Leg Swelling Specialist

What is leg swelling?

Leg swelling occurs when fluid which should be in the blood vessels, “leaks” out into the surrounding tissue. If the valves in veins don’t work and blood isn’t pumped out of the leg as it should, then the pooling of blood in the lower leg creates a pressure that pushes fluid out of the vein and into the tissue. There is usually no associated pain but there may be pressure or fullness sensations, possibly an ache later in the day.

Other medical conditions- heart, kidney, liver- and ankle or soft tissue injury can cause swelling but not nearly as commonly.

The swelling from poorly functioning veins usually affects both legs but is not usual for one leg to be significantly worse than the other. Over time the swelling may progress up the leg.

What causes leg swelling?

Simply- leg swelling is the result of gravity, dependency, and the distance from the heart. To efficiently return blood from the legs, a person needs veins that have normal valves and calf muscles that are functional.

Factors that affect these are:

• Inheritance- the walls of the vein are weak and dilate over time
• Pregnancy- causes veins to dilate making the valves incompetent due to retained fluid and the gravid uterus pushing down on the pelvic veins resisting outflow.
• Menstrual periods- retained fluids dilate veins significantly
• Overweight or Obese- tend to walk flat footed not engaging the calf muscle and increased pressure from the abdomen resists outflow
• Jobs with long periods of standing or sitting- swelling because of the prolonged force of gravity without active calf pumping
• Long trips- prolonged dependence without calf pumping
• Deep Vein Thrombosis/clot (DVT)- Blockage in the veins obstructing outflow

The above causes can be a problem by themselves but when two or more are acting together, the problem of swelling can be compounded.

Is Chronic Leg Swelling something to worry about?

Simply, the answer is Yes. Swelling causes inflammatory fluid to pass into the surrounding tissue. At first, this may be subtle and hardly noticeable but as time goes on it gets worse and the tissue and skin become firm, stiff, brittle, discolored (pinkish or brown) and fragile. An ulcer can occur, or lymphedema with swelling of the foot can result.

Lymphedema results when lymph vessels, which lie adjacent to veins, are scarred, and cease to function. Swelling becomes firmer, extends down into the feet and toes and is much harder to control, often making regular shoes difficult to wear, especially dress shoes. Once swelling has gone into the feet and toes, it cannot be eliminated using compression, elevation, or diuretics.

How Can I Reduce Leg Swelling (Edema)?

Since we cannot escape gravity, anything which lessens its affect helps. Medical-grade graduated compression eliminates or slows swelling if one is on their feet for long periods. Periodic elevation helps. Loss of weight, for those significantly overweight, decreases the resistance to outflow of blood and fluids from the leg. Water exercise is wonderful because of its antigravity effects.

How is leg swelling treated?

The keystone to treatment of leg swelling is graduated compression to assist the calf pump and keep fluid in the vascular space blocking the “leak”.

The greatest impact on controlling the swelling of vein disease is treating the underlying vein problem. This is best accomplished using laser ablation for the source veins and Varithena or foam sclerotherapy for closure of the branch varicose veins.

Lymphedema

Sudden edematous legs especially when the tops of the feet are involved is usually an indication that the venous and lymphatic vessels are both affected. This is a progressive situation which starts with “soft” swelling which goes down overnight and progresses over time to a firm swelling which does not subside overnight. At this point the skin can develop a very ruddy (lumpy) texture. With lymphedema the challenge is to stop the progression by treating the underlying vein problem and using firmer compression wraps.

If you have leg swelling or think you might have lymphedema, call Vascular Vein Centers, or book an appointment online today.