Fluid leaking from ankles: ‘Leaky legs’: strategies for the treatment and management of lower-limb lymphorrhoea
The management of fluid leakage in grossly oedematous legs
There are no easy ways to manage gross oedema and the resulting fluid leakage. It is vital to treat the underlying cause and reduce the risk of complication
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VOL: 99, ISSUE: 21, PAGE NO: 54
Managing patients with grossly oedematous legs poses challenges because the condition is often accompanied by the leakage of considerable volumes of fluid, often known as ‘leaky legs’. Irene Anderson explains why leakage occurs, provides an overview of management strategies and opens the debate on how to manage the condition.
Author: Irene Anderson, BSc, RGN, DPSN, is senior lecturer, tissue viability, University of Hertfordshire, Hatfield.
Oedema occurs when there is an abnormal amount of fluid in the interstitial space. Normally about 85 per cent of the fluid that is filtered out of capillaries into this space is reabsorbed; the rest is drained by the lymphatic system (Tortora and Grabowski, 2000). A rise in capillary blood pressure causes increased quantities of fluid to escape from capillaries. As a result, filtration of fluid into the tissues exceeds the reabsorption rate of fluid into the circulation, leading to oedema (Tortora and Grabowski, 2000) (Fig 1).
Oedema of one limb may be indicative of venous or lymphatic disease, while bilateral limb oedema may be a symptom of heart or kidney disease (Gorman et al, 2000). Pitting oedema may indicate congestive cardiac failure. In ischaemic conditions, the cause may be limb dependency as patients try to alleviate pain by hanging the limb out of the bed (Stubbing and Chesworth, 2001).
Oedema and fluid leakage
Problems can occur if the volume of interstitial fluid in the limb exceeds its capacity to retain it. This may be complicated if there is a breach in skin integrity or an infection. This can result in gross swelling, blistering and leakage of interstitial fluid on to the skin.
Fluid that leaks from grossly oedematous legs will differ depending on the underlying cause. Transudate is excess fluid that is forced out as a result of elevated capillary blood pressure in the lower limb (Cutting and White, 2002). Fluid leakage resulting from failure of the lymphatic drainage system is called lymphorrhoea (Board and Harlow, 2002a). It is important to remember that fluid leakage can also be caused by a large wound or by some skin conditions that result in the formation of papules and vesicles (Moffatt and Harper, 1997).
Management of leaking interstitial fluid often centres on appropriate dressing selection. However, it is essential to take an interdisciplinary approach to managing patients to prevent complications, maintain skin integrity and promote independence.
Consequences of gross oedema
A grossly oedematous limb is physically heavy to lift, affects mobility and well-being, and has a high risk of infection. If it is leaking fluid, it will feel wet and quickly become cold. The fluid will soil clothing and bedlinen, and could pose a safety problem if flooring becomes slippery.
There is a risk of infections such as cellulitis or erysipelas, although the causative organism is rarely identified from skin swabbing (Regnard et al, 1997). Erysipelas can develop rapidly with acute onset of inflammation – it is characterised by a firm red margin and blistering. Cellulitis has a less rapid onset and ill-defined margins, and blistering is less likely to occur.
In both cases the patient will feel unwell and febrile, but will usually respond rapidly to antibiotic or antifungal treatment (Seal et al, 2000). The recurrence rate of erysipelas and cellulitis is significant (Dupuy et al, 1999) and management should focus on reducing the cause of oedema where possible.
It can be difficult to differentiate between varicose eczema and cellulitis. The former is characterised by scaling and crusting, while the latter generally by shiny, tight skin (Quartey-Papafio, 1999). However, in some cases cellulitis may be concurrent with varicose eczema, making distinction difficult. Topical antimicrobials may be indicated, but if the whole lower limb is affected it is crucial not to exceed the recommended dose. In the acute phase of cellulitis or erysipelas the patient may need hospital treatment.
Management of leaking fluid
There is a range of dressings materials and devices for dealing with wound fluid (Anderson, 2002), although choice is limited when treating a grossly oedematous limb, owing to its size and leaking fluid. Dressings designed to deal with significant fluid volumes include foam, alginate, hydrofibre and composite dressings. However, dressings may quickly become saturated and thus extremely heavy, causing them to slip and pull on the skin.
Alginates and hydrofibre dressings are recommended for high exudate levels but would have to be used in sufficient quantity to cover the limb and require a secondary dressing. Low-adherent silicone materials could also be used but, again, these need to be used in sufficient quantity to cover the limb. Padding material, such as surgical pads or absorbent surgical dressings (for example Gamgee tissue), may be used as secondary dressings, but there is a risk of skin damage and discomfort owing to the weight of the wet dressing and cooling of the patient’s leg (Anderson, 2002).
There are anecdotal reports of absorbent disposable continence pads or nappies being used to absorb fluid but there is lack of evidence to support this practice. There may be a case for protecting bedding this way.
Barrier creams are often applied to leaking legs to protect skin from breakdown. This must be balanced against the possibility of blocking the absorptive action of the dressing material. This is particularly pertinent in the case of alginate and hydrofibre dressings that rely on direct contact with wound fluid (Anderson, 2000).
It is not advisable to use adhesive dressings on grossly oedematous legs because they may tear the very fragile taut skin and will require frequent changing.
Compression therapy, elevation and exercise
Because reabsorption of fluid occurs when pressure in the tissues exceeds pressure in the capillaries (Tortora and Grabowski, 2000) (Fig 1), the application of compression to the lower limb aids drainage of excess fluid back in to the capillaries by reducing the capillary pressure (Moffatt and Harper, 1997).
Graduated compression therapy can be applied using multilayer, short-stretch, intermittent compression bandages or compression hosiery. However, it can be difficult to apply these to grossly oedematous limbs because of distortion of limb shape. Pain may also govern the decision to apply compression therapy. It can be difficult to determine the status of arterial supply in the lower limb using a hand-held Doppler device because of the oedema. Compression should not be applied to limbs with significant arterial insufficiency.
If gross oedema is caused by lymphatic failure, the use of specialist therapeutic massage techniques to aid lymph drainage may help (Board and Harlow, 2002b).
Limb elevation is often recommended for dependent oedema. However, arterial insufficiency may make this undesirable because elevation will further reduce the blood supply to the lower limb (Moffatt and Harper, 1997). Great care must be taken when elevating limbs or applying compression therapy in patients with heart failure, as the increased volume of fluid return to the circulation may be catastrophic (Morison et al, 1997).
Exercise is important in managing oedema: muscle pump action assists reabsorption of fluid and drainage via the lymph system (Board and Harlow, 2002c).
