Edema on right side of body: Edema – Symptoms and causes
Swollen Legs | Symptoms, Causes and Treatment
What do you mean by swollen legs?
There are a surprising number of different kinds of swelling of the legs. One leg or both legs could be swollen. If both legs, it could be symmetrical or worse on one side. A specific part of the leg(s) could be swollen, or the entire leg(s). It could have come on suddenly or gradually. It could be there all the time, or it could come and go. It could be painful nor not. Taking into account all these things will help narrow down the likely cause.
Where could the swelling be coming from?
Most often the swelling comes from fluid in the spaces between the cells in the legs. When this is the case it is called oedema. It is called pitting oedema if a dent made when you press with your fingertip stays in the skin after you have taken the fingertip away.
James Heilman, MD (own work) via Wikimedia Commons
The swelling could also be coming from skin, bones, tendons – really from any tissue of the leg.
See also the separate leaflet called Oedema (Swelling) for further information.
What are the causes of swelling of both legs?
The most common cause of swelling in both legs is oedema. This is a collection of fluid in between the cells, which are the building blocks of the tissues of our body. Oedema can occur in one particular part of the body, or it can be generalised. If generalised, gravity takes the fluid to the part of you which is hanging down, or ‘dependent’. This type may be called ‘dependent oedema’ by a healthcare professional. For most people, this oedema affects their legs and tends to improve overnight after you have had your legs up. See the separate leaflet called Oedema (Swelling).
If both legs are swollen to the same level, this is likely to be oedema. Causes of oedema affecting both legs symmetrically include:
- Heat. Some people will find their legs swell up a little in hot weather. Usually this is nothing to worry about and does not need treatment.
- Long journeys or being immobile for other reasons. If your legs are hanging down and not moving for long periods of time, you can develop swollen legs. This improves once you are walking about again, or once you lie down at night. This happens because your muscles are not working to move the blood in your blood vessels around. This means the blood pools in the bits of you which are hanging down, putting pressure on the blood vessels and forcing fluid out into the spaces between them. To avoid this, get up and walk around regularly if possible. If not, move your feet and legs around as much as you can.
- Pregnancy. Pregnant women may have swollen legs in late pregnancy. Usually this is par for the course and nothing to worry about, but if you are pregnant, your midwife will be doing regular checks to be sure you don’t have a blood pressure problem (pre-eclampsia) causing it.
- Heart failure. If you have this condition, your heart is not working as effectively to push the blood around your circulation. You may also feel out of breath, and this can be worse when lying down flat at night or on walking.
- Anaemia. This is a problem with the red blood cells of your body.
- Kidney diseases such as nephrotic syndrome, acute kidney injury and chronic kidney disease.
- Conditions where there are low levels of protein. If there are low levels of protein in the blood, less fluid is drawn into the blood from the surrounding areas. Conditions causing low protein levels include malnutrition, nephrotic syndrome, liver failure, and a gut condition called protein-losing enteropathy.
- Side-effects of medicines such as calcium-channel blockers.
- Having very low thyroid levels (hypothyroidism). This is normally accompanied by other symptoms such as tiredness and gaining weight.
- Idiopathic oedema. This means there is oedema but no specific cause has been found for it.
What are the causes of swelling affecting one leg or part of one leg?
There are numerous causes including:
- Injuries – for example, fractures, sprains, large bruises.
- Wear and tear arthritis (osteoarthritis) – in particular this might affect a knee (or both knees) or the big toe(s).
- Joint problems caused by inflammation – for example, gout, rheumatoid arthritis, psoriatic arthritis. One or more joints would be warm, red and painful.
- Skin infections – for example collections of pus (abscesses) or cellulitis.
- Skin reactions – for example an allergy to a bite or sting or medicine.
- Deep vein thrombosis (DVT). This is a blood clot in the deep blood vessels, which most commonly affects the calf. You are more at risk of a DVT if you have recently had a period of time when you didn’t move very much. Examples include a long plane journey, an illness, an operation. If you have cancer or are having treatment for cancer, your risk is also increased.
- Bone infection (osteomyelitis).
- Lymphoedema. In this condition lymph fluid collects in the tissues because it can’t drain very well. This is usually because the lymph nodes are blocked for some reason. This can happen after an operation, after radiotherapy, or due to cancer, injury or infection.
- Baker’s cyst. This is a soft swelling at the back of your knee.
What are the symptoms of swollen legs?
Having ‘swollen legs’ is a symptom itself, but legs can be swollen in different ways. The clue to the cause (and therefore the treatment) may well be in the type of swelling. The swelling can be:
- One-sided or both-sided. Oedema due to conditions of general body systems is usually on both sides and is symmetrical (for example, if due to heart failure or pregnancy or kidney problems.) One-sided swelling is more likely to be due to a problem with a particular part of that leg.
- In a specific area or generalised. Swelling around joints is usually caused by injury or a type of arthritis. Swelling in specific areas of skin may be caused by allergy or infection. Swelling around the back of the heel suggests a problem of the Achilles tendon, etc. Generalised swelling, especially if on both sides, is likely to be oedema.
- Painful or painless. Painful conditions include infections, deep vein thrombosis (DVT), injuries and joint problems. Oedema is not usually painful, although legs can ache and feel tight.
- Accompanied by red (inflamed) or normal skin colour. If the skin is reddened, it is likely to be due to an infection (such as cellulitis), or inflammation (for example, gout, rheumatoid arthritis or DVT).
- Pitting or not. Pitting means that if you press a fingertip into the swollen area and then take your fingertip away, a dent remains in the skin. (See photo earlier in leaflet.) Oedema tends to be pitting. Lymphoedema, a condition where there is a blockage to lymph fluid, does not usually pit so much.
Are there any other symptoms?
In addition to the leg or legs being swollen, there may be other associated symptoms. Again, these help give a clue to the cause of the leg swelling. For example:
- Breathlessness which started at the same time as the leg swelling might suggest heart failure (if both legs) or DVT (if one leg) spreading to the lungs (pulmonary embolism).
- A high temperature (fever) suggests some type of infection.
- Tiredness might suggest a more general illness, such as anaemia or kidney problems.
- Diarrhoea might suggest a gut problem affecting the amount of protein being absorbed in the guts.
- Being yellow (jaundiced) suggests a liver problem, such as cirrhosis.
