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Dealing with swollen legs in older adults

Swollen legs are a common problem faced by people aged 65 and over, particularly those with mobility issues. If this is something you are concerned about for yourself (or for a loved one that you care for), it can help to understand why legs can become swollen and what to do about it so you can effectively manage this frustrating symptom and avoid further health issues.

Here, we are taking a look at what to watch out for with swollen legs, why they can be a problem, what the cause may be, what at-home remedies and exercises could help, how to prevent it from happening, when to see a doctor, and more. 

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global home care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about medical concerns in ageing adults, we can help. 

Important: Swollen legs can be a sign of another health issue, but you should seek medical care immediately if your legs seem to swell for no reason, after a fall or injury, or if you also experience:

  • Pain, including a throbbing or cramping sensation 
  • Difficulty breathing
  • Chest pain 
  • Dizziness or fainting  
  • Coughing up blood 
  • One swollen leg with cool, pale skin 

Some of these symptoms can indicate a blood clot or a serious heart condition, so it is important to address them as soon as possible. 

Why do some older people get swollen legs?

The symptom of swollen legs is sometimes referred to as oedema, or lower extremity oedema. While oedema can affect any part of the body, it is most common in the legs and feet. Swelling happens when excess fluid builds up in an area of the body it should not be in, and some of the most common reasons for this happening in the legs include:

Problems with the blood vessels

Oedema can cause the small blood vessels in your body to leak fluid into tissues elsewhere. This isn’t an issue in itself, but it can happen due to having an infection or inflammation, so it is important to see your doctor if you suspect you may have this. 

Lymphoedema

Lymphoedema means fluid has built up in the lymphatic vessels rather than the veins, which can cause swelling symptoms. When lymphoedema is not managed well it can cause swelling, as well as difficulty moving limbs due to a heavy sensation, and skin that feels itchy, burning, tighter, thicker, harder, or looks red or puffy.

Kidney problems

When the kidneys are not functioning as they should, blood vessels can be affected. Kidneys work to regulate fluid levels in the body by adjusting the level of water and salt that is retained or excreted. When this process does not happen as it should, blood vessels become overloaded and oedema can be the result. Having swollen legs due to issues with your kidneys is something to see your doctor about to ensure everything is working as it should. Heart issues can also reduce blood flow to the kidneys, so if you have a heart condition, swollen legs could be a symptom. 

Liver problems

The liver is responsible for making something called albumin, which is a component of protein found in the blood. When the liver is not functioning at full capacity, it may not be able to maintain the correct levels of albumin. This means fluid can leak to places it should not be which can cause swelling in certain areas. Swollen legs can sometimes be an indication of issues with the liver, so it is important to pay attention to this symptom and see your doctor if you are worried about it. 

Chronic venous insufficiency

Known as CVI, chronic venous insufficiency is a common cause of leg oedema in older adults. Over the years the valves in our veins become less effective, meaning blood stays in the veins longer than it should. This can cause swelling, which can lead to things like oedema and varicose veins. Chronic venous insufficiency can affect older people, those with a family history of the condition, those who stand for long hours for their job or don’t stand and move enough, those who are overweight, and smokers. 

Medication issues

Certain medications can cause or worsen swollen legs, such as beta blockers or corticosteroids. Sometimes this side effect is nothing to worry about, but in other cases it could be an indication that something is not working, so it is always best to speak to your doctor if you have been prescribed a new medication and experience swollen legs. 

What do swollen legs look like?

Sometimes you won’t notice your legs are swollen when looking at them, but you may be able to feel discomfort. Your shoes and socks may become difficult to put on, or you may feel a tightness when putting weight on your legs. 

In some cases swollen legs are obvious. You might notice: 

  • Your legs are enlarged in size 
  • Your skin is puffy, shiny or stretched 
  • There is less definition around your ankle, shin and knees 
  • There are indentations from clothing 
  • Your skin is discoloured (paler, redder, or with a bluish tint)
swollen legs in elderly

What can be done at home for swollen legs?

You should definitely see a doctor if you have swollen legs and are unsure what the cause might be. However, if your swollen legs are due to something like low mobility, hot weather, or they are a symptom of a condition you are already aware of, you may be looking for ways to manage and alleviate the discomfort of swollen legs at home. Here are some top tips:

  • Elevate your legs often, such as while watching television in the evening, or while chatting on the phone. You may also want to take regular breaks throughout the day where you sit down and elevate your legs.  
  • Avoid wearing tight shoes on your feet, as this can cause further discomfort. If you are wearing loose fitting clothing and shoes, be careful not to let them catch on things as you move around the house as this could lead to a trip or fall.
  • Adjust your diet to help reduce swelling. You could reduce your salt intake, and eat a magnesium-rich diet or supplement with magnesium to help manage water retention. 
  • Drinking plenty of water can help to reduce swelling as the body becomes more hydrated and is less likely to retain fluids as a result. 
  • Move around regularly. This does not need to be intense exercise – a simple walk around the house can help to ease swelling. 

Wear compression socks. You should seek a diagnosis from your GP before using compression socks. If your GP recommends these, they can be worn to apply even pressure to the legs which improves blood flow and circulation while reducing aches and swelling. Usually compression socks cover the area of the leg from the ankle to the knee and can help to prevent deep vein thrombosis (DVT), ulcers and blood clots. You can buy compression socks online or from your local chemist, however do keep in mind that many care agencies (including Home Instead) will not be able to apply compression socks that have not been supplied by a GP or nurse in charge of your care. This is to ensure the correct and safe level of compression is applied.