Potassium permanganate is a mild antiseptic with astringent properties. There is a debate about its role in managing exuding wounds (Hollinworth and Quick, 1995). It may be useful in the short term for treating extensively leaking legs, under supervision of a dermatologist. However, clinical experience would suggest it only offers brief respite.
Pharmaceutical agents, such as diuretics, are used to control circulating fluid volumes in the body. It is important to use these appropriately and not merely to reduce dependent oedema (Khan, 2000).
It is vital to record changes in limb volume, to assess the impact of clinical decisions. This may be as simple as measuring limb circumference. This is important if compression hosiery is being used – as fluid levels reduce, compression bandages will need to be reapplied more frequently. The patient may benefit psychologically from seeing the difference in limb size.
Interdisciplinary care Nurses play a vital role in assessing, monitoring and providing psychological support. The patient may need to be referred to a dermatologist, microbiologist and vascular consultant. Occupational therapists can provide aids for activities of daily living, while physiotherapists can offer exercises and help with mobility. There can be a role for the specialist nurse in lymphoedema, particularly if limb size does not reduce in the short term. Although this is a distinct condition, the specialist nurse’s experience can be utilised for patients suffering similar difficulties.
There are no easy ways to manage gross oedema and the resulting fluid leakage. It is vital to treat the underlying cause and reduce the risk of complication, such as infection and injury to wet, vulnerable skin.
Anderson, I. (2002) Practical issues in the management of highly exuding wounds. Professional Nurse; 18: 3, 145–148.
Board, J., Harlow, W. (2002a) Lymphoedema 2: classification, signs, symptoms and diagnosis. British Journal of Nursing; 11: 6, 389–395.
Board, J., Harlow, W. (2002b) Lymphoedema 3: the available treatments for lymphoedema. British Journal of Nursing; 11: 7, 438–450.
Board, J., Harlow, W. (2002c) Lymphoedema 1: components and function of the lymphatic system. British Journal of Nursing; 11: 5, 304–309.
Cutting, K.F., White, R. (2002) Avoidance and management of peri-wound maceration of the skin. Professional Nurse; 18: 1, 33–36.
Dupuy, A. et al (1999) Risk factors for erysipelas of the leg (cellulitis): case-control study. British Medical Journal; 318: 7198, 1591–1594.
Gorman, W.P. et al (2000) Swollen lower limb 1: general assessment and deep vein thrombosis. British Medical Journal; 320: 7247, 1453–1456.
Khan, M.G. (2000) Cardiac Drug Therapy. London: W.B Saunders.
Hollinworth, H., Quick, A. (1995) Using potassium permanganate for wound cleansing. Journal of Wound Care; 4: 2, 194.
Moffatt, C., Harper, P. (1997) Leg Ulcers. London: Churchill Livingstone.
Morison, M. et al (1997) Nursing Management of Chronic Wounds. London: Mosby.
Quartey-Papafio, C.M. (1999) Importance of distinguishing between cellulitis and varicose eczema of the leg. British Medical Journal; 318: 7199, 1672–1673.
Regnard, C. et al (1997) ABC of palliative care: mouth care, skin care and lymphoedema. British Medical Journal; 315: 7114, 1002–1005.
Seal, D.V. et al (2000) Skin and wound infection. London: Martin Dunitz.
Stubbing, N., Chesworth, J. (2001) Assessment of patients with vascular disease. In: Murray, S. (ed.) Vascular Disease: Nursing and Management. London: Whurr Publishers.
Tortora, G.J., Grabowski, S.R. (2000) Principles of Anatomy and Physiology. Chichester: Wiley and Sons.
Types, Causes, Symptoms, and Treatment
“Edema” is the medical term for swelling. Body parts swell from injury or inflammation. It can affect a small area or the entire body. Medications, pregnancy, infections, and many other medical problems can cause edema.
Edema happens when your small blood vessels leak fluid into nearby tissues. That extra fluid builds up, which makes the tissue swell. It can happen almost anywhere in the body.
Types of Edema
Peripheral edema. This usually affects the legs, feet, and ankles, but it can also happen in the arms. It could be a sign of problems with your circulatory system, lymph nodes, or kidneys.
Pedal edema. This happens when fluid gathers in your feet and lower legs. It’s more common if you’re older or pregnant. It can make it harder to move around in part because you may not have as much feeling in your feet.
Lymphedema. This swelling in the arms and legs is most often caused by damage to your lymph nodes, tissues that help filter germs and waste from your body. The damage may be the result of cancer treatments like surgery and radiation. The cancer itself can also block lymph nodes and lead to fluid buildup.
Pulmonary edema. When fluid collects in the air sacs in your lungs, you have pulmonary edema. That makes it hard for you to breathe, and it’s worse when you lie down. You may have a fast heartbeat, feel suffocated, and cough up a foamy spittle, sometimes with blood. If it happens suddenly, call 911.
Cerebral edema. This is a very serious condition in which fluid builds up in the brain. It can happen if you hit your head hard, if a blood vessel gets blocked or bursts, or you have a tumor or allergic reaction.
Macular edema. This happens when fluid builds up in a part of your eye called the macula, which is in the center of the retina, the light-sensitive tissue at the back of the eye. It happens when damaged blood vessels in the retina leak fluid into the area.
Causes of Edema
Things like a twisted ankle, a bee sting, or a skin infection will cause edema. In some cases, like an infection, this may be helpful. More fluid from your blood vessels puts more infection-fighting white blood cells in the swollen area.
Edema can also come from other conditions or from when the balance of substances in your blood is off. For example:
Low albumin. Your doctor may call this hypoalbuminemia. Albumin and other proteins in the blood act like sponges to keep fluid in your blood vessels. Low albumin may contribute to edema, but it’s not usually the only cause.
Allergic reactions. Edema is a part of most allergic reactions. In response to the allergen, nearby blood vessels leak fluid into the affected area.
Obstruction of flow. If drainage of fluid from a part of your body is blocked, fluid can back up. A blood clot in the deep veins of your leg can cause leg edema. A tumor blocking the flow of blood or another fluid called lymph can cause edema.
Critical illness.Burns, life-threatening infections, or other critical illnesses can cause a reaction that allows fluid to leak into tissues almost everywhere. This can cause edema all over your body.
Congestive heart failure. When the heart weakens and pumps blood less effectively, fluid can slowly build up, creating leg edema. If fluid builds up quickly, you can get fluid in the lungs. If your heart failure is on the right side of your heart, edema can develop in the abdomen.