- Swelling in other places other than the legs – for example, in the tummy, hands or around the eyes. This would suggest a problem with another or a general body system rather than a problem with the leg or legs.
Do I need to see a doctor?
If you don’t know why you have swollen legs, or you know the reason but it isn’t settling then see your doctor. There are so very many causes for swollen legs that it is important to make sure it isn’t due to something which needs treatment.
If your legs swell up a little in the hot weather but go down again overnight, you don’t need to see a doctor. Or if both ankles are a little puffy after a long flight but there is no pain or redness of the calf, and the puffiness settles quickly then you do not need to see a doctor. Minor swellings from bites or trivial injuries don’t usually need medical attention. In most other situations, it is wise to consult a health professional. If you have swollen legs and are pregnant, make sure you keep your regular appointment with your midwife. Your midwife will regularly check your blood pressure, and check your wee (urine) for protein to make sure your swollen ankles are not a sign of anything serious.
When should I see a doctor urgently?
In some situations, the cause of swollen legs can be serious, and you should see a doctor as an emergency. Obviously if you have had a serious injury and think you have a broken leg, you would attend an accident and emergency (A&E) department.
You should see your GP urgently if you:
- Think you might have a deep vein thrombosis (DVT). This might be the case if one calf is warm, swollen, red and tender. You might have swelling in the foot of that leg. A DVT is more likely if you are not very active – due to being in a wheelchair, for example, or after an operation or illness. It is also slightly more likely if you have recently been on a long flight.
- Feel out of breath.
- Have a high temperature.
- Feel generally unwell in yourself.
- Are in severe pain.
- Notice your skin has turned a yellow colour.
What will the doctor do?
Your doctor will want more information about the swelling in your leg(s). For example, when it started, if it hurts and whether it comes and goes or stays much the same. They will also want to know if you have been on any recent long journeys or had any times when you were not very mobile recently, and if you are on any medicines.
The doctor will examine your legs and then may go on to examine other areas. This might include your chest and/or tummy and groins.
Will I have to have any tests?
This will depend on the information the doctor has obtained by listening to you and examining you. In some cases, no further tests will be needed. In others, tests will be advised. These might include:
- Testing your urine. This can usually be done in the doctor’s surgery. The urine is tested with a dipstick to see if there is any protein in it, which might suggest a kidney problem, for example.
- Blood tests. You might have blood tests to check you for anaemia, heart failure or a DVT. Tests may be done to check the function of your kidney, liver or thyroid gland.
- A chest X-ray. This would check you for conditions such as heart failure or a pulmonary embolism.
- An ultrasound scan of the leg. This can look at the nature of the swelling and establish where it is coming from. It can be helpful to diagnose tendon problems (such as Achilles tendinopathy), DVT and other problems in the veins of the legs.
- An X-ray if a fracture or infection of the bone is suspected.
Depending on the results of these tests, other investigations may be needed in some cases.
What is the treatment for swollen legs?
Treatment will be different depending on the cause. If the cause is fluid in the legs (oedema), this can often be relieved in the short term by taking tablets called ‘water tablets’ (diuretics). Diuretics increase the amount of fluid that the kidney filters off to be passed in your wee (urine). So when you take diuretics you eventually pee away some of the fluid which was collecting around your legs.
However, diuretics are not used for many causes of swollen legs. A few examples of some treatments of some common causes are as follows.
Are there any complications?
Again this depends on the cause. The most common complication in swollen tissue is infection. Where the skin is stretched, it is more prone to be dry. If it is dry, it is more prone to breaks in the skin, allowing germs from the outside of the skin underneath. This can result in cellulitis of the legs. If this is the case a large area of the skin of the legs becomes hot and red. It may cause a high temperature (fever).
Edema | Sparrow
Edema is swelling caused by excess fluid trapped in your body’s tissues. Although edema can affect any part of your body, you may notice it more in your hands, arms, feet, ankles and legs.
Edema can be the result of medication, pregnancy or an underlying disease — often congestive heart failure, kidney disease or cirrhosis of the liver.
Taking medication to remove excess fluid and reducing the amount of salt in your food often relieves edema. When edema is a sign of an underlying disease, the disease itself requires separate treatment.
Signs of edema include:
- Swelling or puffiness of the tissue directly under your skin, especially in your legs or arms
- Stretched or shiny skin
- Skin that retains a dimple (pits), after being pressed for several seconds
- Increased abdominal size
When to see a doctor
Make an appointment to see your doctor if you have swelling, stretched or shiny skin, or skin that retains a dimple after being pressed (pitting). See your doctor immediately if you experience:
- Shortness of breath
- Difficulty breathing
- Chest pain
These can be signs of pulmonary edema, which requires prompt treatment.
If you’ve been sitting for a prolonged period, such as on a long flight, and you develop leg pain and swelling that won’t go away, call your doctor. Persistent leg pain and swelling can indicate a blood clot deep in your vein (deep vein thrombosis, or DVT).
Edema occurs when tiny blood vessels in your body (capillaries) leak fluid. The fluid builds up in surrounding tissues, leading to swelling.
Mild cases of edema may result from:
- Sitting or staying in one position for too long
- Eating too much salty food
- Having premenstrual signs and symptoms
- Being pregnant
Edema can also be a side effect of some medications, including:
- High blood pressure medications
- Nonsteroidal anti-inflammatory drugs
- Steroid drugs
- Certain diabetes medications called thiazolidinediones
In some cases, however, edema may be a sign of a more serious underlying medical condition. Several diseases and conditions may cause edema, including:
- Congestive heart failure. If you have congestive heart failure, one or both of your heart’s lower chambers lose their ability to pump blood effectively. As a result, blood can back up in your legs, ankles and feet, causing edema. Congestive heart failure can also cause swelling in your abdomen. Sometimes, this condition can cause fluid to accumulate in your lungs (pulmonary edema), which can lead to shortness of breath.
- Cirrhosis. Fluid may accumulate in your abdominal cavity (ascites) and in your legs as a result of liver damage (cirrhosis).
- Kidney disease. When you have kidney disease, extra fluid and sodium in your circulation may cause edema. The edema associated with kidney disease usually occurs in your legs and around your eyes.
