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Swelling is an increase in the size or a change in the shape of an area of the body. Swelling can be caused by collection of body fluid, tissue growth, or abnormal movement or position of tissue.
Most people will have swelling at some time. When it is hot and you have stood or sat in the same position for a long time, you might notice swelling in your feet and ankles. Staying in one position for any length of time increases the risk that the lower legs, feet, or hands will swell because body fluid will normally move down a limb from the effects of gravity. Swelling can also be caused by heat-related problems, such as heat edema from working or being active in a hot environment.
Body fluid can collect in different tissue spaces of the body (localized) or can affect the whole body (generalized). Causes of localized swelling include:
- Injury to a specific body area. Bruising (hematoma) from an injury is caused by tears in the small blood vessels under the skin. Bleeding can also affect the joint (hemarthrosis) or the area that cushions and lubricates the joint (traumatic bursitis). Swelling can affect just one area or may involve large sections of the body, such as swelling that occurs following a motor vehicle accident.
- Infection, which can occur in a joint or under the skin. An abscess is a pocket of pus that forms at the site of infected tissue. Cellulitis is a skin infection that can cause mild or severe swelling.
- Burns, which can cause swelling at the site of the burn or in a larger area around the burn.
Inflammation that occurs when tissue is irritated by overuse or repeated motion.
- Swelling of the tendon and swelling caused by a series of small tears around a tendon (tendinosis) can occur together or separately.
- Swelling of the sac that cushions and lubricates the joint (bursitis) can be caused by prolonged or repeated pressure or by activities that require repeated twisting or rapid joint movements.
- Insect bites or stings. Most insect bites or stings cause a small amount of redness or swelling. Some people have an allergic reaction to a bite or sting and develop a lot of swelling, redness, and itching.
- Other causes, such as swelling related to a sac-shaped structure with clear fluid, blood, or pus (cyst) or a swollen gland, such as a salivary gland. For more information, see the topic Swollen Glands, Hernias, and Other Lumps Under the Skin.
Causes of generalized swelling include:
- Allergic reaction. Sudden swelling of the hands and face may be a severe allergic reaction (anaphylaxis) and needs immediate medical evaluation.
- Autoimmune diseases, such as lupus, rheumatoid arthritis, and scleroderma. These diseases can cause swelling when the body produces antibodies and other cells that attack and destroy tissues in the body.
- Medicines. Some medicines change how body fluids circulate, causing swelling. Swelling may also occur as an allergic reaction to a medicine.
- Circulation problems related to certain medical conditions, such as peripheral arterial disease, heart failure, diabetes, or kidney disease. Thrombophlebitis causes swelling of an extremity when a blood clot interrupts blood flow in a vein in the arm or leg.
- Fluid that accumulates in the abdomen (ascites) because of other problems, such as malnutrition, cirrhosis, or liver disease.
Some people may experience swelling as a reaction to a medical treatment, procedure, or surgery. Swelling from a medical treatment may be related to the procedure or to a substance, such as dye, used during the procedure. Swelling may occur at an intravenous (IV) site used during a procedure or at an IV site used for medicines given at home. Some swelling at the site of surgery is normal, such as swelling of the arm after a mastectomy. Lymphedema is swelling that occurs in an area around lymph nodes that have been removed (such as following surgery) or injured (such as following radiation treatments).
Swelling can also be caused by the fluctuation of hormone levels within the body. Some women may notice swelling from retaining fluid during their menstrual cycles. This may be called cyclical edema because it is related to the menstrual cycle. Some women experience mild swelling in their hands or feet during pregnancy. Swelling in the feet may be more noticeable in the third trimester of the pregnancy. Generalized swelling can be a sign of a pregnancy-related problem called pre-eclampsia. For more information, see the topic Pregnancy-Related Problems.
Most of the time swelling is mild and goes away on its own. You may not even know what caused the swelling. Home treatment is usually all that is needed to relieve mild symptoms.
Check your symptoms to decide if and when you should see a doctor.
Check Your Symptoms
The medical assessment of symptoms is based on the body parts you have.
- If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
- If your symptoms aren’t related to those organs, you can choose the gender you identify with.
- If you have some organs of both sexes, you may need to go through this triage tool twice (once as "male" and once as "female"). This will make sure that the tool asks the right questions for you.
Many things can affect how your body responds to a symptom and what kind of care you may need. These include:
- Your age. Babies and older adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
- Medicines you take. Certain medicines, such as blood thinners (anticoagulants), medicines that suppress the immune system like steroids or chemotherapy, or natural health products can cause symptoms or make them worse.
- Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Try Home Treatment
You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.
- Try home treatment to relieve the symptoms.
- Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Pain in adults and older children
- Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
- Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.
Swelling can be a sign that you are having an allergic reaction to a medicine. This can happen with almost any medicine.
Many prescription and non-prescription medicines also may cause swelling as a side effect. A few examples are:
- Hormones, such as birth control pills and hormone therapy used to treat menopause symptoms.
- Some blood pressure medicines.
Symptoms of difficulty breathing can range from mild to severe. For example:
- You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you're at rest (severe difficulty breathing).
