SymptomBones, joints & muscles
Foot or Toe Swelling: Causes and What to Do
Foot or toe swelling is puffiness or enlargement of the foot, ankle or toes. When both feet swell, usually by evening, the cause is often fluid from standing, heat, pregnancy or medicines, and sometimes heart, kidney or vein problems. When one foot or one toe swells, a local cause is more likely: a sprain or fracture, gout, an infection, an ingrown toenail or a blood clot. Sudden one-sided swelling, or a red, hot foot with fever, needs prompt medical care.
Also called: Swollen feet, swollen toes, pedal edema, foot edema, swollen ankles and feet
At a glance
- Both feet
- Usually fluid (edema) from standing, heat, pregnancy, medicines, vein problems, or heart, kidney or liver disease.
- One foot
- More often injury, infection, gout, DVT or arthritis.
- One toe
- Gout, fracture, ingrown toenail, paronychia or dactylitis (sausage toe).
- Urgent signs
- Sudden one-sided swelling, red hot skin with fever, or swelling with breathlessness.
- Self-care
- Raise the feet, move, reduce salt and wear supportive shoes.
When to get help
Call 911 or go to the ER
- Swollen feet with sudden breathlessness, chest pain or coughing up blood
- A swollen foot that is cold, pale, blue or numb, or a deformed foot after an injury
- Severe swelling in pregnancy with headache, vision changes or upper belly pain (possible preeclampsia)
See a doctor within a day or two
- Sudden swelling of one foot and calf, especially with calf pain (possible DVT)
- A red, hot, swollen foot with fever above 38 °C (100.4 °F) or red streaks
- A red, hot, very painful toe or foot joint that came on overnight (possible gout or joint infection)
- Any swelling, redness or wound on the foot in someone with diabetes
- Unable to walk 4 steps after a foot injury, or pain on pressing the foot bones
Book a routine appointment
- Swelling of both feet that does not go down overnight
- A swollen toe that has lasted more than a week
- Foot swelling after starting a new medicine
- Swelling with weight gain, tiredness or getting short of breath on exertion
Usually safe to manage at home
- Mild swelling of both feet after a long day on your feet, a long flight or hot weather, gone by morning
- Mild swelling after a minor stubbed toe, if you can walk normally
Swelling in both feet
When both feet swell equally, the cause is usually something affecting the whole body or both legs, and the swelling is fluid that pits when pressed. Common causes:
- standing or sitting for long periods, long flights
- hot weather
- pregnancy, especially late pregnancy
- being overweight
- medicines such as amlodipine, NSAIDs, steroids, estrogen and pregabalin
- venous insufficiency: weak vein valves, often with varicose veins
- heart failure, kidney disease, liver disease and low thyroid
For a full guide to fluid-related swelling, its grading and investigation, see peripheral edema.
Swelling in one foot
| Cause | Clues |
|---|---|
| Ankle sprain | Rolled ankle, swelling on the outer side, bruising |
| Foot fracture | Injury, bone tenderness, difficulty walking; stress fractures develop gradually |
| Cellulitis | Red, warm, spreading skin, sometimes fever |
| Deep vein thrombosis | Swollen calf and foot, ache, recent travel, surgery or immobility |
| Gout | Sudden severe pain, redness and swelling, often in the big toe |
| Arthritis | Swollen, stiff joints; worse in the morning in inflammatory arthritis |
| Charcot foot | Warm, swollen, often painless foot in diabetes with nerve damage |
| Lymphedema | Swelling that includes the toes and does not pit easily |
| Insect bite or sting | Itchy swelling around a bite mark |
Swollen toe causes
Gout
Gout causes sudden, intense pain, redness, warmth and swelling, classically in the joint at the base of the big toe, often overnight. Even a bedsheet touching it hurts. Attacks are triggered by alcohol, red meat, seafood, dehydration and diuretics.
Injury and fracture
A stubbed or crushed toe can fracture. The toe swells, bruises and hurts to walk on. Most small toe fractures heal with buddy taping and a stiff-soled shoe. A fracture of the big toe, or a toe that looks bent, needs an X-ray.
Ingrown toenail and paronychia
An ingrown toenail digs into the side of the toe, causing redness, swelling and sometimes pus. Paronychia is an infection of the nail fold.
Sausage toe (dactylitis)
A whole toe swelling like a sausage suggests psoriatic arthritis, reactive arthritis or, in children, sickle cell disease.
Bunions and other deformities
Bunions, hammer toes and bursitis cause swelling and rubbing over joints, worse in tight shoes.
Chilblains
Itchy, red-purple, swollen toes after cold exposure.
How doctors find the cause
A doctor asks whether one or both feet are affected, how quickly it started, any injury, pain, color change, medicines and medical history. The exam looks at pitting, warmth, redness, joint tenderness, pulses and sensation. Tests may include:
- X-ray for fractures, arthritis or gout changes
- ultrasound of the leg veins for DVT
- blood tests: uric acid, inflammation markers, kidney and liver function, blood count
- joint fluid test from a swollen joint to confirm gout or exclude infection
- urine test for protein, and heart tests if heart failure is suspected
Treatment and home care
- Raise your feet above heart level for 20 to 30 minutes several times a day.
- Move: ankle pumps and walking help pump fluid away.
- Compression stockings for fluid swelling from veins, after checking circulation if you have diabetes or poor pulses.
- Reduce salt.
- Wear wide, supportive shoes, and avoid tight footwear.
- After an injury: rest, ice for 15 to 20 minutes at a time, compress and elevate.
- Pain relief: acetaminophen (paracetamol) or ibuprofen, following the label dose; avoid NSAIDs if you have kidney problems, stomach ulcers or heart failure.
Specific treatments include gout medicines, antibiotics for infection, blood thinners for DVT, removal of an ingrown nail edge, and treating heart, kidney or vein problems.
Frequently asked questions
What causes swelling in only one foot?
Swelling in one foot usually has a local cause: a sprain, fracture, infection, gout, arthritis or a blood clot in the leg. Sudden one-sided swelling, especially with calf pain, should be checked the same day to rule out a DVT.
Why are my feet swollen at the end of the day?
Gravity pulls fluid into the feet while you stand or sit. Heat, salt, pregnancy and some medicines make it worse. If swelling goes down overnight and you have no other symptoms, it is usually harmless. Swelling that persists or comes with breathlessness needs a check.
Why is my toe swollen and painful?
A swollen, painful toe is commonly caused by gout, an injury or fracture, an ingrown toenail infection or arthritis. Gout causes sudden severe pain and redness, often overnight. A red, hot toe with fever or spreading redness needs prompt care.
When should I worry about swollen feet?
Get urgent help for swollen feet with breathlessness or chest pain, sudden one-sided swelling, red hot skin with fever, or swelling in pregnancy with headache or vision changes. See a doctor if swelling does not go down overnight or keeps getting worse.
Can walking reduce swollen feet?
Yes, for fluid-related swelling. Walking activates the calf muscle pump, which pushes fluid back toward the heart. Combine walking with raising your feet when resting. Swelling from an injury needs rest first.
Sources
This guide was written from current patient and clinical guidance, including:
- MedlinePlus: Foot, leg, and ankle swelling
- American College of Foot and Ankle Surgeons: Swollen feet and ankles
- NHS: Swollen ankles, feet and legs (oedema)
- American College of Rheumatology: Gout
- American Academy of Orthopaedic Surgeons: Toe and forefoot fractures