What exercises can help with swollen legs?

One of the best things you can do to alleviate swollen legs is to move around regularly, and move your legs and ankles where possible to keep swelling down. There are a few recommended exercises to help with swelling, such as:

  • Foot rocks – While sitting down with your feet flat on the floor, lift your heels off the ground so you are on your toes, then do the inverse, lifting your toes off the ground with your heels on the floor. You can repeat this up to 10 times. 
  • Ankle pumps – While lying down or sitting, straighten and bend your ankle slowly so it goes from a straight position to an L-shape. Your toes should be pointed away from you and then pulled back towards you. Do this up to 10 times per foot. 
  • Knee flexion – Start by sitting on a chair with your feet flat on the floor, and then pull your leg backwards under the chair as far as you can, so your knee bends. Hold each stretch for 3 seconds then relax, and do this 10 times per leg. 
  • Knee extensions – Similar to the above, sit in a chair and extend your legs out in front of you for 5-10 seconds, then return to the starting position. You can do this up to 10 times on each leg. 
  • March on the spot – While seated, lift your knee upwards on the seat as if you are marching, then down, then swap to the other leg. You can do this for up to a minute then rest. 
swollen legs in elderly

How can swollen legs be prevented?

Swollen legs are a common frustration for older people, and are usually nothing to worry about. Some of the above home remedies could help to reduce your symptoms, however, if you would like to lower your risk of recurring swollen legs or experiencing them in the first place, here are some tips:

  • Try not to stand around or sit for long periods of time, and take regular movement breaks if you do 
  • Avoid smoking, as this can negatively impact your circulatory system which increases your risk of skin damage, leg ulcers and oedema
  • Get into the habit of elevating your legs when sitting for a while
  • Maintain a healthy weight to avoid putting pressure on your legs 
  • Maintain a healthy diet with adequate hydration, and keep an eye on your salt intake 

Sometimes oedema is unavoidable if you have another underlying health condition such as issues with your heart, liver or kidneys, but you can discuss this with your doctor who can suggest ways to manage your symptoms.

swollen legs in elderly

Should you see a doctor about swollen legs?

If your legs look or feel swollen and you aren’t sure what the cause may be, it is a good idea to check with your doctor or community nurse if they visit you. They may be able to check for other symptoms, and determine if something else is causing the issue. 

Some warning signs to watch out for that would warrant a visit to the doctor include if you:

  • Notice a break in the skin that is not healing 
  • Notice a change in the colour and/or temperature of your foot or leg 
  • Experience leg pain or cramps during the night
  • Notice your leg feels hot to the touch, excessively itchy, painful, or is red in colour
  • Feel faint or dizzy 

If you notice any of the below symptoms, you should seek immediate medical assistance:

  • Difficulty breathing
  • Chest pain
  • Coughing up blood 
  • One leg is swollen with cool, pale skin 
  • Swelling that is severe, painful or has started very suddenly
  • Swelling that is red or feels hot 
  • A very high temperature, or feeling hot and shivery

If you have diabetes and are experiencing leg swelling, you should also seek immediate medical care. 

When you visit your doctor, let them know your symptoms so they can try to determine what could be causing your swollen legs and rule out any serious conditions. Your doctor will likely ask you how long the swelling has been going on for, if it is painful, what medications you are taking, and any other symptoms you may be experiencing. They may also ask if it gets better overnight or when you elevate your legs, so try to consider the answers to these questions before you go.  

Don’t be worried if they proceed with an examination of your heart, kidney or liver, as issues with these organs can contribute to leg swelling, so it is important to rule this out. 

What medical solutions are there for swollen legs?

If your oedema is determined to be a side effect of a medication you are currently taking, your doctor may reevaluate your medication needs and prescribe an alternative medication or a different dosage. Never stop taking your medication unless your doctor instructs you to. 

If your leg swelling is not a result of medication changes, and has not eased with home remedies, your doctor may prescribe something like a venoactive agent, which studies show can reduce swelling.

Can home care support those with swollen legs? 

Yes, having a carer visit your home means you can receive regular support to manage and ease the discomfort of swollen legs. Regular movement can help to relieve this, but having swollen legs in the first place means it can be difficult and unsafe to move around as normal. If this is the case for you or a loved one, it can be helpful to consider home care options. For example, domiciliary care from Home Instead can provide:

  • Encouragement and reminders from our Care Professionals to move regularly and engage in seated exercises (like the ones mentioned above) to reduce swelling
  • Meal planning and preparation to ensure a low salt intake and plenty of liquids
  • Home help and housekeeping to keep on top of daily cleaning and organising chores while your mobility is impaired
  • Personal care services if daily washing and dressing becomes too painful or difficult due to swollen legs
swollen legs in elderly

At Home Instead, we understand there’s no place like home, so our home care offering aims to help older adults retain independence and stay in familiar surroundings. We offer a number of bespoke services which can be tailored to your needs, and our Care Professionals are highly trained to deliver the individualised service you need. Reach out to the team at Home Instead to learn more.