Drink water and skip salty snacks and alcohol.
• Do ankle pumps and circles every 30 to 60 minutes.
• Walk the aisle or stop the car at least every hour or two.
• Take a walk and raise your legs once you arrive.

Swelling in just one leg after a long trip needs to be checked the same day.

Everyday habits that keep swelling down

• Move every hour. If you sit all day, stand up and walk for a few minutes each hour. If you stand all day, shift your weight, walk and do calf raises.
• Walk most days. Twenty to thirty minutes of walking, swimming or cycling keeps the calf pump working.
• Keep salt low. Aim for under 2,300 mg of sodium a day, unless your doctor gives you a different target.
• Keep a healthy weight. Even losing 5 to 10 percent of your body weight can ease pressure on the veins in your legs.
• Wear comfortable shoes with a low heel and room to adjust, such as laces or straps.
• Look after your skin. Swollen skin is fragile. Moisturize daily, check your feet for cuts and cracks, and see a doctor about any sore that doesn’t heal.

Medical treatments for swelling

When swelling keeps coming back, a doctor will look for the cause and treat that. Treatment depends on what’s behind it.

Prescription compression

For vein problems and lymphedema, compression is the main treatment. Your doctor or a fitter will measure your legs and recommend a strength:

Most people feel less heaviness within days. A visible drop in swelling usually takes 2 to 4 weeks of daily wear. Replace stockings every 4 to 6 months, because they lose their stretch. Our compression socks guide covers choosing and fitting them.

Compression isn’t safe for everyone. People with poor blood flow to the legs (peripheral artery disease) can be harmed by strong compression. Signs of poor blood flow include cold or numb feet, calf pain when walking that eases with rest, sores that won’t heal and weak foot pulses. A simple test comparing blood pressure at your ankle and arm can check before you start. If compression causes numbness, tingling, pain or blue toes, take it off.

Water pills (diuretics)

Water pills make your kidneys pass more salt and water. They help when swelling comes from heart failure, kidney disease or liver disease, and sometimes for a short time when a medicine is causing swelling. They usually start working within a day or two.

They don’t help much with swelling from standing, vein problems or lymphedema, and they can cause harm if they’re not needed. Your doctor will usually check your kidney function and blood salts before and after you start, and may ask you to weigh yourself daily. Never use leftover water pills or over-the-counter “water pills” without talking to your doctor, especially in hot weather or if you’re older.

Changing a medicine that causes swelling

Some blood pressure medicines, anti-inflammatory pain relievers, steroids, hormones, certain diabetes medicines and some nerve pain medicines can cause ankle swelling. Your doctor may lower the dose or switch you to something else. Don’t stop a medicine on your own.

Treatment for vein problems

For weak leg veins, compression, elevation and walking come first. If swelling, varicose veins or skin changes continue, a vein specialist can check the veins with an ultrasound and may recommend a procedure to close off the faulty veins.

Treatment for lymphedema

Lymphedema is treated by a specially trained therapist with a combination of gentle drainage massage, compression bandaging, exercises and skin care, followed by fitted compression garments for daily wear. Water pills don’t help lymphedema.

Treating heart, kidney or liver disease

When swelling comes from the heart, kidneys or liver, treating that condition is what brings it down. That may include medicine, a lower-salt diet and, sometimes, a limit on fluids. If you have kidney disease or your doctor suspects it, Evolve Health offers nephrology and kidney care. For swelling after a foot or ankle injury, or with foot pain, our podiatrists can help.

When these treatments need extra care

• Poor circulation or diabetes: check with your doctor before using compression, and check your feet daily, since you may not feel if socks are too tight.
• Heart failure or lung disease: if you get short of breath lying flat, ask your doctor how to raise your legs safely.
• Pregnancy: after the first trimester, raise your legs while lying on your side rather than flat on your back.
• Older adults: water pills raise the risk of dehydration, dizziness and falls, so they need regular check-ups.
• Kidney disease: fluid, salt and potassium limits may differ from general advice. Follow your kidney doctor’s plan.

When to see a doctor

Home care helps everyday swelling. See a doctor if swelling:

• is new and you don’t know why
• doesn’t go down overnight, or keeps coming back
• leaves a dent when you press it
• started after a new medicine
• comes with breathlessness, foamy urine, skin changes or pain

Get seen the same day for sudden swelling in one leg, and call 911 if swelling comes with chest pain or trouble breathing. You can find a provider near you and book online.