- Kidney damage. Damage to the tiny, filtering blood vessels in your kidneys can result in nephrotic syndrome. In nephrotic syndrome, declining levels of protein (albumin) in your blood can lead to fluid accumulation and edema.
- Weakness or damage to veins in your legs. If you have chronic venous insufficiency, the one-way valves in your leg veins are weakened or damaged, which allows blood to pool in your leg veins and causes swelling. Sudden onset of swelling in one leg accompanied by pain in your calf muscle can be due to a blood clot (deep vein thrombosis, or DVT) in one of your leg veins. If this occurs, seek medical help immediately.
- Inadequate lymphatic system. Your body’s lymphatic system helps clear excess fluid from tissues. If this system is damaged — for example, by cancer surgery — the lymph nodes and lymph vessels draining an area may not work correctly, and edema can occur.
- Severe, long-term protein deficiency. An extreme lack (deficiency), of protein in your diet over a long period of time can lead to fluid accumulation and edema.
If you are pregnant, your body retains more sodium and water than usual due to the fluid needed by the fetus and placenta. This can increase your risk of developing edema.
Your risk of edema may be increased if you take certain medications, including:
- High blood pressure medications
- Nonsteroidal anti-inflammatory drugs
- Steroid drugs
- Certain diabetes medications called thiazolidinediones
A chronic illness — such as congestive heart failure or liver or kidney disease — can increase your risk of edema. Also, surgery can sometimes obstruct a lymph node, leading to swelling in an arm or leg, usually on just one side.
If left untreated, edema can cause:
- Increasingly painful swelling
- Difficulty walking
- Stretched skin, which can become itchy and uncomfortable
- Increased risk of infection in the swollen area
- Scarring between layers of tissue
- Decreased blood circulation
- Decreased elasticity of arteries, veins, joints and muscles
- Increased risk of skin ulcers
To understand what might be causing your edema, your doctor will first perform a physical exam and ask you questions about your medical history. This information is often enough to determine the underlying cause of your edema. In some cases, X-rays, ultrasound exams, magnetic resonance imaging, blood tests or urine analysis may be necessary.
Mild edema usually goes away on its own, particularly if you help things along by raising the affected limb higher than your heart.
More-severe edema may be treated with drugs that help your body expel excess fluid in the form of urine (diuretics). One of the most common diuretics is furosemide (Lasix). However, your doctor will determine whether these types of medications are a good option for you based on your personal medical history.
Long-term management typically focuses on treating the underlying cause of the swelling. If edema occurs as a result of medication use, your doctor may adjust your prescription or check for an alternative medication that doesn’t cause edema.
Lifestyle and home remedies
The following may help decrease edema and keep it from coming back. Before trying these self-care techniques, talk to your doctor about which ones are right for you.
- Movement. Moving and using the muscles in the part of your body affected by edema, especially your legs, may help pump the excess fluid back toward your heart. Ask your doctor about exercises you can do that may reduce swelling.
- Elevation. Hold the swollen part of your body above the level of your heart several times a day. In some cases, elevating the affected body part while you sleep may be helpful.
- Massage. Stroking the affected area toward your heart using firm, but not painful, pressure may help move the excess fluid out of that area.
- Compression. If one of your limbs is affected by edema, your doctor may recommend you wear compression stockings, sleeves or gloves, usually worn after your swelling has gone down, to prevent further swelling from occurring. These garments keep pressure on your limbs to prevent fluid from collecting in the tissue.
- Protection. Keep the affected area clean, moisturized and free from injury. Dry, cracked skin is more prone to scrapes, cuts and infection. Always wear protection on your feet if that’s where the swelling typically occurs.
- Reduce salt intake. Follow your doctor’s suggestions about limiting how much salt you consume. Salt can increase fluid retention and worsen edema.
Preparing for an appointment
Unless you’re already under a specialist’s care for a current medical condition, you’ll probably start by seeing your family doctor to begin evaluation for what could be causing your symptoms.
Here’s some information to help you prepare for your appointment, and what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there’s anything you need to do in advance to prepare for common diagnostic tests.
- Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Make a list of your key medical information, including any other conditions for which you’re being treated, and the names of any medications, vitamins or supplements you’re taking.
- Consider questions to ask your doctor and write them down. Bring along notepaper and a pen to jot down information as your doctor addresses your questions.
For edema, some basic questions to ask your doctor include:
- What are the possible causes of my symptoms?
- What kinds of tests do I need? Do these tests require any special preparation?
- Is my condition temporary?
- Will I need treatment?
- What treatments are available?
- I have other medical problems; will this treatment interfere with them?
- Do you have any brochures or other printed material that I can take home with me? What websites do you recommend visiting?
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time for you and your doctor to review important points.
Questions your doctor might ask include:
- What symptoms are you experiencing?
- How long have you been experiencing these symptoms?
- Do your symptoms seem to come and go, or are they always there?
- Have you had edema before?
- Does anything seem to make your symptoms better?
- Is there less swelling after a night’s rest in bed?
- Does anything seem to make your symptoms worse?
- What kinds of foods do you regularly eat?
- Do you restrict your intake of salt and salty foods?
- Do you drink alcohol?
- Do you seem to be urinating normally?
- Do you notice swelling all over your body, or does it seem to be in just one area, such as an arm or leg?
- Does swelling diminish if you raise the swollen limb above heart level for an hour or so?
Content From Mayo Clinic Updated:
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Swelling, Edema, and Ascites
Cancer and its treatment may cause swelling which also can be called edema or ascites, depending on the area affected.
Swelling or edema
Swelling or edema is a build-up of fluid in the tissues. This can be caused by retaining salt and water because of certain medicines. It can also be a sign of heart, liver, or kidney damage or failure. Other causes might include surgery, infection, poor nutrition, tumor growth, or a blockage.
Swelling that happens because lymph nodes are blocked or removed causes lymph flow to be impaired. This is called lymphedema
Some medications, like diuretics, can help edema. Diuretics are often called water pills. They stimulate your kidneys to remove sodium and water from your body, so you’ll urinate more often and get rid of extra fluid. But diuretics can have possible dangerous side effects. Talk to your doctor to learn more about this if you are prescribed diuretics for swelling or edema.
