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What is Leg Swelling?

Leg swelling refers to swollen or puffy legs that may occur in any region of the legs, including the thighs, calves, ankles, or feet. Leg swelling may have several causes. Some causes of leg swelling, such as walking or standing for long periods, are usually harmless. However, chronic or sudden swelling in the legs can point to a health problem.

Leg Swelling

Causes of Leg Swelling

Your legs commonly swell for 2 main reasons:

  • Edema or fluid build-up: It occurs when the blood vessels or tissues in your legs retain more fluid than they should. Edema can occur simply from being inactive, overweight, standing or sitting for long periods, or wearing tight stockings or jeans, or due to more serious medical conditions.
  • Inflammation: This occurs when the tissue in your legs becomes irritated and swollen. This is a natural response if you tear a ligament or tendon or break a bone, but it also may indicate a more serious inflammatory condition, such as arthritis.

Of the two, edema is the most common reason for leg swelling and may occur due to conditions and the use of certain medications, including:

  • Congestive Heart Failure: This condition occurs when your heart is too weak to pump all the blood your body requires. This results in fluid buildup, particularly in your legs. Other symptoms of congestive heart failure include:
    • Fatigue or tiredness
    • Difficulty breathing or shortness of breath
    • Cough
  • Venous Disorders:
    • Deep vein thrombosis (DVT): This is a condition in which a blood clot forms in a vein in your leg, resulting in swelling of the leg and other symptoms.
    • Thrombophlebitis: This is an inflammatory condition that causes a blood clot to form and block one or more veins, typically in the legs.
    • Varicose Veins/Venous Insufficiency: This is a condition where veins in the body (most often in the legs) have difficulty sending blood from your legs back to your heart. This causes blood to accumulate in the veins of the legs and they become varicose (enlarged or dilated) over time.
    • Lymphedema: This is a chronic condition that causes swelling in the body tissues. Lymphedema can develop in any part of the body but is commonly seen in the arms and legs.
  • Kidney Problems: A long-term or chronic kidney condition occurs when your kidneys do not function normally. Instead of filtering water and waste material from your blood, fluid accumulates in your body, which causes swelling in your legs and arms.
  • Medications: Occasionally, swelling can be an adverse reaction to certain medications. These drugs may include:
    • Heart medicines known as calcium channel blockers
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Some antidepressants
    • Certain diabetes medications
    • Hormone medications containing progesterone or estrogen
  • Pregnancy: By the 3rd trimester, your developing baby puts pressure on the veins in your legs. This slows down the blood circulation and causes accumulation of fluid, resulting in mild swelling.
  • Liver disease: The liver produces albumin, a protein that prevents fluid from leaking out of blood vessels and into surrounding tissues. A diseased liver does not produce sufficient albumin. Consequently, fluid can accumulate in the feet, ankle, and legs.

Symptoms of Leg Swelling

Symptoms that can be associated with leg swelling include:

  • Leg pain
  • Redness
  • Numbness
  • Rash
  • Itching
  • Skin ulceration
  • Discoloration
  • Shortness of breath

Diagnosis of Leg Swelling

Physicians use several methods to diagnose vascular conditions that cause leg swelling including:

  • Complete review of medications, symptoms, and medical history
  • Venography
  • Angiography
  • Magnetic resonance angiography
  • Ankle-brachial index
  • Doppler ultrasound flow studies
  • Exercise tests
  • Segmental blood pressure measurements
  • Venous Doppler studies to evaluate for venous insufficiency

Treatment for Leg Swelling

Conservative treatment for leg swelling may include the following:

  • Cutting back on salty foods
  • Wearing compression stockings
  • Getting regular exercise
  • Raising your legs above your heart level for 30 minutes, several times a day
  • Adjustment of medications that may lead to swelling
  • Switching positions and stopping for breaks frequently during long car rides
  • Taking frequent breaks to stand up and move around while traveling
  • Close monitoring and management of conditions that may be contributing to the swelling

Treatment of Venous Disease

Treatment for venous disease mostly involves minimally invasive procedures and may include:

  • Closure or ablation of the superficial veins by utilizing specialized laser catheters or radiofrequency or injecting medication directly into the malfunctioning vein(s)
  • Treatment of the deep veins may involve venous stent placement, venoplasty procedure, Intravascular Ultrasound (IVUS), and venogram procedure

Treatment for Lymphedema

For lymphedema treatment, your physician may recommend an evaluation with a lymphedema specialist. A lymphedema specialist specializes in compression therapy and/or specific massage therapy to help drain fluid from the tissues back into the circulatory and lymphatic systems.

Lymphedema pumps (pneumatic compression devices) may be prescribed for utilization at home. Pneumatic compression devices allow for the convenience of use in the home on a regular basis. The device provides intermittent compression at different levels of the legs to push fluid out of the tissues back into the circulatory and lymphatic systems.

Other Vascular Conditions

  • American Board of Internal Medichine
  • American Board of Vascular Medicine
  • Society for Cardiovascular Angiography and Interventions