Severe trouble breathing means:
- You cannot talk at all.
- You have to work very hard to breathe.
- You feel like you can't get enough air.
- You do not feel alert or cannot think clearly.
Moderate trouble breathing means:
- It's hard to talk in full sentences.
- It's hard to breathe with activity.
Mild trouble breathing means:
- You feel a little out of breath but can still talk.
- It's becoming hard to breathe with activity.
Symptoms of a severe allergic reaction can start within minutes of eating or being exposed to an allergen. While symptoms usually occur within 2 hours, in rare cases the time frame can vary up to several hours after exposure. Do not ignore early symptoms. When a reaction begins, it is important to respond right away.
Symptoms of a severe allergic reaction can vary from person to person. The same person can have different symptoms each time they have a severe allergic reaction. Symptoms can include any of the following:
- Skin: hives, swelling (face, lips, tongue), itching, warmth, redness
- Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny, itchy nose and watery eyes, sneezing), trouble swallowing
- Gastrointestinal (stomach): nausea, pain or cramps, vomiting, diarrhea
- Cardiovascular (heart): paler than normal skin colour/blue colour, weak pulse, passing out, dizziness or lightheadedness, shock
- Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, metallic taste
A severe reaction can take place without hives, so make sure to look out for all of the signs of an allergic reaction.
Adapted from: Anaphylaxis in Schools and Other Settings, Copyright 2005-2009 Canadian Society of Allergy and Clinical Immunology
Seek Care Today
Based on your answers, you may need care soon. The problem probably will not get better without medical care.
- Call your doctor today to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care today.
- If it is evening, watch the symptoms and seek care in the morning.
- If the symptoms get worse, seek care sooner.
Make an Appointment
Based on your answers, the problem may not improve without medical care.
- Make an appointment to see your doctor in the next 1 to 2 weeks.
- If appropriate, try home treatment while you are waiting for the appointment.
- If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.
Seek Care Now
Based on your answers, you may need care right away. The problem is likely to get worse without medical care.
- Call your doctor now to discuss the symptoms and arrange for care.
- If you cannot reach your doctor or you don't have one, seek care in the next hour.
- You do not need to call an ambulance unless:
- You cannot travel safely either by driving yourself or by having someone else drive you.
- You are in an area where heavy traffic or other problems may slow you down.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
Sometimes people don't want to call 911. They may think that their symptoms aren't serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.
Mild swelling will usually go away on its own. Home treatment may help relieve symptoms.
Swelling and pain are very common with injuries. When you have swelling, you should look for other symptoms of injury that may need to be evaluated by your doctor.
If you have a medical condition that may cause swelling, follow your doctor's instructions on how to treat your swelling.
- Rest and protect a sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
- Elevate the injured or sore area on pillows while applying ice and any time you are sitting or lying down. Try to keep the area at or above the level of your heart to help minimize swelling.
- Avoid sitting or standing without moving for prolonged periods of time. Exercising the legs decreases the effect of gravity, so swelling goes down.
- A low-sodium diet may help reduce swelling.
- Drink plenty of fluids to help prevent swelling caused by dehydration.
- Keep your skin cool in hot environments.
Try a non-prescription medicine to help treat your fever or pain:
Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.
Be sure to follow these safety tips when you use a non-prescription medicine:
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- Swelling increases or spreads.
- Other symptoms develop, such as pain, fever, trouble breathing, or decrease in urination.
- Symptoms become more severe or frequent.
The following tips may help prevent swelling.
- Do not sit with your feet hanging down for long periods of time. Elevate your feet whenever possible. If you take a car trip, stop and walk around every 1 to 2 hours. If you are travelling in an airplane, be sure to get up and walk around every 1 to 2 hours.
- Limit the amount of salt in your diet.
- Exercise regularly. Warm up and stretch before exercising.
- Drink plenty of fluids, and keep your skin cool in hot environments.
- Avoid repetitive motions, or take frequent breaks often to rest a body area.
- Take medicines as instructed. If swelling occurs often, discuss with your doctor whether taking your medicine at another time of day would decrease the swelling.
- Do not smoke cigarettes or use other tobacco products. They increase circulation problems.
If you have a chronic medical condition or are pregnant, follow your doctor's instructions on how to prevent swelling and when to call to report your symptoms.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:
- What are your main symptoms?
- How long have you had your symptoms?
- What do you think is causing the swelling?
- What specific body area is swollen?
- Did the swelling begin suddenly, or did it develop gradually?
- Is the swelling always present? Is it worse in the morning or the evening?
- Have you had this problem before? If so, do you know what caused the problem at that time? How was it treated?
- What activities make your symptoms better or worse?
- Do you think that activities related to your job or hobbies caused your symptoms?
- Do you do sports activities?
- Have you recently moved from a different climate, such as from a colder climate to one with more heat or humidity?
- What home treatment measures have you tried? Did they help?
- What prescription and non-prescription medicines do you take?
- Do you have any health risks?
Current as of:
February 26, 2020
Author: Healthwise Staff
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
David Messenger MD
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