Liverdisease. Severe liver disease, such as cirrhosis, causes you to retain fluid. Cirrhosis also leads to low levels of albumin and other proteins in your blood. Fluid leaks into the abdomen and can also cause leg edema.
Kidney disease. A kidney condition called nephrotic syndrome can cause severe leg edema and sometimes whole-body edema.
Pregnancy. Mild leg edema is common during pregnancy. But serious complications of pregnancy like deep vein thrombosis and preeclampsia can also cause edema.
Head trauma, low blood sodium (called hyponatremia), high altitudes, brain tumors, and a block in fluid drainage in the brain (known as hydrocephalus) can cause cerebral edema. So can headaches, confusion, unconsciousness, and coma.
Medications. Many medicines can cause edema, including:
When they cause swelling, usually it’s mild leg edema.
Symptoms of Edema
Your symptoms will depend on the amount of swelling you have and where you have it.
Edema in a small area from an infection or inflammation (like a mosquito bite) may cause no symptoms. On the other hand, a large allergic reaction (such as from a bee sting) may cause edema on your entire arm that can bring pain and limit your arm’s movement.
Food allergies and allergic reactions to medicine may cause tongue or throat edema. This can be life-threatening if it interferes with your breathing.
Leg edema can make the legs feel heavy. This can affect walking. In edema and heart disease, for example, the legs may easily weigh an extra 5 or 10 pounds each. Severe leg edema can interfere with blood flow, leading to ulcers on the skin.
Pulmonary edema causes shortness of breath and sometimes low oxygen levels in the blood. Some people with pulmonary edema may have a cough.
There may be an indent or a “pit” that remains for a while after you push on the skin in some types of edema. This is called pitting edema. If the tissue springs back to its normal shape, it’s called non-pitting edema. It’s a symptom that may help your doctor figure out the cause of your edema.
Treatment of Edema
To treat edema, you often must treat its underlying cause. For example, you might take allergy medications to treat swelling from allergies.
Edema from a block in fluid drainage can sometimes be treated by getting the drainage flowing again. A blood clot in the leg is treated with blood thinners. They break down the clot and get drainage back to normal. A tumor that blocks blood or lymph can sometimes be shrunk or removed with surgery, chemotherapy, or radiation.
Leg edema related to congestive heart failure or liver disease can be treated with a diuretic (sometimes called a ”water pill”) like furosemide (Lasix). When you can pee more, fluid from the legs can flow back into the blood. Limiting how much sodium you eat can also help.
Oedema – build-up of fluid
What is oedema?
Oedema (pronounced ‘uh-dee-ma’) is a swelling caused by a build-up of fluid. It often affects the legs and ankles but can affect any part of the body. Oedema causes swelling under the skin, and can also cause:
- stretched, shiny or discoloured skin
- pain and discomfort
- stiff joints
- leaking of fluid from the skin
- a feeling of tightness or heaviness.
What are the causes of oedema?
Oedema can be caused by:
- illness, including cancer, heart failure and kidney failure
- side effects of medications
- not moving for long periods
- a very low level of protein in your blood (hypoalbuminemia).
What are the treatments for oedema?
If you think you have oedema, let your nurse or doctor know. They can suggest ways to help. You might be referred to a specialist physiotherapist, occupational therapist or nurse for advice. They will look for the specific cause of your oedema. If they can identify it, they’ll treat it directly. If they can’t find a cause they will help you find ways to get relief from the symptoms.
Options for managing oedema include:
- using compression stockings
- putting your feet up when sitting
- keeping active – even gentle exercise can help
These techniques all encourage the fluid to drain away and reduce the swelling.
What is lymphoedema?
Lymphoedema is a swelling in the body caused by blockage or failure of the lymphatic (pronounced ‘lim-fa-tick’) system. The lymphatic system is made of lymph nodes (glands) and a network of tiny tubes (lymph vessels). The fluid in your body drains into lymph vessels so it can be carried back to your heart and into your blood.
If there is a problem with the lymphatic system, the fluid isn’t drained away properly and builds up under the skin.
Lymphoedema most commonly affects your arms or legs, but can also happen in other areas of your body.
When lymphatic fluid builds up in the body, it can cause problems including:
- pain or discomfort
- a feeling of tightness or heaviness
- difficulty moving
- leaking of fluid from the skin
- thickening of the skin
- skin infection – lymphoedema means you have a higher risk of infection if you have a cut or scratch in your skin.
Lymphoedema can be distressing for some people. It can change the way you think about your body and make you feel low or worried.
What are the causes of lymphoedema?
There are lots of reasons why a person might have lymphoedema. It’s often caused by cancer and treatments for cancer, including radiotherapy and surgery.
What are the treatments for lymphoedema?
If you think you have lymphoedema, speak to your doctor or nurse about your concerns. If it’s a new problem, they can offer you tests to find out what’s causing the lymphoedema. They can also refer you to a specialist team for assessment, if one is available in your area. You can contact the Lymphoedema Support Network to find out about your local lymphoedema service.
Lymphoedema can’t be cured but there are things that can be done to manage it. There are four main way to treat it:
- Compression – wearing special clothing or bandages that gently squeeze the part of your body that’s affected and encourage the fluid to drain away.
- Massage – a special type of massage called Manual Lymphatic Drainage encourages the fluid to drain away. This massage can be done by yourself, a carer or family member, or by a healthcare professional.
- Skin care – keep your skin clean and moisturised. Clean any cuts or scratches with an antiseptic and cover them with a plaster – this can help to reduce the risk of infection. If you have lymphoedema in your arm or leg, it’s important to have blood tests or blood pressure tests done on the affected arm or leg.
- Exercise – moving your body, even a little bit, helps the lymphatic fluid to drain away.
Diuretics (water tablets) are not recommended in the treatment of lymphoedema.
There are also specialist treatments available in some areas. Your doctor, nurse, or lymphoedema specialist will help you find the techniques that work best for you.
Oedema | Fluid & Water Retention
Oedema is fluid retention. It used to be called dropsy. Oedema can be most easily seen around the ankles after you’ve been standing (peripheral oedema). After lying down for a while, your eyes may look puffy and swollen. In severe cases, oedema can also collect in your lungs and make you short of breath.
Mild oedema is common and usually harmless. It may be due to medication, allergies, or more serious underlying disease.
It is important to seek medical attention if you have oedema. Often no particular cause will be found. The most common causes are mentioned below.
What is oedema?
Oedema is a collection of fluid in the spaces between cells of the body. Fluid leaks out of damaged cells. The fluid cannot be simply drained with a needle and may not improve if you take ‘water pills’ (diuretics).
Types of oedema include:
- Idiopathic – no known cause.
