Ankle swelling related to varicose veins and venous insufficiency may be subtle, leaving indentations from socks.

Swollen Ankles at Night

Thick, swollen ankles are signs that blood or other fluid is congested in the leg and/or leg veins. Over time, damaged vein walls can become even more stretched out and permeable, allowing fluid and protein to filter from the veins into surrounding leg tissue. When you lie down at night, the pressure from gravity is equalized across your leg. Usually, vein related swelling (venous edema) becomes apparent later in the day or worse throughout the day and improved with leg elevation or overnight during sleep.  Often in the morning, there may be no swelling. But, as the day progresses gravity causes poo

Pooling of blood around the ankle in incompetent veins. Venous insufficiency is one of the most common causes of ankle swelling that worsens throughout the day. Sometimes, the swelling can be subtle, leaving indentations from sock lines. Or, it may cause the skin to feel firm, shiny, or puffy by the end of the day.

If you have swelling, you should discuss it with your healthcare provider. Venous insufficiency can be diagnosed with a venous duplex sonogram, which is a non-invasive study of the leg veins.