Ascites is excess fluid buildup in the belly (abdomen) because of pressure from tumors. It can make the belly hard and swollen (distended). Patients with ascites may also have nausea, vomiting, and fatigue. Sometimes the fluid also pushes on lungs which can cause difficulty breathing. Ascites is common in some cancers that have reached the advanced stages and spread in the abdominal area, including cancer of the ovary, liver, colon, stomach, or pancreas. Sometimes chemotherapy or surgery might help manage ascites. More often, a procedure is done to drain the fluid, called a paracentesis. A paracentesis gives temporary relief that may last days or weeks, but fluid often comes back. Sometimes a catheter (tube) is placed and left in the belly, allowing fluid to drain out as needed.
What to look for
- Trouble breathing, especially when lying down
- Heart racing or palpitations (or an awareness that the heartbeat is fast or irregular)
- Feet and lower legs get larger (swell), usually when you sit in a chair, stand, or walk
- Rings feel too tight for fingers
- Hands feel tight when making a fist
- Large, puffy, hard, or blown-up abdomen (belly)
- Difficulty putting on pants or an outfit
What the patient can do
- Limit your salt intake. Avoid using salt in cooking, and don’t eat foods that are very high in sodium (check food labels). Talk with your cancer team about this.
- Eat as well as you can (see Eating Problems).
- Take medicines as prescribed.
- If your feet or legs are swollen, rest in bed with them up on 2 pillows.
- When sitting up in a chair, keep your feet raised by sitting in a recliner or by placing your feet on a footstool with pillows.
What caregivers can do
- Watch for any new symptoms, especially shortness of breath or swelling in the face.
- Encourage the patient to keep the swollen body part propped up as high as is comfortable when sitting or lying down.
- Learn to read food labels and talk with the cancer care team about how to keep intake of sodium down.
- Don’t add salt, soy sauce, or monosodium glutamate when cooking or preparing food.
- Weigh the patient every 1 to 2 days on the same scale, at the same time of day. Keep a list of weights and dates.
Call the cancer care team if the patient
- Develops a hard, puffy, or blown-up belly
- Notices that a swollen area is getting red or hot
- Has shortness of breath or a racing heart
- Can’t eat for a day or more
- Hasn’t urinated or has passed very little urine for a day or more
- Has only one arm or leg that swells up
- Can press a finger into a swollen area and the dent remains after the finger is removed
- Has swelling that spreads up legs or arms
- Has a swollen face and neck, especially in the mornings
- Gains several pounds in a week or less
Symptoms of liver cancer | Cancer Research UK
Cancer that starts in the liver (primary liver cancer) doesn’t usually cause symptoms in the early stages. When you do have symptoms, they can include:
- weight loss
- yellowing of the skin and whites of the eyes (jaundice)
- feeling sick
- swollen tummy (abdomen)
- loss of appetite or feeling full after eating small amounts
- pain in your abdomen
- a lump in the right side of your abdomen
If you already have a liver condition such as cirrhosis, tell your doctor if you have any new or worsening symptoms.
See your GP if you have any of these symptoms. Remember primary liver cancer isn’t common in the UK and these symptoms can be caused by other conditions. But it’s important to get them checked by a doctor.
About these symptoms
The symptoms vary depending on where the cancer is. Some symptoms, such as itching, are caused by the jaundice.
Symptoms of liver cancer are often quite vague, such as feeling sick and loss of appetite.
Unexplained weight loss is a symptom of liver cancer. This means losing weight without meaning to.
Your doctor will want to find out the cause if you lose more than 5% of your normal weight over 6 to 12 months. See your doctor if there is no obvious reason for your weight loss.
Yellowing of the skin and whites of the eyes (jaundice)
Jaundice is the yellowing of the skin and the whites of the eyes. When you have jaundice your wee (urine) is darker than normal and your poo (stools or faeces) is lighter in colour. Most people who have jaundice also have itchy skin and may feel sick.
Jaundice is caused by a blockage in the bile duct or your liver not working properly.
You can get a high temperature (fever) when you have jaundice. High temperature can be a sign of inflammation or an infection. When your temperature is high you may feel cold and shivery.
A swollen tummy (abdomen)
Liver cancer can cause swelling of the tummy (abdomen). This might be because:
- the liver gets bigger from the growing cancer, and causes swelling on the right side of your abdomen
- the cancer (or cirrhosis) increases pressure in the liver causing blood to back up in the vessels (veins). This forces fluid out of the veins into the abdomen (ascites)
The increased pressure in the veins can make them swell so they might be seen under the surface of your abdomen. Ascites can also develop when the liver isn’t making enough blood protein (albumin).
A swollen abdomen might cause discomfort or pain, and a loss of appetite or feeling full quickly.
A swollen (enlarged) liver can cause pain in your right shoulder. This is because the enlarged liver stimulates nerves that connect to nerves in the shoulder. It is called referred pain.
Edema (Swelling) and Cancer Treatment – Side Effects
Certain exercises and diet changes can help, if edema is the cause of swelling. Your doctor may also prescribe medicine called a diuretic.
What Is Edema?
Edema, a condition in which fluid builds up in your body’s tissues, may be caused by some types of chemotherapy, certain cancers, and conditions not related to cancer.
What Are Signs of Edema?
Signs of edema may include:
- swelling in your feet, ankles, and legs
- swelling in your hands and arms
- swelling in your face or abdomen
- skin that is puffy, shiny, or looks slightly dented after being pressed
- shortness of breath, a cough, or irregular heartbeat
Tell your health care team if you notice swelling. Your doctor or nurse will determine what is causing your symptoms, advise you on steps to take, and may prescribe medicine.
Some problems related to edema are serious. Call your doctor or nurse if you feel short of breath, have a heartbeat that seems different or is not regular, have sudden swelling or swelling that is getting worse or is moving up your arms or legs, you gain weight quickly, or you don’t urinate at all or urinate only a little.
Ways to Prevent or Lessen Edema
Steps you can take to prevent or lessen edema-related swelling include:
- Get comfortable. Wear loose clothing and shoes that are not too tight. When you sit or lie down, raise your feet with a stool or pillows. Avoid crossing your legs when you sit. Talk with your health care team about wearing special stockings, sleeves, or gloves that help with circulation if your swelling is severe.
- Exercise. Moving the part of your body with edema can help. Your doctor may give you specific exercises, including walking, to improve circulation. However, you may be advised not to stand or walk too much at one time.