- Localised – fluid retention in a particular part of the body. It is usually due to injury or an allergic reaction.
- Generalised – affects the whole body. It usually causes puffy ankles after standing and puffy eyes after lying down for a while. This may be due to an underlying heart condition.
- Cerebral oedema – fluid on the brain, usually due to infection (meningitis) or serious brain disease (stroke or brain tumour).
- Pulmonary oedema – fluid on the lungs, usually due to heart disease.
- Lymphoedema – a build-up of lymph fluid when lymph channels are damaged – eg, after breast cancer surgery.
What causes oedema?
Fluid retention (oedema) may be caused by many different conditions. Oedema may be due to having to spend a long time sitting or having to stay in bed (immobility). Varicose veins and pregnancy are also common causes of oedema. Oedema may also be caused by serious conditions such as heart failure, liver disease or kidney disease.
No known cause (idiopathic)
Idiopathic oedema is the term for fluid retention which it not caused by a known medical condition. It is most common in women and can sometimes worsen with age. Although there is no cure for idiopathic oedema, having a healthy diet which is low in salt can make a real difference.
Many people with fluid retention are overweight, and losing weight can make a big difference to improve the oedema. A gradual weight loss (rather than fasting and bingeing) is recommended. Support stockings and regular exercise are also beneficial. Avoiding long periods of standing can also help.
An excess collection of watery fluid in the lungs (pulmonary oedema) is often caused by heart failure. The fluid collects in the many air sacs (alveoli) of the lungs, making it difficult to breathe. When the heart is unable to pump blood to the body efficiently, the amount of blood staying in the veins that take blood through the lungs to the left side of the heart increases. As the pressure in these blood vessels increases, fluid is pushed into the alveoli in the lungs. This fluid reduces normal oxygen movement through the lungs, which can lead to shortness of breath.
Angio-oedema is a condition that can cause swelling of the deeper layers of the skin. These include the dermis and subcutaneous tissues. It also affects the tissues just under the lining of the airways, mouth and gut (the submucosal tissues).
In most cases there is no known cause and it is not clear why it occurs. This is called idiopathic angio-oedema. Although the cause is not clear, in up to half of cases there is a link to an autoimmune disorder. These include chronic urticaria, systemic lupus erythematosus (SLE), or having an underactive thyroid gland (thyroiditis, hypothyroidism). In some cases there are known triggers that can cause the release of histamine, which leads to tissue swelling of angio-oedema. These include allergic reactions and non-allergic reactions to medicines.
Other possible causes of oedema include anaemia, pregnancy and some kidney diseases. A blood clot in a leg (deep vein thrombosis) can make the leg (with the blood clot) swell.
The doctor will want to know when you first noticed the oedema, how long it lasted for and whether you have any other symptoms. It is important to mention if you’ve started any new medication. You will be given a physical examination of your lungs, heart and blood pressure as well as the part which is puffy. You will probably be asked for a urine sample and to have a blood test. You may need further tests on your heart, and a chest X-ray.
What treatments may be offered?
Treatment will depend on the likely cause of your fluid retention (oedema). Most cases will be managed by your GP but you may be referred for further investigation and treatment at a hospital. Treatments include:
How can I get rid of oedema fast?
There is no one-size-fits-all solution and no quick fix. Mild oedema (particularly of the legs and ankles) is often the result of excess weight and exercise, so addressing these issues will help. You may be surprised how quickly the extra fluid disappears once your weight reduces. However, persistent oedema needs assessment by a doctor to detect the underlying cause .
How can I treat itching?
Itching with oedema can be due to several causes.
- Mechanical stretching of the skin due to fluid retention can cause a local disturbance which results in itching. This usually settles once the oedema is treated.
- Angio-oedema is often treated with antihistamine tablets and steroid tablets.
- Varicose veins can cause a combination of oedema and an itchy rash known as varicose eczema. Make sure your legs are raised when you are sitting down, keep active, and use moisturising cream. Steroid ointments are occasionally prescribed if the rash becomes very itchy.
What should you do next?
You should call an ambulance if you experience severe shortness of breath or chest pain. Mild puffiness of your ankles that gets better when you lie down for a few hours, may not need any treatment. In all cases, you should see your GP to find out if there is an underlying cause.
Who is affected by oedema?
Women are more prone than men to fluid retention (oedema). Female hormones (progesterone) tend to cause fluid retention so some women notice puffy ankles just before a period. Oedema may occur for the first time at any age if you have an allergic reaction or become anaemic. Older people can develop oedema, as they sit for long periods of time. They are also more likely to have underlying heart or kidney conditions that may cause oedema.
For more information, see the separate leaflet called Swollen Legs.
How can I avoid oedema?
You will need to find the underlying cause of the fluid retention (oedema) and try to address it if possible. Idiopathic oedema has no specific cause and is very common. The best approach is to walk regularly, avoid becoming overweight and put feet up on a footstool when resting.
What is the outlook (prognosis)?
This depends on the underlying cause. Oedema can be dangerous if untreated, particularly if you get fluid retention in the lungs. However, providing the underlying condition is recognised and treated, the outlook is generally very good. Most oedema is due to standing too long on a hot day, especially if you are overweight.
12 causes and how to treat them
There are many different causes of swollen ankles. In most cases, swelling is due to injury or edema.
The term edema means swelling due to the accumulation of excess fluid. It is particularly common in the lower leg, ankles, and feet.
In this article, we look at 11 causes of swollen ankles and cover some of the best treatment options.
Possible causes of swollen ankles include:
Share on PinterestA person may experience inflammation due to an injury on the ankle or foot.
People who sustain an injury to the foot or ankle may experience inflammation in that area, causing it to appear swollen.
An ankle sprain is one of the most common foot injuries.
The American Orthopedic Foot and Ankle Society recommend the following home treatment for a sprained ankle:
- wearing an ankle brace
- applying ice in a thin piece of cloth for no more than 20 minutes
- applying a compression wrap
- elevating the foot above the waist
Bacterial infections in the skin are called cellulitis. People with diabetes are particularly prone to this type of infection.
Cellulitis can cause a range of symptoms, including redness, warm skin, and swelling that spreads rapidly. In rare cases, cellulitis can be life-threatening without treatment.
People with cellulitis need to take antibiotics. It is essential to tell a doctor if the swelling does not reduce or gets worse after a few days of treatment.
Some medications can cause the ankles to swell as a side effect. Such medications include:
People who suspect that their ankles are swollen as a side effect of medication may wish to talk to their doctor.
A doctor may prescribe diuretic medications or suggest methods for reducing the swelling if it is uncomfortable.
