Leg swelling, or edema, as it is called in the medical profession is a common condition that plagues many of our community members. Edema can afflict both men and woman and adults of all ages. Edema can be caused by many different factors so it is crucial to work with your primary care doctor and the right specialist to alleviate your issue. Once identified and treated your quality of life can be greatly improved.
Edema is swelling of both legs from a buildup of extra fluid. Edema has many possible causes:
- Prolonged standing or sitting, especially in hot weather, can cause excess fluid to accumulate in the feet, ankles and lower legs.
- Tiny valves inside the veins of the legs can become weakened, causing a common problem called venous insufficiency. This problem makes it more difficult for the veins to pump blood back to the heart, and leads to varicose veins and buildup of fluid.
- Severe chronic (long-term) lung diseases, including emphysema and chronic bronchitis, increase pressure in the blood vessels that lead from the heart to the lungs. This pressure backs up in the heart. The higher pressure causes swelling in the legs and feet.
- Congestive heart failure, a condition in which the heart can no longer pump efficiently, causes fluid buildup in the lungs and other parts of the body. Swelling is often most visible in the feet and ankles.
- Pregnancy can cause edema in the legs as the uterus puts pressure on the vena cava. Fluid retention during pregnancy also can be caused by a more serious condition called preeclampsia.
- Low protein levels in the blood caused by malnutrition, kidney and liver disease can cause edema. The proteins help to hold salt and water inside the blood vessels so fluid does not leak out into the tissues. If a blood protein, called albumin, gets too low, fluid is retained and edema occurs, especially in the feet, ankles and lower legs.
Symptoms vary according to the type of edema and its location. In general, the skin above the swollen area will be stretched and shiny. You should see a doctor to determine the cause of leg swelling. If both legs are swollen, your doctor will ask about other symptoms and will examine you. A urine test will show if you are losing protein from the kidneys. Blood tests, a chest x-ray and an electrocardiogram (EKG) also may be done. Arterial or venous ultrasound tests may be done to look for blockages in your leg arteries or bad valves in your leg veins.
Treatment of edema focuses on correcting the cause of the fluid accumulation. A low-salt diet usually helps. You also should avoid drinking too much fluid. If you are not short of breath, elevate your legs above the level of your heart to keep swelling down. Your doctor might suggest that you take a low dose of a diuretic (water pill).
For swollen ankles and feet caused by pregnancy, elevate your legs and avoid lying on your back to help improve blood flow and decrease swelling.
If you have leg edema caused by venous insufficiency, elevate your legs periodically and wear support (compression) stockings. However, to permanently fix this issue a simple in office medical procedure (called endovenous ablation) covered by most insurance plans is needed to improve the flow of blood through the leg veins.
No matter what the cause of edema, any swollen area of the body should be protected from pressure, injury and extreme temperatures. The skin over swollen legs becomes more fragile over time. Cuts, scrapes and burns in areas that have edema take much longer to heal and are more likely to get infected.
The outlook for edema of the legs depends on the cause. For most people with edema, the prognosis is excellent as long as you don’t ignore the problem and talk to your doctor.