- Limit salt (sodium) in your diet. Avoid foods such as chips, bacon, ham, and canned soup. Check food labels for the sodium content. Don’t add salt or soy sauce to your food.
- Take your medicine. If your doctor prescribes a medicine called a diuretic, take it exactly as instructed. The medicine will help move the extra fluid and salt out of your body.
Talking with Your Health Care Team about Edema
Prepare for your visit by making a list of questions to ask. Consider adding these questions to your list:
- Are my medications or treatment likely to increase my risk of developing edema?
- Are there steps I can take to prevent edema?
- What symptoms or problems should I call you about?
- What steps can I take to feel better if I notice swelling?
- Are there foods, drinks, or activities I should avoid?
Swollen Face on One Side | Causes of Your Facial Swelling
Salivary duct stone (sialolithiasis)
A salivary duct stone is the most common disorder of the salivary glands (where you make spit). They can range in size from tiny particles to stones that are several centimeters in length.
Top Symptoms: swelling on one side of the face, swollen jaw, painful face swelling, spontaneous jaw pain, painful jaw swelling
Urgency: Phone call or in-person visit
A skin abscess is a large pocket of pus that has formed just beneath the skin. It is caused by bacteria getting under the skin, usually through a small cut or scratch, and beginning to multiply. The body fights the invasion with white blood cells, which kill some of the infected tissue but form pus within the cavity that remains.
Symptoms include a large, red, swollen, painful lump of pus anywhere on the body beneath the skin. There may be fever, chills, and body aches from the infection.
If not treated, there is the risk of an abscess enlarging, spreading, and causing serious illness.
Diagnosis is made through physical examination.
A small abscess may heal on its own, through the body’s immune system. But some will need to be drained or lanced in a medical provider’s office so that the pus can be cleaned out. Antibiotics are usually prescribed.
Keeping the skin clean, and using only clean clothes and towels, will help to make sure that the abscess does not recur.
Top Symptoms: rash with bumps or blisters, red rash, red skin bump larger than 1/2 cm in diameter, pus-filled rash, rash
Symptoms that always occur with skin abscess: rash with bumps or blisters
Urgency: Primary care doctor
Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.
The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.
Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.
Symptoms arise somewhat gradually and include sore, reddened skin.
If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.
Symptom of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.
Diagnosis is made through physical examination.
Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.
Top Symptoms: fever, chills, facial redness, swollen face, face pain
Symptoms that always occur with cellulitis: facial redness, area of skin redness
Urgency: Primary care doctor
Bruise of the face
A bruise is an area of skin discoloration. A bruise occurs when small blood vessels break and leak their contents into the soft tissue beneath the skin.
Top Symptoms: swelling on one side of the face, head or face injury, painful face swelling, warm and red face swelling, face bruise
Symptoms that always occur with bruise of the face: head or face injury
Hypothyroidism, or “underactive thyroid,” means that the thyroid gland in the neck does not produce enough of its hormones. This causes a slowing of the body’s metabolism.
The condition can occur due to autoimmune disease; any surgery or radiation treatment to the thyroid gland; some medications; pregnancy; or consuming too much or too little iodine. It is often found among older women with a family history of the disease.
Common symptoms include fatigue, constantly feeling cold, weight gain, slow heart rate, and depression. If left untreated, these and other symptoms can worsen until they lead to very low blood pressure and body temperature, and even coma.
Diagnosis is made through a simple blood test.
Hypothyroidism is easily managed with daily oral medication. The patient usually starts feeling better after a couple of weeks and may even lose some extra weight. It’s important for the patient to be monitored by a doctor and have routine blood testing so that the medication can be kept at the correct levels.
Top Symptoms: fatigue, depressed mood, difficulty concentrating, weight gain, muscle aches
Urgency: Primary care doctor
Infection of the salivary duct (sialadenitis)
The ducts that create saliva can be infected by bacteria and is typically found after surgery in the mouth and in the elderly that take medications that slow saliva production.
Top Symptoms: fever, chills, swelling on one side of the face, pain on one side of the face, swollen jaw
Urgency: Hospital emergency room
Swelling caused by use of an ace inhibitor
ACE Inhibitors are drugs used to prevent, treat or improve symptoms in conditions such as high blood pressure, coronary artery disease, heart failure and diabetes. In rare cases, these drugs can cause an allergic reaction that can be life-threatening.
Top Symptoms: shortness of breath, swollen face, trouble swallowing, swollen lips, swollen tongue
Symptoms that never occur with swelling caused by use of an ace inhibitor: hives, red swollen bumps or patches with a pale center
Urgency: Hospital emergency room
The Body’s Reaction to Injury
You step in a hole and turn your ankle or your knee. You throw too much and feel a twinge in your shoulder. You try to break your fall with your wrist. Acute injuries are easy to recognize: first comes the pain, and then comes the swelling. Chronic or long-term injuries take weeks, sometimes even months, to develop, but it is the same story: first comes the pain, then swelling.
Swelling is a normal reaction of the body to an injury. Sometimes the body goes overboard and the swelling response is excessive. When this happens it can actually begin to cause more harm than good.
What is swelling?
Swelling is any abnormal enlargement of a body part. It is typically the result of inflammation or a buildup of fluid. Edema describes swelling in the tissue outside of the joint. Effusion describes swelling that is inside a joint, such as a swollen ankle or knee. Hemarthrosis is a condition where there is blood and swelling within a joint. This indicates either a ligament injury, such as an ACL tear or a fracture. Hemarthrosis is determined by removing some fluid from the joint with a needle. Acute refers to swelling that occurs within 24 hours of injury. If the swelling occurs within the first 2 hours, it is probably associated with hemarthrosis and should be checked out by a physician. Chronic refers to swelling that occurs over a long period of time and can be difficult for an athlete to detect, but is very harmful if left untreated.
Why can swelling be a bad thing?
The body always responds to an injury with a predictable inflammatory response, as the first step towards healing. Redness, heat, swelling and pain are associated with this first stage. Redness and heat are caused by increased blood flow. Swelling is the result of the increased movement of fluid and white blood cells into the injured area. The release of chemicals and the compression of nerves in the area of injury cause pain. The pain and swelling can keep the athlete from using the injured part, serving to protect it from further injury. However, often times, the body’s response is excessive.
