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Swelling of the legs (lower extremities) can affect both legs equally or be more pronounced in one lower limb. Often, leg edema is caused by several factors, such as venous insufficiency, obesity, or a previous saphenous vein harvest for cardiac bypass surgery.
Edema of the lower extremities
Swelling of the legs (lower extremities) can occur due to increased pressure in the veins, local trauma, inflammation, obstructed lymphatic drainage, infection, low blood protein, obesity, pregnancy, fluid retention, or drug exposure. High pressure in the veins of the legs causes fluid, proteins and blood cells to seep through the walls of small veins into soft tissues, especially near the ankles. This causes pinpoint edema, a swelling that leaves a temporary dent in the skin when the shoe is compressed, the toe cap, or deliberate pressure, such as when pressed with a finger.
Causes of swelling of the legs (lower extremities) due to increased venous pressure include:
- Venous insufficiency, valve failure in the veins
Varicose veins and swelling of the legs
- Obesity, which increases pressure on veins and lymphatic channels in the abdomen and pelvis, resulting in partial obstruction of venous and lymphatic drainage from the legs back to the heart
- Deep vein thrombosis, clots obstructing venous flow back to the heart,
- Postthrombophlebitis syndrome, chronic blockage of veins in the leg or pelvis due to previous deep vein thrombosis
- Compression of the pelvic veins due to an overlying artery, organ, or tumor
- Inability of the calf muscles to pump venous blood from the legs due to stroke, venous injury, arthritis limiting the ankle's mobility, or inactivity
- Localized swelling of the legs (lower extremities) can also be the result of trauma, hematoma (accumulation of blood in soft tissues), infections, fracture, superficial thrombophlebitis (clots in the veins of adipose tissue), tendon or muscle rupture, cysts in the joint (for example, synovial cyst in knee), and sometimes spontaneous bleeding into tissue due to a ruptured blood vessel.
- Chronic swelling of the legs (lower extremities) can also be caused by conditions that lead to a general increase in body fluid, which may be more pronounced in the legs due to gravity, for example:
- Congestive or ischemic heart failure
- Pulmonary hypertension
- Pericarditis, which limits the pumping function of the heart
- Idiopathic edema, often affecting both the upper and lower limbs in premenopausal women
- Liver disease
- Kidney disease
- Low protein conditions, such as malnutrition, protein loss due to illness, kidney or intestinal disease,
- Drug-induced edema.
- Some of the most common medications that cause leg swelling are non-steroidal anti-inflammatory drugs, taken to relieve pain or discomfort from arthritis, and calcium channel blockers, taken for heart disease or hypertension. Some of the more common medications that can cause swelling of the legs (lower extremities) in some people include:
- Antihypertensive drugs, calcium channel blockers, beta blockers (clonidine, hydralazine, methyldopa, minoxidil)
- Non-steroidal anti-inflammatory drugs (ibuprofen, naproxen, and many others in this class)
- Hormones (estrogen, progesterone, testosterone)
- Cellulite, an infection of the skin and fatty tissues of the leg can cause the legs to swell with pain and soreness. The pain from cellulite can be very severe or appear as pasty and mild pain with pink to bright red skin.
- Swelling of the foot, especially if the skin does not form pits with short-term pressure, can be caused by lymphedema, a malfunction of the microscopic network of channels that move tissue fluid from the limb back into the bloodstream at the level of the upper foot and chest.
Swelling with lipedema
Depending on the causes, lymphedema is divided into:
- Congenital - present at birth,
- Acquired - due to recurrent infection or obstruction of the lymphatic vessels,
- Postoperative - excision of a vein for venous grafts, lymphadenectomy for a tumor,
- Malignant neoplasms - lymphoma or other diseases affecting the lymph nodes
- Obesity - due to compression of the lymphatic channels in the abdomen or pelvis.
After venous insufficiency, obesity is the next most common cause of leg (lower limb) edema in the United States, European countries and Russia. Abdominal obesity partially obstructs venous and lymphatic drainage from the legs. Obesity also accelerates the stretching of the leg veins by gravity, thereby contributing to the progression of venous insufficiency.
How to get rid of swelling of the legs (lower limbs)?
In most situations, you can get rid of leg swelling only with the help of a doctor. First you need to find out the cause of the edema. You can start the diagnosis with a visit to a therapist and phlebologist.
Why does leg edema occur with varicose veins?
Swelling of the legs with varicose veins of the lower extremities occurs due to disruption of the valve apparatus of the venous vessels. This leads to fluid stagnation and the formation of puffiness.
How to treat swelling of the legs (lower extremities)?
Swelling of the legs is treated depending on the underlying cause. Pathology of the heart, kidneys, venous system, trauma require their own, specific treatment. You need to start treating leg swelling by contacting a good, attentive doctor.
Which doctor should you go to if your legs are swollen?
If your legs are swollen, you may need to see several specialists. You can start with a therapist or cardiologist.
One leg is swollen, how to treat it?
If you have swelling in one leg, you need to urgently seek medical help. Better to visit a phlebologist and orthopedist. Unilateral swelling of the lower limb can be a sign of such a formidable condition as deep vein thrombosis.