Swollen feet and legs (manas sa paa): causes, relief and when to worry

Manas (pamamanas or pamamaga ng paa) is swelling caused by extra fluid under the skin. Doctors call it edema. Gravity pulls the fluid down, so it shows most in the feet, ankles and lower legs.

You may notice:

• puffy feet, ankles or legs, often worse at the end of the day
• tight, stretched or shiny skin
• a dent that stays for a few seconds after you press the swollen skin
• shoes or slippers that feel tight, and heavy, tired legs

Manas in both feet that comes and goes is often harmless. Swelling in only one leg, swelling that comes on fast, or swelling with breathlessness needs a doctor (see When manas can be serious).

Most manas has a simple cause:

• standing or sitting still for too long, such as a long shift at a store counter, or hours on a bus, jeepney, plane or boat
• hot weather, especially when you stand or walk a lot
• sunburn
• salty food: patis, toyo, bagoong, instant noodles, canned meats and chips
• being overweight
• pregnancy (see Manas sa buntis), or hormones before a period or from the pill
• varicose veins or weak leg veins (manas is more common as people get older)
• some medicines (see Medicines)
• an injury, such as a sprained ankle, or an insect bite or sting
• thyroid problems

Sometimes swollen feet are the first sign of an illness. Only a doctor can find the cause, but these patterns tell you how fast to act:

• Heart failure: fluid builds up in the legs and sometimes the lungs, with shortness of breath (worse when lying down), weakness or tiredness, and sudden weight gain. See our heart failure guide.
• Kidney disease (sakit sa bato): swollen ankles, feet or hands. Long-term kidney disease often has no signs at first, and diabetes and high blood pressure are common causes. Passing much less urine than usual needs a doctor the same day. See our kidney disease guide.
• Liver disease (cirrhosis): swollen legs and belly.
• A blood clot (DVT): usually one swollen, painful leg (see One swollen leg).
• A skin infection (cellulitis): a red, hot, painful, swollen leg, sometimes with fever or flu-like illness. It needs a doctor the same day, because antibiotics work best when started early.
• Pre-eclampsia in pregnancy or soon after birth: sudden swelling of the face, hands or feet.

A sudden, very painful, hot, red and swollen joint, often the big toe, can be gout: see our gout guide. With a high fever as well, it could be an infection in the joint and needs urgent care.

A deep vein thrombosis (DVT) is a blood clot in a deep vein, usually in the calf or thigh. A piece can break off and travel to the lungs (pulmonary embolism), which can be life-threatening.

Signs of a DVT are throbbing pain and swelling in one leg, red or darker skin around the sore area (harder to see on brown skin), and swollen veins.

A clot is more likely after a trip of more than 4 hours, surgery, a hospital stay, 3 or more days in bed, in pregnancy or the 6 weeks after giving birth, and if you take the pill or hormone therapy, smoke, are overweight, are over 60, have cancer or heart failure, or had a clot before.

Get checked the same day. The doctor usually orders a leg ultrasound; treatment is blood-thinning medicine that only a doctor can prescribe. If you also feel short of breath or have chest pain, go to the emergency room or call 911. Don't drive yourself. Until a doctor has checked it, don't let anyone massage (hilot) the painful leg: deep massage could break a clot loose.

If both feet are mildly swollen and you have no warning signs, these steps often help within a few days:

• Raise your legs on a chair or stool. When lying down, rest them on pillows, higher than your heart.
• Keep moving. Walk, and point your toes up and down and circle your feet. Working calf muscles pump fluid back up.
• Don't sit or stand still for long. On long trips, get up or move your feet whenever you can.
• Wear wide, comfortable shoes, and avoid tight socks, garters and straps that dig in.
• Eat less salt (see Prevention).
• Drink enough water. Drinking less won't drain the swelling, and being dehydrated makes a clot more likely. Follow your doctor if you were told to limit fluids for heart or kidney disease.
• Care for your feet. Wash, dry well between the toes and moisturize, so cracked skin doesn't let in an infection.
• Support (compression) stockings from the botika or a medical supply store can help. Don't use them on a red, hot or painful leg until a doctor checks it, and ask a doctor first if your feet are numb or you have poor blood flow in your legs.

See a doctor if it isn't better in a few days, gets worse or keeps coming back. Not sure how urgent it is? Ask Joy, our AI symptoms guide.

There is no medicine you can buy that safely removes manas by itself. Treatment depends on the cause.