“Prolonged inflammation and pain can lead to atrophy of the muscles surrounding the joint and a decreased ability to activate the muscles,” states Lisa Kluchurosky, ATC, service line administrator for the Sports Medicine Department at Nationwide Children’s Hospital. “If not treated appropriately, the swelling can become chronic, or long term. Chronic swelling leads to tissues becoming more rigid and less pliable than their healthy counterpart. Less pliable tissues are more susceptible to further injury.”
What to do about swelling?
In the early phase, remember PRICE:
- P = Protection from further damage
- R = Rest to avoid prolonging irritation
- I = Ice (cold) for controlling pain, bleeding, and edema
- C = Compression for support and controlling swelling
- E = Elevation for decreasing bleeding and edema
- Protection can mean immobilization with a brace, or a wrap, or even just staying off the body part.
- Rest means not moving the body part in a painful way. Movement is good, and can increase healing, but it should be pain free at this stage.
- Ice for the first 72 hours, 20 minutes out of every hour. Leaving ice on longer actually reverses the effect it has, and may increase swelling. Chemical icepacks should never be applied directly to the skin, or frostbite can occur. Do not use heat for the first 72 hours; heat will increase the swelling.
- Compression, with an ace wrap. Your athletic trainer or doctor can show you how to wrap the body part to minimize swelling.
- Elevation, or resting with the injury above heart level, to encourage swelling to return towards the body, instead of collecting in the extremities where it is difficult to get rid of.
If your swelling is chronic, or lasts longer than 2-3 weeks, you should see your doctor. Your doctor will be able to recommend medication, exercise or therapy to resolve the swelling. Remember, swelling is the body’s reaction to an injury; if the swelling is still present, so is the injury.
Returning to Play
You are not ready to return to play until all the swelling is gone.
Kluchurosky says, “You should be able to perform multiple repetitions of the activities your sport requires (jumps, sprints, kicks, etc) without an increase in swelling or pain in the injured area before attempting to return to competition.”
Nationwide Children’s Hospital Sports Medicine specializes in diagnosing and treating sports-related injuries in youth, adolescent, and collegiate athletes. Services are available in multiple locations throughout central Ohio. To make an appointment, call 614-355-6000 or request an appointment online.
90,000 Swelling of the right side of the body – Question to the therapist
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90,000 what is the reason and what will help
On the air of the Russia 1 TV channel, rehabilitologist Sergei Agapkin and obstetrician-gynecologist, head of the Center for Gynecology, Reproductive and Aesthetic Medicine Yekaterina Zhumanova told what to do with edema, and first of all – with leg edema, and how to understand what their reason.
Someone, doctors say, is enough to raise – throw your legs over your head, someone – to drink more water.However, if simple advice like this doesn’t work, then there is a reason.
Agapkin explains that the appearance of edema is always based on some conditions that make it difficult to remove fluid from the body. And leg swelling is no exception.
Ekaterina Zhumanova, for her part, says that women should not blame everything on hormonal changes (including menopause).
First of all, edema occurs with excess weight and a sedentary lifestyle.
However, in childbearing age, Agapkin adds, premenstrual syndrome (PMS) can lead to such consequences.
Among the possible causes of edema are also ovarian dysfunction, impaired lymph flow, thrombosis.
There is only one recommendation in this case: go to the doctor, take a blood test and do an ultrasound of the veins of the lower extremities in order to understand if there are any problems with venous outflow.
Another cause of edema is renal failure, says Dr. Agapkin.
Doctor Zhumanova adds that she (as well as kidney problems in general) is characterized by facial edema.
In this case, it is necessary to pass a urine test to determine if there are kidney problems.
If they are, the expert explains, then just raising your legs and drinking more will not help in this case – it is treated in a completely different way.
It is very difficult to figure it out on your own, adds Zhumanova.
Experts explain: if swelling does not occur every day (for example, when it is hot, you sit more, move less, or this is clearly the second phase of the cycle), then most likely this is some kind of physiological process that can be controlled.
If this occurs every day, increases, or (as with thrombosis) one leg swells more than the other, then in no case should one self-medicate – an urgent need to go to a doctor.
Dr. Agapkin gives advice to those who have edema only in the heat. It is enough for them to come home, take a towel, soak them in cold water and wrap their legs for 5-10 minutes to cool the skin and subcutaneous fatty tissue.
If swelling occurs in the afternoon, lie down and raise your legs.However, if a person gets up in the morning with swollen legs, this method most likely will not bring him any relief, doctors say.
Thus, doctors summarize, people who regularly have swollen legs should go to the doctor, take urine tests, as well as a biochemical, clinical blood test.
In addition, women need to visit a gynecologist to find out their hormonal status. It is also advisable to do an ultrasound examination of the veins of the lower extremities, and then it will become clear what treatment to prescribe to those faced with this problem.
British doctors: with a microstroke you need to drink aspirin
Photo author, istock
Aspirin will help with a microstroke
British doctors advise people who have had a microstroke to start taking aspirin immediately. This can significantly reduce the likelihood of recurrent or more extensive strokes.
Scientists from the University of Oxford noted that although doctors now advise patients to take aspirin after micro-strokes, the positive dynamics from taking the drug at the earliest stage is “very underestimated.”
In an article published in the British medical journal Lancet, doctors from Oxford called for an update of the guidelines for medical practitioners on the use of aspirin in this case.
The National Health Service of England (NHS) has already announced that it will carefully review the results of the study.
Most critical hours
Photo by, istock
Aspirin has the most positive effect in the first minutes after a stroke
Microstrokes, or transient ischemic attacks (TIA), occur due to impaired blood circulation in the brain.They can cause numbness in the limbs, speech or vision problems.
All these symptoms usually disappear within a few days. However, in the first few days after a microstroke, there is an increased risk of major stroke, causing more serious and long-term symptoms.
It has been known before that aspirin can significantly reduce this risk. Doctors have long prescribed aspirin to people at risk because it reduces the risk of blood clots and thins the blood.However, now scientists have shown that aspirin is most beneficial in the first critical hours after a microstroke or TIA.
Oxford scientists estimate that taking aspirin at an early stage can reduce the risk of major stroke by five times, from one in 20 people to one in 100.
