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Leg Swelling : Overview, Symptoms, Causes & Treatments

Team AckoDec 27, 2024

If you’re someone who spends long hours standing at work or has been diagnosed with heart or kidney problems, you’ve probably seen Leg Swelling (LS) first-hand. LS is a commonly encountered complaint that can affect the entire leg or be restricted to a specific part like the ankle, calf, or thigh. There are many causes for LS. It can be an isolated symptom or be associated with other problems depending on the underlying cause. It’s best to let the doctor decide how serious the condition is and the ideal management. Swelling in the foot, leg, and ankle is a common condition that can result from various factors ranging from minor injuries to serious health issues. Understanding the root cause is crucial for proper management. This guide dives into the possible reasons behind swelling and offers insights into its diagnosis and treatment. Read ahead to get an overview of this medical issue so that you can understand it better.

leg-swelling

Contents

What are the Causes of Leg Swelling?
Mechanism Behind Leg Swelling
Diagnosis and treatment
Frequently Asked Questions:

What are the Causes of Leg Swelling?

Let’s understand the underlying conditions that contribute to leg swelling:

1. Medical Conditions and Fluid Accumulation in the Legs
Several medical conditions lead to fluid retention in the legs, causing swelling. This condition is commonly referred to as peripheral oedema. Some of the most notable causes include:

Heart Disease: Swelling can occur in heart failure due to fluid retention. This is often accompanied by symptoms like difficulty breathing, fatigue, shortness of breath when lying down, chronic cough, and sometimes, abdominal distension.
Kidney Disease: Kidney dysfunction, including nephrotic syndrome, leads to fluid retention. The kidney’s inability to properly filter the blood can cause excess sodium to build up or decrease protein levels, both of which contribute to oedema, particularly in the legs, hands, and face.
Liver Disease: Liver failure, including conditions like cirrhosis and portal hypertension, can cause a decrease in blood protein levels (albumin), leading to fluid accumulation. High pressure in the liver veins also contributes to swelling.
Venous Insufficiency: When the veins in the legs are unable to return blood effectively to the heart, blood can pool in the lower limbs, causing swelling.
Drug-Induced: Certain medications, such as painkillers (ibuprofen, naproxen) and beta-blockers, can increase fluid retention, leading to swelling in the legs.
Lymphedema: A blockage in the lymphatic system, which is responsible for draining excess fluid from the tissues, can result in leg swelling.

2. Injuries and Inflammatory Conditions
Swelling in the legs can also be caused by injuries or inflammation. This type of swelling is typically localised to the injured area and can be associated with pain, redness, and warmth.

Sprains, Fractures, and Tendon Injuries: These direct injuries can cause immediate swelling. In the case of tendon injuries, such as an Achilles tendon rupture, swelling occurs around the injury site.
Arthritis: Conditions like rheumatoid arthritis, osteoarthritis, and gout can cause swelling in the joints of the legs due to inflammation.
Infections: Infections such as cellulitis (skin infection), osteomyelitis (bone infection), or abscess formation can lead to localised swelling, which is often accompanied by redness, warmth, and pain.

3. Lifestyle Factors
Certain lifestyle factors can contribute to temporary swelling in the legs, often due to gravity or poor circulation.

Prolonged Sitting or Standing: When you sit or stand for long periods, gravity causes fluid to pool in the lower legs, leading to dependent oedema. This is usually temporary and can be relieved by walking, elevating the legs, or performing calf exercises.
Pregnancy: In the later stages of pregnancy, the growing uterus puts pressure on the veins returning blood from the legs to the heart, which slows blood flow and can cause swelling in the lower limbs.
Footwear: Wearing ill-fitting shoes that restrict blood flow or lymphatic drainage can contribute to swelling, particularly in the feet and ankles.
High Salt Intake: Excess sodium in the diet can lead to fluid retention, which can cause swelling in the legs.

Mechanism Behind Leg Swelling

Leg Swelling is primarily influenced by these two mechanisms:

Fluid accumulation and buildup in the leg
Injury or inflammation of the structures of your leg

1. Fluid Accumulation in the legs

Clinically this is referred to as peripheral edema. In this condition, Leg Swelling is usually associated with a feeling of heaviness and tightness of skin. In severe cases, this can hamper daily activities and cause difficulty in walking.

Sometimes, when you press on the skin for a few seconds, it leaves a depression. This is known as pitting edema. Some of the most common causes for this condition are:

Dependent edema: This refers to LS that you develop when you leave your legs hanging for too long (during travelling, sitting for too long, or prolonged standing). This is not a serious issue and is relieved by keeping the leg elevated, walking, and performing calf exercises.
Pregnancy: In the later stages of pregnancy, the enlarged uterus can compress on the veins returning from the leg resulting in the slowing of blood flow away from the leg which causes edema.
Heart Disease: LS is a sign of Heart Failure. It is usually associated with shortness of breath, palpitations, breathing difficulties on lying down, chronic cough, and sometimes with abdominal distension, transient loss of consciousness etc.
Liver Disease: There are many causes for liver failure, including alcoholism, infections, autoimmune causes, etc. Liver failure causes a decrease in the amount of protein (albumin) in your blood. This can cause edema. Increase in the pressure in the veins of the liver (portal hypertension) also causes edema.
Kidney Disease: Kidney failure (both acute & chronic) can cause LS. A condition called nephrotic syndrome, which can commonly be seen in children can result in generalised edema throughout the body, particularly in legs, hands, and face. The mechanisms behind this are varied; to put it shortly, kidney dysfunctioning causes defective filtering of the blood which can cause increased sodium levels, or decreased protein levels in the blood.
Drug-Induced: Several medications can cause Leg Swelling because of increased fluid retention. This includes painkillers like ibuprofen and naproxen, and medicines like beta blockers.
Issues with the blood vessels of the legs: Conditions like chronic venous insufficiency (where the veins stop functioning adequately), Deep Vein Thrombosis (blood clot in the deep veins of your leg), Thrombophlebitis, etc., can all cause stagnation of blood, which can result in swelling of the affected leg.
Lymphedema: The lymphatic system is a part of the immune and circulatory systems, and any blockage in the lymph vessels can cause edema of the legs, referred to as lymphedema.