• Water pills (diuretics, pampaihi), such as furosemide or hydrochlorothiazide, are prescription medicines. Doctors use them for heart, kidney or liver disease after checking you. Taken on your own or borrowed from a relative, they can make you dizzy or faint, dry you out, upset the body's balance of water and salts, and hide an illness that keeps getting worse.
• For swelling without a serious cause, home care should be tried before any medicine.
• Some medicines can cause swelling, such as amlodipine and other calcium channel blockers for blood pressure, steroids, hormones, some diabetes medicines and some antidepressants. Don't stop them on your own: tell your doctor, who can adjust or change them.
• Pain relievers like ibuprofen can make the body hold on to fluid. Ask a doctor or pharmacist first if your feet swell often or you have heart or kidney disease.

Pregnant or breastfeeding, or is it a child? Ask a doctor before taking or giving any medicine or herbal product.

• Raised legs, walking, ankle exercises and less salt are the home remedies with evidence behind them.
• Soaking your feet may feel soothing, but we found no evidence that it removes the fluid. Use lukewarm, not hot, water, especially if your feet are numb or you have diabetes.
• Herbal teas sold as pampaihi don't treat the cause. Ask your doctor first if you have heart or kidney disease or take maintenance medicines.
• "Drink less water so the manas goes down." Not true for most people. Limit fluids only if your doctor says so.
• "It's only pagod." Often, yes. But swelling that lasts, keeps coming back, or comes with breathlessness, a puffy face or much less urine needs a check-up.

Some swelling of the feet, ankles and fingers is common in pregnancy, especially in the last months and in hot weather. Swelling that comes on slowly is usually not harmful.

Sudden swelling can be a sign of pre-eclampsia, a dangerous high blood pressure of pregnancy. It is most likely from 20 weeks of pregnancy onwards, and can also start in the days or weeks after birth. Go to the hospital right away if you have sudden swelling of the face, hands or feet, a severe headache that doesn't go away, blurred vision or flashing lights, pain below the ribs, heartburn that antacids don't help, vomiting, or you feel very unwell.

Pre-eclampsia often has no symptoms at first, so keep your prenatal check-ups, where your blood pressure and urine are checked. See our prenatal check-up guide. One swollen, painful leg in pregnancy or after birth needs a doctor the same day.

Before trying anything for the swelling, including pampaihi or herbal products, ask your midwife or doctor what is safe for you.

The doctor will ask where and when the swelling started, whether it eases when you raise your legs, and which medicines you take. They will check your heart, lungs, belly, legs and blood pressure. Tests may include a complete blood count (CBC), creatinine (a kidney test), urinalysis, an ECG (heart tracing), a chest X-ray, or an ultrasound of the leg veins if a clot is possible.

• Your YAKAP clinic. Every Filipino can register with one PhilHealth YAKAP clinic of their choice; the list of accredited clinics is on the eGovPH app and the PhilHealth website. You can also find a rural health unit or health center near you. Check-ups at your YAKAP clinic are free, and PhilHealth's primary care test list (from Konsulta, which YAKAP expanded) includes CBC, creatinine, urinalysis, ECG and chest X-ray when your YAKAP doctor orders them. A private YAKAP clinic may charge up to ₱900 per person for the whole year (PhilHealth, July 2025). See our PhilHealth YAKAP guide.
• Medicines. As of January 2026, the 21 medicines PhilHealth says stay available at YAKAP clinics include amlodipine, losartan, enalapril and hydrochlorothiazide, when your YAKAP doctor prescribes them.
• A leg ultrasound is usually done at a hospital and isn't on that test list (it covers only upper-belly, pelvic and breast ultrasound): ask the price first.
• Emergencies go to the nearest emergency room. For help with a public hospital bill, see our Malasakit Center guide.

Questions before you go? Book a call with a nurse.

• Cut down on salt. The WHO advises adults to eat less than 5 grams of salt a day in total, about one teaspoon, counting the salt already in food and sauces. Go easy on patis, toyo, bagoong, instant noodles and canned goods, and flavor with garlic, onion, ginger and calamansi instead.
• Move often, and on long trips get up or move your feet every hour or so.
• Keep a healthy weight, and don't smoke. Smoking makes clots more likely.
• Control long-term illnesses. Keep your blood pressure and blood sugar in check, take maintenance medicines as prescribed, and ask about regular kidney blood and urine tests if you have diabetes or high blood pressure. Learn the signs of diabetes.
• With heart failure or kidney disease, weigh yourself regularly and tell your doctor about sudden weight gain, which can mean fluid is building up.

More on this area: heart and blood pressure guides.