Head of the research team, Professor Peter Rothwell, said that the benefits of immediate aspirin therapy “are enormous. degree is underestimated. ”
“We want people, if they suspect that they have had a microstroke or TIA, immediately take aspirin and go to the doctor,” he added.
Stroke symptoms. Check the following:
Photo author, istock
The larger the stroke, the more severe the symptoms and the longer they last
- Face – Has the face moved to one side? Can the patient smile?
- Arms – can the patient raise both arms above the head and hold them in this position?
- Speech – can the patient pronounce words normally?
- Time – If you notice any of these symptoms, it is a stroke, call an ambulance immediately.
Additional symptoms of stroke and microstroke
- Sudden loss of vision or blurred vision in one or both eyes;
- Sudden weakness or numbness on one side of the body;
- Sudden memory loss or disorientation;
- Sudden dizziness, inability to stay on your feet, falling, especially in combination with any of the above symptoms.
Scientists are now urging all medical services, including ambulance workers and NHS telephone operators, to recommend that patients take aspirin as soon as possible at the first suspicion of a stroke.
At the same time, they emphasize that it is not necessary to immediately send patients with microstroke home from the hospital, providing them with a prescription for aspirin. A careful medical examination is still very important.
Photo author, istock
Aspirin is one of the most widely used drugs in the world
Oxford doctors studied data from 15 clinical studies, which involved thousands of people. All of them took aspirin both immediately after the stroke and in the longer term to prevent repeated strokes.
Dr. Dade Webb of the Stroke Association charity said the results of the study “filled him with optimism.”
“However, it is important to note that taking aspirin is not an alternative to full-fledged medical care. Anyone who suspects they have a stroke should immediately call an ambulance,” he said. “Nonetheless, these studies show that if the patient experiences some symptoms that may indicate a microstroke, but his condition gradually improves, then he should take aspirin. “
What is it
Transient ischemic attack (also known as microstroke) – symptoms usually disappear within 24 hours, most often within 10-60 minutes.
Mild stroke – Symptoms last more than 24 hours but usually resolve within a few days and are relatively mild.
Major stroke – usually means that a number of symptoms do not go away at all.
- Source : Professor Peter Rothwell, University of Oxford
Meanwhile, Tony Rudd, director of Stroke Clinical Research at the National Health System, noted that while the new study certainly contains important data, should be read carefully before changing recommendations for medical practitioners.
Health experts generally advise against taking aspirin without first consulting a doctor for people suffering from bleeding or asthma.
New guidelines for doctors on how to treat strokes are to be published in Britain in the fall.
History of aspirin
Photo author, istock
Salicylic acid was isolated from plant alkaloids
3000 – 1500 BC : Ancient Sumerians and Egyptians used bark and anesthetic as an anesthetic and pain reliever means.
400 BC : Hippocrates recommended giving tea made from willow leaves (they contain the natural alkaloid from which aspirin was isolated) to women to relieve pain during childbirth.
1763: The Royal Society of England published the results of a study on the use of dried pounded willow bark for the treatment of fever. The study was conducted by Edward Stone, a priest in Chipping Norton Ward in Oxfordshire.
Photo author, istock
The healing properties of willow bark, which contains salicin, have been known since ancient times
1828 : Josef Buchner, professor of pharmacology at the University of Munich in Germany, has successfully isolated the active ingredient from willow in in the form of bitter yellow crystals, which he called salicin.
1830 : Swiss pharmacist Johann Pagenstecher isolated salicin from meadowsweet flowers. Later, the same results were achieved by the German scientist Karl Jacob Levig.
1853 : French chemist Charles Frederic Gerard determined the chemical structure of salicylic acid and was able to synthesize it chemically.
1876 : The first clinical trials of salicin showed that it reduced fever and joint inflammation in patients with rheumatism.
1897 : An employee of the German pharmaceutical company Bayer, chemist Felix Hoffmann, added an acetyl group to salicylic acid, thereby reducing the irritant effect that the latter had on the stomach. The company patented this find.
1899 : Bayer markets acetylsalicylic acid under the trade name aspirin. “A” – acetyl, “spir” – from the Latin name of meadowsweet Spiraea ulmaria, “in” – a common suffix in the names of drugs of that time.
Photo author, istock
The structural formula of acetylsalicylic acid was determined only in the middle of the 19th century
1950 : Aspirin enters the Guinness Book of Records as the most common pain reliever in the world.
1971 : John Wayne, professor of pharmacology at the University of London, publishes a paper explaining how aspirin affects the body.
1974 : Results of the first clinical trial of aspirin published as an agent that reduces the risk of death from heart attack.The results showed a 12% decrease in deaths in the first six months, and 25% in a year. However, the results were statistically mixed.
1991 and 1993 : A positive role for aspirin in cancer treatment has been reported in the United States.
1997 : A study in China showed that the use of aspirin in the early stages of treating ischemic strokes has a small but beneficial effect.
1998 : Studies show that aspirin significantly reduces the risk of heart attacks.
2005 : The United States confirms that aspirin reduces the risk of stroke in women.
Photo author, Getty Images
Bayer was the first to receive a patent for aspirin
2011 : Eight clinical trials have been published in Britain showing that people who have taken aspirin regularly for four years have 44 % reduced risk of dying from cancer compared with placebo controls.
2013 : Further studies have confirmed the beneficial effects of aspirin in the fight against cancer, but patients are at increased risk of stomach ulcers and intestinal bleeding.
2014 : Several scientific studies have shown the long-term preventive effect of regular aspirin in the prevention of bowel, stomach and esophageal cancer.
2018 : A study is pending on how beneficial the effects of aspirin use for older people over 70 years of age and how much it outweighs the potential risks.
Choosing a mattress according to the sleeping position
The position in which a person most often sleeps has a great influence on well-being in the morning, the quality of sleep and the general condition of the body.
Unfortunately, there is no one ideal and correct sleeping position. It is necessary to choose it depending on the degree of hardness of your mattress and the characteristics of the body.
In this article, we will look at how resting position affects the human body and what are the best sleeping positions.
The content of the article
- What does sleep posture affect
- Sleep on stomach
- Why sleeping on the left side is the most beneficial
- Sleep on the right side
What does sleep posture affect
Do you often wake up in a bad mood? Maybe it’s not you, but your mattress or the wrong sleeping position!
