Chronic ankle swelling can be a leading symptom of venous reflux disease, also called venous insufficiency.
In this disorder, the great saphenous vein within the leg becomes unable to pump blood back to the heart with normal efficiency. As a result, gravity pulls blood down to the veins of the calf and ankle, where blood pools. Swelling can become noticeable — characterized by a reddish or purple discoloration — and quite painful. Rope-like varicose veins often develop under the skin, as well.
If you work on your feet for a living, you may know the pain and discomfort of living with chronic swollen ankles. People who stand for long periods of time and frequently engage in heavy lifting often suffer from leg swelling related to venous reflux disease.
It is important to note that chronic swollen ankles can be caused by heart failure, as well. Not all patients who have swollen ankles have venous insufficiency. How can we tell these two very different diseases apart? Chronic swollen ankles related to heart failure are often accompanied by shortness of breath, and skin discoloration is not apparent. Ankle swelling related to venous insufficiency is not accompanied by shortness of breath, but does entail skin discoloration.
Why Does Venous Insufficiency Cause Swollen Ankles?
To understand how swollen ankles develop in relation to venous insufficiency, it's important to have a basic understanding of how leg veins work.
Our legs have two systems of veins: the deep venous system (located deep within the leg) and the superficial venous system (which lies just under the skin). Both vein systems are equipped with valves; when closed, the valves help blood flow back to the heart.
Of all of the veins in our superficial venous system, the vein that tends to develop valve failure is the great saphenous vein. When a valve in the saphenous vein fails, blood is allowed to "leak" toward the ankles. Blood is not sent back to the heart. Swollen ankles develop as blood pools in the smaller veins near the skin.
Radiofrequency ablation is a leading venous insufficiency treatment. This nonsurgical procedure closes the great saphenous vein, which is an accessory vein, and re-routes blood flow to the leg's deep vein.
Treatment for Venous Insufficiency
Many patients seek treatment at John C. Lincoln after suffering chronic ankle swelling for several months. During the patient's initial medical evaluation, a physician will determine the patients' level of discomfort and swelling. He will ask whether it hurts when pressure is applied to the lower leg or ankle.
To visually determine the presence and severity of a varicose vein, the patient will be standing, or sitting on the examination table, with the affected leg dangling over the edge. Within minutes, this simple test will accentuate swelling symptoms. If this swelling is accompanied by discomfort and discoloration, the patient may be an appropriate candidate for radiofrequency ablation treatment and, if varicose veins are present, varicose vein removal with sclerotherapy.