Swollen Ankles

[LittleBetter123]

Can anyone confirm if very swollen ankles is a symptom of being on prednisalone for a long time? Mine are very swollen recently and ache and I'm wondering if it's becsuse I am now down to 1mg and my body is storing fluid to protect my joints, my ankles in this case.

[SnazzyD]

Hello, it depends on whether you mean the fluid is in or closely around the joint or in the soft tissue between the skin and the joint. Broadly, if it’s in the joint it may be inflammation or mechanically related and if it’s in the tissue it could be fluid retention due to various things such as cardiac, kidney function or the veins becoming weak or inflamed. Does it go down over night and get worse through the day or is it the same all the time? Do the joints themselves hurt to move? Whatever, if it’s new it needs assessing.

[LittleBetter123 in reply to SnazzyD]

Hi SnazzyD tnx for your response. My ankles go down slightly overnight but still swollen. I feel an ache when circling or streching my ankles which I never had before and if I am on my feet for any length of time the swelling gets worse.

[PMRpro Ambassador in reply to LittleBetter123]

I have a similar problem with my right ankle - which according to the physio I saw last night is possibly linked to the achilles tendonitis I have had for a few months.

His suggestion was cold foot baths and feet up any time I sit down (do anyway) but also wriggling my feet at regular intervals during the way. More walking too - but that's been a problem for me recently.

[SnazzyD in reply to LittleBetter123]

So it’s sort of under the skin and if you press it, it leaves a dent for a bit? The pain is not in the joint?Pred made my veins less able to return the blood so I used to wear support socks all the time until the dose dropped and I was off steroids but it started on higher doses.

Also, Pred makes you retain fluid but hanging on to salt but at 1mg that shouldn’t be an issue. Really a doc needs to find out why you are retaining fluid at all if this is new. It’s in your ankles because of gravity if you are generally not passing the fluid out. Saying that, there are other autoimmune condition that can make your feet swell.

[PMRpro Ambassador in reply to SnazzyD]

I would suspect something of the sort if it were both legs - but it isn't!!!

[SnazzyD in reply to PMRpro]

My sister had her tendonitis treated very successfully with half a GTN patch on each Achilles. It was her GP that did it, my podiatrist had never heard of it. I did find a reference where it said the local blood supply was enhanced with good effect.

[PMRpro Ambassador in reply to SnazzyD]

Interesting!

It is actually much better today but not sure if that is due to this week's TCZ jab on Wednesday, the lymph drainage session I had last night (at great expense, was a bit eye-watering!) or the pain relief I took this morning as I had a lot to do. But it seems to be improving still and I still have no pain in the bursitis either - so I suspect the TCZ had done something!

[LittleBetter123 in reply to SnazzyD]

Thank you so much for your reply and insight into my problem of swollen ankles. I have had a tendency to retain fluid there eg when pregnant and in hot weather on holiday but not for a long time and it doesn't seem to be subsiding much. I will ask my GP about it if it doesn't get better soon. Don't want to risk vital diagnosis by putting it down to prednisalone side effects.

Thanjs skdo to PMRpro and Winfong for their wise advise too.

[SnazzyD in reply to LittleBetter123]

Ah yes, the first real insult to our lower venous system is pregnancy, though one can come out of it not noticing the damage. As we age and gravity has been pecking away, the valves can become slowly less competent at keeping the blood going back up. Any blood that pools in the lower leg can cause the vessels to leak water through the vessel wall into the tissues. If you then add challenges like steroids, it further worsens with conditions like standing and hot weather. Add in extra fluid from heart insufficiency or anything else and your feet become like water balloons. Your GP might give you diuretic tablets if it looks like your heart isn’t pumping hard enough to clear the excess fluid through the kidneys. So it’s not necessarily a case of either or as a cause but a combination of things. Leaving legs swollen risks leg ulcers, a type of eczema and cellulitis. If no other cause is found you might be recommended to have a Doppler scan to see what state the vessels are in and be prescribed compression hosiery to stop the buildup. Over the counter ones are light compression (Class 1) but any more than that needs a Doppler check first.

[LittleBetter123 in reply to SnazzyD]

Thanks again SnazzyD that is very interesting and fits well with my condition. I have terrible difficulty in giving blood due to very thin veins and quite frequently I have numb or swollen fingers due to bad circulation or a burst blood vessel in them I will ask my GP about the Doppler scan and take it from there. Very grateful to you for your knowledge and insight.

[winfong]

My doc always checks my ankles because of the meds I take. I know it's also a sign of heart disease and other more serious problems. Definitely check with your doc.