It is enough to sit on an uncomfortable chair for half an hour, so that thoughts of unpleasant sensations drive out all the others from the head.Now remember that we spend about 8 hours a day in a dream, and if all this time the body is in the wrong position, it can cause significant harm to the body. Specifically what the sleeping posture affects:
- blood supply to organs, including the brain;
- muscle regeneration,
- spine condition,
- facial skin condition,
- on the lymphatic system.
Sleep on stomach
According to studies, about 15% of people prefer to sleep on their stomachs.Unfortunately, this sleeping position can hardly be called healthy for the body. The main problem is the incorrect position of the spine and cervical spine, as well as excessive pressure on the chest and internal organs. As a result, instead of removing the load accumulated during the day, the body experiences additional discomfort.
Another negative factor is that the person actually has to sleep with their face in the pillow. Because of this, swelling of the face occurs, the skin is compressed, which leads to the appearance of early wrinkles and aging of the skin.In addition, there is no support for the cervical spine, which is fraught with discomfort in the neck in the morning and migraines.
We recommend that you stop sleeping on your stomach and choose the sleeping position on your back or on your side. If you are not able to immediately quit this bad habit, choose models of mattresses with elastic fillers in the upper layers. An excellent solution would be to choose a mattress with memory effect (MEMORY) in the composition.
How to reduce the negative effect on the body?
- Change position slightly.It is enough to bend one leg to relieve the load on the spine and reduce the pressure on the internal organs.
- To avoid waking up in the morning with a puffy face and to avoid premature wrinkles, choose anatomical pillows made of memory foam. They delicately follow every curve of your body without putting back pressure on your face. It is the squeezing of the skin of the face that causes the appearance of wrinkles. Thanks to the unique property of memory foam, this can be avoided.The pillow should be low so that the cervical spine is in the correct position.
In order to reduce the negative effect of sleeping on the abdomen, you should choose moderately soft or medium models with or without springs. But in order to get the full benefit from sleeping on an orthopedic mattress, it is better to choose sleeping on your back.
One of the best sleeping positions, provided that you sleep in the correct sleeping place for you.The spine in this position assumes a neutral position. This allows him to get rid of the load accumulated during the day. At the same time, muscles also rest – it is not for nothing that athletes are recommended to sleep on rigid models. Effective muscle relaxation contributes to their accelerated regeneration.
Among the disadvantages of this position are snoring and an increased chance of encountering sleep paralysis. It is also best not to sleep on your back if you are suffering from sleep apnea. But these phenomena are quite rare. If you have not previously encountered them, you can safely choose this position for a night’s rest.
Mattress and pillow for sleeping on the back
Almost any mattress is suitable for sleeping on your back. The main thing is that he has orthopedic qualities. Even a soft mattress is able to keep the body and especially the spine in the correct position. But when choosing a soft model, you should look at the mattresses on an independent spring block. Preferably with a block of springs not lower than S1000. When choosing medium, moderately hard, and firm mattresses, choose mattresses of any design.
Choosing the wrong pillow while sleeping on your back will lead to muscle tension and pain in the neck
Sleeping on your back is better on an orthopedic pillow with bolsters.These pillows have a special recess for the head. And the rollers will support the cervical spine, relieving it of the accumulated load overnight. You can also choose a classic anatomical pillow, but not too high.
Sleep on the left side
Although it is not without its flaws, this sleeping position can be called the best! Rest on the left side has the following advantages:
- No heartburn. The stomach is located lower in relation to the esophagus, so gastric juice cannot enter it.
- Improved digestion. First, it’s all about simple gravity – it will be easier for food waste to move from the colon to the colon, which makes it easier for the intestines to work. Secondly, since the stomach and pancreas are displaced to the left side, it will be easier for them to perform their function, because they will be in a natural position.
- The possibility of snoring and apnea in this position is minimized.
- Benefits for the lymphatic system. It flows into the thoracic duct, which is located on the left side.Sleeping on the left side facilitates the elimination of toxins from the body.
- Less likely to experience sleep paralysis compared to supine position.
But this position also has disadvantages, which appear with the wrong choice of mattress rigidity and pillow model:
- Firstly, these are creases on the face due to contact of the face with the pillow and earlier aging.
- Second, impaired blood flow in the shoulders and arms.
The right side sleep position lacks almost all of the benefits of left side sleep.Of the advantages, only the absence of snoring and breathing disorders during sleep can be noted. But resting on your side can cause heartburn. The fact is that during sleep on the right side, gastric juice can enter the esophagus, because it will be located higher. Obviously, if you like to sleep on your side, it’s best to choose the left side.
Matching mattresses and pillows for sleeping on the side
When sleeping on your side, too firm mattresses should be avoided (left picture). Optimum rigidity is not higher than average (right picture).In the second case, the spine will be in its natural position
For this resting position, it is better to choose mattresses not higher than the average firmness level with balanced orthopedic and anatomical properties. The body should “sink” a little into the mattress so that the spine takes an even position, and soft tissues are not squeezed. A mattress that is too hard will cause a distortion of the spinal column and pain in the body – in the shoulders and soft tissues.
An example of a mattress for comfortable sleeping on the side.The thick soft latex top layer is complemented by a hard coconut coir layer. The center of the structure is the spring block.
The right side sleeping mattress has an anatomical top layer, approx. 3 cm high, which adapts to the contours of the body. For example, natural latex, memory foam or natural soy. A hard layer under the soft material, as well as a block of independent springs, are responsible for the correct support of the spine in a dream.
When choosing a pillow, it is better to pay attention to orthopedic models with rollers.The largest cushion is made for sleeping on the side, it resiliently supports the cervical spine. While resting on the side, the face is in contact with the pillow, so it is better to choose models from anatomical materials, as indicated in the paragraph about sleeping on the stomach.
Sleep pose has a great impact on the human body. If you want your sleep to be healthy, choose sleeping on your back or on your left side. But also do not forget about accessories for sleeping. The wrong mattress or too high a pillow can negate all the benefits of sleeping in the right position.Not sure which stores sell mattresses from our catalog? We will give you a hint: these are the MultiSna showrooms in the Baby Store shopping center and the Furniture Park shopping center in Moscow.
Contact our specialists if you need help choosing a mattress depending on your favorite sleeping position and other parameters.