The most common type of edema is from chronic venous insufficiency (CVI). CVI is a condition that affects the valves in the leg veins.
These valves usually make sure that blood flows toward the heart. In CVI, however, the valves malfunction and allow some of the blood to flow backward and pool in the lower legs and ankles.
Although CVI does not have severe complications, it can be painful and uncomfortable. It may also cause noticeable changes to the skin.
A doctor can help a person with CVI develop a personalized treatment plan.
Examples of some treatment options include:
- keeping the legs raised to improve blood flow
- wearing compression stockings to reduce swelling
- taking medications, such as aspirin
- undergoing radiofrequency ablation, which uses heat to close the affected vein
Sometimes, a blood clot, or “thrombosis,” can develop in one of the veins in the arm or leg. This is called deep vein thrombosis (DVT) and requires urgent medical attention.
DVT obstructs the flow of blood returning to the heart, causing it to build up in the affected limb.
Sometimes, the body is able to compensate for the blockage by gradually diverting blood through smaller neighboring veins. Over time, these veins get larger and are able to drain blood from the limb.
If these veins do not increase in size, the limb may remain swollen. Persistent pain and swelling after a DVT is called post-thrombotic syndrome.
People who experience a DVT should consider:
- elevating the affected limb
- wearing compression stockings to promote blood flow
- taking anticoagulant medications, or blood-thinners
- undergoing a stenting procedure, during which a surgeon inserts a tube called a stent into the vein to keep it open
During pregnancy, the body produces more blood and bodily fluids to support the developing fetus.
Swelling is a common side effect of pregnancy, especially in the third trimester. It can affect the ankles, feet, legs, face, and hands.
Slight swelling is normal and usually harmless. However, sudden swelling of the hands and face could be a sign of a potentially life-threatening condition called preeclampsia.
Women who experience mild swelling during pregnancy may get relief from home remedies such as:
- eating foods high in potassium
- reducing salt intake
- avoiding caffeine
- wearing comfortable shoes
- wearing support stockings
- avoiding standing for long periods
- elevating the feet when resting
- applying cold compresses
- wearing loose-fitting clothes
- limiting time outdoors during hot weather
- resting in a pool
Preeclampsia is a life-threatening condition that can occur during the second or third trimester of pregnancy, or up to 6 weeks after giving birth.
Preeclampsia is characterized by dangerously high blood pressure and protein in the urine. It can cause a variety of symptoms, including headaches, changes in vision, weight gain, and edema.
Preeclampsia that occurs during pregnancy can also affect the fetus.
It requires urgent medical treatment. Treatment may include medications to prevent seizures and lower blood pressure.
Delivering the baby is the most effective treatment, although some women may experience worsening symptoms before they get better.
Lymphedema is a type of swelling that affects the soft tissues in the arms or legs, including the ankles. It is due to a buildup of a fluid called lymph. This is mainly composed of white blood cells, which help fight infection.
Lymphedema occurs when there is a blockage or some other damage to the lymphatic system. The lymphatic system is a network of tissues and organs that help rid the body of infection and keep fluids in balance.
Lymphedema can result from infections, cancer, and surgical removal of the lymph nodes. Some hereditary conditions can also cause lymphedema.
Damage to the lymphatic system is irreversible, so treatment aims to reduce swelling and prevent other symptoms.
Potential treatments include:
- wearing pressure garments and bandages
- increasing heart and respiration rate through exercise
- getting a gentle massage from a therapist who is trained in treating lymphedema
Heart failure occurs when the heart can no longer pump blood as effectively as it should. There are three different types of heart failure: left-sided, right-sided, and congestive heart failure.
In right-sided and congestive heart failure, there is a reduction in blood flow out of the heart, causing blood to back up into the veins. This may lead to a buildup of fluid in tissues, including the legs and ankles.
Heart failure also affects the kidneys, reducing their ability to remove salt and water from the body. This further contributes to edema.
Although there is no cure for heart failure, there are many different treatment options.
A doctor may prescribe diuretic medications and suggest monitoring and reducing fluid intake. Both of these treatments can help reduce swelling in the ankles and legs.
Chronic kidney disease refers to permanent kidney damage, which can worsen over time.
A person may not experience any symptoms until they are in the late stages of the disease, called kidney failure or end-stage renal disease (ESRD).
During ESRD, the kidneys struggle to remove waste and extra fluid from the body. This can lead to a range of symptoms, including swollen ankles.
The following lifestyle factors can also help maintain kidney function for as long as possible:
- reducing salt and fat in the diet
- maintaining a healthy weight
- maintaining a healthy blood pressure
- exercising for at least 30 minutes per day
- quitting smoking
- limiting alcohol
- controlling blood sugar levels
The healthy liver produces a protein called albumin. Albumin prevents fluid from leaking out of the blood vessels and into surrounding tissues.
Very low levels of albumin due to liver disease can cause a buildup of fluid in the legs, ankles, and abdomen.
A doctor may prescribe medications and offer advice on certain lifestyle factors that could help prevent or slow further liver damage. Examples include:
- exercising regularly
- eating a healthful diet
- limiting salt intake
- avoiding alcohol
Hypothyroidism can affect a person’s muscles and joints in numerous ways, causing aches, pains, stiffness, and swelling.
If a person has hypothyroidism, or an underactive thyroid, it means that their thyroid gland produces too few hormones.
A 2017 study suggests that there may be a link between thyroid disorders and rheumatoid arthritis, which can also cause painful swelling in the joints.
A doctor can carry out a blood test to check a person’s thyroid hormone levels, and treatment involves taking synthetic thyroid hormones.
A person should see a doctor if they have:
- heat or redness in the swollen area
- swelling that worsens or does not improve
- a fever
- a sudden increase in swelling during pregnancy
- a history of heart, kidney, or liver disease
Many cases of edema, or swollen ankles, will resolve themselves with proper home treatment.
Swollen ankles, feet and legs (oedema)
Swelling in the ankles, feet or legs often goes away on its own. See a GP if it does not get better in a few days.
Common causes of swollen ankles, feet and legs
Swelling in the ankles, feet and legs is often caused by a build-up of fluid in these areas, called oedema.
Oedema is usually caused by:
- standing or sitting in the same position for too long
- eating too much salty food
- being overweight
- being pregnant – read about swollen ankles, feet and fingers in pregnancy
- taking certain medicines – such as some blood pressure medicines, contraceptive pills, antidepressants or steroids
Oedema can also be caused by:
Check if you have oedema
Symptoms of oedema include:
Swollen or puffy ankles, feet or legs.
Shiny, stretched or red skin.