2. Conditions due to injury/inflammation to the legs

Any direct injury to the leg resulting in fractures, sprain, ligament tears, tendon injury, and ruptures can present with swelling in the affected area. Depending on the extent of the injury, it can be localised just to the site of injury, or it can involve the entire limb.

There are some inflammatory conditions that affect the joints in the lower limb, which can also produce swelling, such as:

There are also infective conditions that can cause Leg Swelling, such as:

Cellulitis (infection of the skin and subcutaneous tissues)
Abscesses in the leg
Infection of the bone (osteomyelitis)

What Are the Symptoms of Leg, Foot, and Ankle Swelling?

Depending on the cause, there can be many features associated with Leg Swelling, such as:

Redness and warmth (indicating infection or inflammation).
Skin tightness and shiny appearance (seen in fluid accumulation).
Pain, tenderness, or heaviness in the affected area.
Overlying ulcers, blisters, or skin breakdown in severe cases.

Other symptoms include:

Breathing difficulty, palpitations, shortness of breath while lying down, and transient loss of consciousness (with heart disease).
Jaundice, swelling of the abdomen, tiredness & lethargy, upper abdominal pain, disorientation, vomiting, mood changes (with liver disease).
Redness, severe crampy calf pain, swollen veins in that region (with deep vein thrombosis).
Excruciating pain in case of any injury or infection. Always look for any overlying ulcer or pus discharge.

Diagnosis and treatment

Now that we know that there are so many reasons for Leg Swelling to develop, the next step is to figure out which one is the specific cause. Luckily, we now have access to a wide range of investigations to help us do just that.

Blood Tests: Mention tests for kidney function, liver function, and inflammatory markers.
Imaging: Include X-rays for injuries, Doppler ultrasound for vascular issues, and CT/MRI scans for detailed soft tissue analysis.
Special Studies: Add echocardiograms (heart evaluation) and fibroscan (liver function).

Treatments for Leg, Foot, and Ankle Swelling

General Remedies
- Elevation of legs to reduce fluid pooling.
- Compression stockings to prevent edema (with doctor's advice).
- Hydration and salt moderation in diet.
Condition-Specific Treatments
- Heart Failure: Diuretics and medications to improve heart function.
- DVT: Anticoagulants and clot-dissolving therapies.
- Kidney and Liver Disease: Specialised care based on underlying organ dysfunction.
- Infections: Antibiotics or surgical drainage for cellulitis or abscess.

What is the treatment of Leg Swelling?

The treatment of Leg Swelling involves diagnosing and fixing the underlying problem. There are multiple treatment modalities available for each of those conditions.

In general, if you have dependent edema while travelling or standing for too long, the following measures are helpful:

Elevate the legs (in sleeping position) using a couple of pillows under your legs, as well as while you are sitting by resting the feet over a small stool.
Using support stockings or compression bandages at night to decrease swelling (check with your doctor if it is safe for you to use these for a prolonged period).
Walking, calf exercises, heel raise exercises all stimulate the calf muscles which act as a peripheral pump to send back blood from the veins to the heart and thereby reducing the pooling of blood.

Consult your doctor if you have Leg Swelling at the earliest to ensure early diagnosis and a proper care plan to minimise the complications of the specific causes.

Prevention of Leg, Foot, and Ankle Swelling

Here is a list of preventions that can be followed to avoid Leg, Foot and Ankle Swelling:

Stay physically active with regular walking or stretching.
Avoid prolonged sitting or standing.
Maintain a healthy weight and reduce salt intake.
Choose proper footwear with adequate arch support.
During long travel, practice leg exercises and stay hydrated.

Frequently Asked Questions:

Here are some common questions and answers related to leg Swelling.

I feel my legs are swollen every day when I get back from work. Is this normal?

In jobs involving prolonged standing or sitting with the legs hanging, it is common to develop Leg Swelling. Ensure that your legs and back are supported well while sitting.

What can be done to avoid Leg Swelling in pregnancy?

Some common steps to avoid leg swelling in pregnancy include drinking enough water, resting with the legs elevated, resting on a pillow, and doing light exercises such as walking. Consult your doctor if the swelling causes any difficulties.

Can wearing tight shoes cause Leg Swelling?

Yes. Wearing shoes that are too tight or don’t fit well can affect the circulation of blood in the feet. This can cause Leg Swelling.

Can dehydration cause leg swelling?

Yes, dehydration can lead to fluid retention and reduced circulation, contributing to leg swelling, especially if combined with other factors like heat or prolonged inactivity.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions. Leg Swelling is written as LS in this article on a few occasions.