How to ease swelling yourself
Swelling in your ankles, feet or legs should go away on its own, but there are some things you can try to help.
lie down and use pillows to raise the swollen area when you can
get some gentle exercise, like walking, to improve your blood flow
wear wide, comfortable shoes with a low heel and soft sole
wash, dry and moisturise your feet to avoid infections
do not stand or sit for long periods of time
do not wear clothes, socks or shoes that are too tight
Non-urgent advice: See a GP if your ankle, foot or leg is swollen and:
- it has not improved after treating it at home for a few days
- it gets worse
Coronavirus (COVID-19) update: how to contact a GP
It’s still important to get help from a GP if you need it. To contact your GP surgery:
- visit their website
- use the NHS App
- call them
Find out about using the NHS during COVID-19
Urgent advice: Get advice from 111 now if:
- the swelling is only in 1 ankle, foot or leg and there’s no obvious cause, such as an injury
- the swelling is severe, painful or starts very suddenly
- the swollen area is red or feels hot to the touch
- your temperature is very high, or you feel hot and shivery
- you have diabetes
111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need one.
Go to 111.nhs.uk or call 111.
Other ways to get help
Get an urgent GP appointment
A GP may be able to treat you.
Ask your GP practice for an urgent appointment.
Treatment for swelling and oedema
Treatment for swelling or oedema that does not go away on its own will depend on the cause.
It may include lifestyle changes, such as losing weight or going on a low-salt diet.
Page last reviewed: 14 November 2018
Next review due: 14 November 2021
Lymphoedema – NHS
Lymphoedema is a long-term (chronic) condition that causes swelling in the body’s tissues. It can affect any part of the body, but usually develops in the arms or legs.
It develops when the lymphatic system does not work properly. The lymphatic system is a network of channels and glands throughout the body that helps fight infection and remove excess fluid.
It’s important that lymphoedema is identified and treated as soon as possible. If it is not treated, it can get worse.
Symptoms of lymphoedema
The main symptom of lymphoedema is swelling in all or part of a limb or another part of the body. It can be difficult to fit into clothes, and jewellery and watches can feel tight.
At first, the swelling may come and go. It may get worse during the day and go down overnight. Without treatment, it will usually become more severe and persistent.
Other symptoms in an affected body part can include:
- an aching, heavy feeling
- difficulty with movement
- repeated skin infections
- hard, tight skin
- folds developing in the skin
- wart-like growths developing on the skin
- fluid leaking through the skin
What causes lymphoedema?
Lymphoedema is caused by a problem with the lymphatic system, a network of vessels and glands spread throughout the body. The main functions of the lymphatic system are helping fight infection and draining excess fluid from tissues.
There are 2 main types of lymphoedema:
- primary lymphoedema – caused by faulty genes that affect the development of the lymphatic system; it can develop at any age, but usually starts during infancy, adolescence, or early adulthood
- secondary lymphoedema – caused by damage to the lymphatic system or problems with the movement and drainage of fluid in the lymphatic system; it can be the result of a cancer treatment, an infection, injury, inflammation of the limb, or a lack of limb movement
Read more about the causes of lymphoedema
Lymphoedema is thought to affect more than 200,000 people in the UK. Primary lymphoedema is rare and is thought to affect around 1 in every 6,000 people. Secondary lymphoedema is much more common.
Secondary lymphoedema affects around 2 in 10 people with breast cancer, and 5 in 10 people with vulval cancer. About 3 in every 10 people with penile cancer get lymphoedema.
People who have treatment for melanoma in the lymph nodes in the groin can also get lymphoedema.
Your treatment team will let you know if you’re at risk of getting lymphoedema from your cancer or cancer treatment. Any planned treatment you have will try to avoid causing damage to your lymph nodes.
Cancer Research UK has more information about lymphoedema and cancer.
See a GP if you experience the typical symptoms of lymphoedema, such as swelling in your arms and legs. They may refer you to a specialist lymphoedema treatment centre for further assessment.
In many cases, lymphoedema can be diagnosed from your symptoms and medical history, and by examining the affected body part and measuring the distance around it to see if it’s enlarged.
Occasionally, further tests may be necessary to assess and monitor your condition.
Read more about diagnosing lymphoedema
There’s no cure for lymphoedema, but it’s usually possible to control the main symptoms using techniques to minimise fluid build-up and stimulate the flow of fluid through the lymphatic system.
These include wearing compression garments, taking good care of your skin, moving and exercising regularly, having a healthy diet and lifestyle, and using specialised massage techniques.
Read more about treating lymphoedema and preventing lymphoedema.
Cellulitis is the most common complication of lymphoedema. It can also have a significant psychological impact. It can be serious if it’s not treated quickly.
If you have lymphoedema, the build-up of fluid in your tissues makes you more vulnerable to infection.
Cellulitis is a bacterial infection of the deep layer of skin (dermis) that often affects people with lymphoedema. Cellulitis can also sometimes cause lymphoedema.
Symptoms of cellulitis can include:
- redness and a feeling of heat in the skin
- pain and increased swelling in the affected area
- a high temperature
Antibiotics taken by mouth (orally) can usually be used to treat cellulitis, although severe cases may need to be treated in hospital with antibiotics given directly into a vein (intravenously).
Living with a long-term condition that affects your appearance can cause a great deal of distress and lead to periods of depression.
You may be depressed if you’ve been feeling down for the past few months and no longer find pleasure in things you usually enjoy.
If this is the case, talk to a GP or a member of your lymphoedema treatment team. Effective treatments are available for depression.
Talking to other people with lymphoedema can be reassuring and decrease feelings of isolation, stress and anxiety.
The Lymphoedema Support Network provides information and advice, and can put you in touch with a support group in your area.
If you persevere with your treatment plan, your symptoms should eventually become less noticeable.
Video: lymphoedema – Philippa’s story
In this video, Philippa describes how she lives with primary lymphoedema.
Media last reviewed: 2 December 2020
Media review due: 2 December 2023
Page last reviewed: 25 November 2019
Next review due: 25 November 2022
90,000 is an accumulation of lymphatic fluid in the tissues due to a violation of its transportation
What causes lymphedema?
The lymphatic system, together with the cardiovascular system, constitutes the circulatory system of the body and performs a number of important functions. It plays a crucial role in the immune system, so a healthy person hardly has any reason to think about the lymphatic system. We remember about her only when there are disruptions in her work, for example, in the case of the development of lymphedema.
What is it? Lymphedema occurs when lymph fluid cannot drain away from tissues and builds up in tissues. The arms and legs increase in volume and chronic edema forms.
However, with the right treatment and a positive attitude, the patient can lead a normal daily life. One thing is for sure: there are ways to stop the development of lymphedema.
Hazardous waste disposal service of the body
The lymphatic system can be compared to a “hazardous waste disposal” service in that it removes them from the body.Such wastes include, for example, proteins, metabolic products, inflammatory mediators or fats absorbed during digestion. The vessels of the lymphatic system are located along the blood vessels and cover our body like a network.
Every day, the lymphatic system transports up to four liters of purified lymph back into the bloodstream. Lymphedema can develop if the flow of fluid from tissues is impaired. With modern treatment options, a patient with lymphedema can lead a normal life.
Forms of lymphedema
There are two forms of lymphedema: primary and secondary lymphedema:
Primary lymphedema is a congenital disorder. As a rule, it develops due to a violation of the development of lymph nodes and blood vessels.
Secondary lymphedema is edema that is not congenital and develops over the course of a patient’s life.Causes can be, for example, surgery, infection, injury, etc.
Signs and Symptoms
The so-called Stemmer symptom is a reliable diagnostic sign for recognizing lymphedema. Try the skin in a crease (for example, on the back of your toe). If it is difficult or even impossible to do this, we speak of a “positive Stemmer symptom”.
This is a symptom of lymphedema.In addition, deepening of the natural folds of the skin over the joints, swelling on the back of the hands and feet, and taut skin indicate the presence of lymphedema.
Stages of lymphedema
- Stage 0: The lymphatic vessels are damaged, but there is no visible edema yet.
- Stage 1: Swelling develops during the day, but partially or completely disappears when the limb is in an elevated position. When you press on the tissue with your finger, a fossa is formed, which persists for some time.
- Stage 2: Raising the limb no longer helps. The swelling persists even with prolonged rest. The skin begins to thicken. It is difficult or even impossible to make a hole in the skin with pressure.
- Stage 3: Characterized by severe swelling and changes in the skin (for example, openings from which lymphatic fluid leaks). Another name for this stage of development of lymphedema is elephantiasis or elephantiasis.
It is recommended to consult a doctor at the earliest possible stage (ideally already at the first stage).The doctor will recommend an appropriate treatment and check that the swelling does not increase, but begins to decrease, or at least has stabilized. Thus, it is possible to prevent the further development of edema up to Stage 3.
Lymphedema after surgery for the treatment of breast cancer
Breast cancer is one of the most common forms of cancer in women. More than 70,000 new cases are diagnosed annually.
On average, 20 to 30% of patients suffer from lymphedema associated with surgery for breast cancer with removal of axillary lymph nodes and adjuvant radiation therapy.
Cancer patients often have to undergo radiation therapy of lymph nodes or remove them completely. Of course, this affects the entire lymphatic system, so edema may begin to develop. Other factors, such as age or female gender, can also contribute to the development of lymphedema.
Lymphedema can also often develop in connection with a previous venous disorder in combination with insufficient exercise.There are many reasons for lymphedema, but the good news at this point is that there are effective treatment options that can restore quality of life to patients.
Do you have lymphedema? Pay attention to the little things in your daily life that can help control swelling. For example, wear clothes that are comfortable and free of pressure and movement. Use only pH neutral products for skin care. Are you overweight? Try to lower it.For example, ask your doctor about groups of remedial gymnastics and exercises to relieve congestion in the extremities. Avoid trauma to the skin. Avoid stress and hypothermia, as this leads to vasoconstriction. Also, activities that can lead to sustained vasodilation, such as sunbathing, going to the sauna or hot baths, are not recommended. Important: Although manual lymphatic drainage has a positive effect on the lymphatic system, rough massage, which can overstrain the affected part of the body, should be avoided.And last but not least, when exercising (for example, while playing sports), be sure to use compression hosiery.
Living with lymphedema – information, treatment, quality of life
Lymphedema changes lives.For the patient, this chronic disease will be a constant companion in all aspects of life. What is the best way to deal with the symptoms of the disease? Which treatment is best for you? How to live a normal life with lymphedema? Medi’s film Living with Lymphedema – Information, Treatment, Quality of Life provides answers to questions as well as practical advice for everyday life.
How can lymphedema be treated?
Lymphedema is a chronic condition.Nevertheless, correct and, above all, continuous treatment gives very good results. Comprehensive physical edema decongestant therapy (PTFE) has been particularly successful. The goal is to first remove the swelling from the affected limbs, as the name suggests.
Initially focused on skin care and hygiene. Clean and care for the affected area thoroughly. The therapist then performs manual lymphatic drainage and then immediately applies a compression bandage.This stimulates the return of lymph fluid during this phase. Without dressing, the swelling will return in about two hours. It is important to move in the process of getting rid of edema, preferably immediately after manual lymphatic drainage and with bandaging.
As soon as the edema removal phase is completed, the second phase begins: the keep-alive phase. The four components are the same as for puffiness: hygiene, lymphatic drainage, compression and physical activity. But now the compression bandage is being replaced by compression hosiery.Flat knit compression stockings are commonly used for this. These are garments that are made of a less stretchable, more rigid material than circular knits. Circular compression garments are used more often for venous diseases such as varicose veins.
Phase 1 – Phase reduction of edema
The goal is to reduce the circumference of the affected limbs.Thus, in the first stage of complex physical therapy for edema (PTFE), manual lymphatic drainage of the whole body is performed once or twice a day in order to facilitate the return transfer of fluid from the tissues. Compression hosiery is applied after each treatment session. Puffiness therapy is also supported with specific exercises. Skin conditions such as cracks or athletic feet are intensively treated at the start of treatment, as inflammation can lead to additional damage.Consistent skin hygiene and grooming are also essential. Only pH neutral cleaners and creams can be used.
The first phase of complex physical therapy for edema lasts from three to six weeks. The individual duration depends on how successfully the edema is reduced. Once the circumference of the affected areas of the body can no longer be reduced, we move on to the State of the Art Supportive Treatment Phase.
Phase 2 – Maintenance Phase
The purpose of the second stage of complex physical therapy for edema (CTE) is to maintain the successes and results obtained in Stage 1.During this phase of treatment, manual lymphatic drainage should be performed at least once a week in winter and twice a week in summer. Compression therapy continues to be supported by compression devices for the upper and lower extremities. Additional treatment measures such as special skin care and exercise cannot be neglected at this stage.
Lymphatic drainage – “Massage” to reduce edema
Manual lymphatic drainage is a special form of massage designed to increase the transport capacity of the lymphatic system.It applies not only to the affected part of the body, but to the entire body.
The massage begins in the neck area, where large lymphatic vessels pass into the veins behind the collarbones. This stimulates the outflow of lymph to the large lymph vessels to facilitate transport in the smaller vessels. Then the torso and limbs are massaged.
Flat Knitted Compression Products for Maintenance Treatment
Flat knit compression garments apply constant pressure to the upper or lower extremities during the Supportive Care Stage.It does not cut into the folds of the skin, which can lead to restriction of movement. Compression knitwear can be purchased with a prescription at an orthopedic salon and made to order according to individual measurements.
Measurements will be removed right in the salon. Compression hosiery is very important to wear regularly. Only then will the result be preserved and the edema will not spread further. Medicines can be taken as an adjunct to treat edema – your doctor will decide if you need them.
Thus, it can be said that lymphedema is not completely curable.However, very good results are achieved with the help of KFTO. Compression garments these days are even available in trendy colors and patterns, so they are much more comfortable for patients to wear than they used to be.
Swelling of the upper and lower extremities should be taken seriously and see a doctor immediately. Look for additional qualifications “Phlebologist” or “Lymphologist” when looking for the right specialist. Phlebologists and lymphologists specialize in diseases of the venous and lymphatic systems and take part in continuous professional development in this area of specialization.The doctor will then prescribe the treatments described here (such as manual lymphatic drainage or compression garments) if needed.
2 Deutsche Krebsgesellschaft e.V. (2008): Interdisziplinäre S3-Leitlinie für die Diagnostik, Therapie und Nachsorge des Mammakarzinoms, Germering, München: W. Zuckschwerdt Verlag.
90,000 Swelling of the ankles of the feet: why, reasons, what to do
Experts told why the ankles of the feet swell, the reasons, and what to do in this case.There are several potential causes of swelling in the legs and ankles, GlavUfa writes.
Certain reasons, such as standing or walking for extended periods of time, are normal and generally harmless. However, sudden or chronic swelling in the feet and ankles may indicate an underlying health condition.
Why do the ankles swell?
Injury to the foot or ankle may cause swelling of the ankle and lower leg. One of the most common causes of injuries in this area is an ankle dislocation.
Ankle sprains can result from simple oversight, sports or physical injury. It happens when the ligaments that connect the ankle to the leg are pulled out. A person who has a sprained ankle may experience pain and limited mobility in the ankle or foot.
The most common treatment for foot or ankle injuries is the rice procedure. RIS is an abbreviation that stands for:
There are a number of other potential causes of leg and ankle swelling.
Infection in the feet, ankles and lower legs can cause swelling in this area.
People with diabetes are at increased risk of developing an infection in their legs. Therefore, they should regularly check their feet for bruises, cuts and scrapes.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), people with diabetes and an untreated infection in the foot or legs may develop gangrene.Gangrene is when body tissue dies as a result of severe infection or reduced blood supply.
- Treatment of a foot infection depends on its severity. In most cases, your doctor will prescribe antibiotics to treat the bacterial infection.
- If the infection has resulted in gangrene, the person may need surgery to remove the damaged toes or feet.
Lymph nodes are glands that are part of the body’s immune system. They are responsible for removing fluid from various parts of the body. If the lymph nodes in the pelvis are damaged or missing, it can cause fluid to build up in the legs.
A person with lymphedema may experience a feeling of heaviness or swelling in the legs or other affected parts of the body.
Some treatment options for lymphedema include:
- dressing of the affected leg
- wearing compression stockings
- Massaging the lymph nodes to stimulate drainage
- Performing gentle exercises to stimulate drainage
Veins in the legs of a person contain special valves that prevent the backflow of blood. Venous insufficiency is a condition in which these valves no longer function properly.
As a result, the veins no longer transport adequate amounts of blood from the legs back to the heart. When a person develops venous insufficiency, blood flows back down the legs and into the soft tissues of the legs and ankles.
A person with venous insufficiency may also experience:
- skin ulcers
- changes in skin color
Treatment of venous insufficiency involves returning blood flow to the legs.
This may include:
- leg lift
- doing regular exercise
- wearing compression stockings
People can also receive medications for the treatment of venous insufficiency. The type of medication a person receives will depend on the severity of their condition and overall health.
A blood clot in the legs can cause a person’s ankles and legs to swell.Blood clots in the legs tend to develop on one side of the limb.
There are two main types of blood clot:
- Superficial blood clots that occur in a vein closer to the surface of the skin
- Deep vein blood clots or “deep vein thrombosis” (DVTs) that occur in a vein deep within the body
A person should seek immediate medical attention if they experience any of the following symptoms:
- edema and pain in one leg
- severe pain in the affected leg
- warm skin on the affected leg
- patch of red skin behind and below the knee
- color change feet
Sometimes part of the clot breaks down and travels to the heart, lungs or brain.It can be life threatening if left untreated.
Typically, people who have a blood clot receive anticoagulant drugs to help prevent the clot from growing. They also help prevent new blood clots from forming. Two common anticoagulant drugs are heparin and warfarin.
The liver produces albumin, which is a protein that prevents fluid from leaking out of the blood vessels and into the surrounding tissues of the body.
The diseased liver does not produce enough albumin. Thus, liver disease can cause fluid to build up in the legs, ankles, and feet.
Most people who have liver disease do not experience symptoms until they develop severe liver damage or cirrhosis.
- The only cure for liver cirrhosis is liver transplantation.
- However, treatment is aimed at controlling the disease and preventing further complications.
- Treatment can also help relieve some of the symptoms of cirrhosis.
People who experience leg swelling as a result of liver cirrhosis may need diuretics such as spironolactone or furosemide. People may also need to reduce their salt intake as this can ease fluid retention.
The main role of the kidneys is to regulate the amount of water in the body and balance the levels of salt and other minerals in the blood.
Kidneys that are severely damaged by disease cannot effectively filter blood and excrete fluids and other wastes through urine. This can lead to a buildup of fluids and other waste products in the body, including in the lower limbs and ankles.
Some other early signs of kidney disease include:
- swollen hands or feet, or persistent puffiness around the eyes
- more frequent urination, especially at night
- high blood pressure or hypertension
- blood or protein in urine
Treatment for kidney disease depends on the underlying cause.Some causes, such as urinary tract infections and kidney stones, respond well to treatment, according to the National Kidney Foundation.
Kidney disease can also result from an underlying medical condition such as high blood pressure or diabetes. In such cases, your doctor will prescribe medications to treat these conditions and slow the rate of kidney disease.
- In some cases, chronic kidney disease can progress to renal failure.
- At this point, the person will need dialysis or a kidney transplant.
Drug side effects
In some cases, medications can cause swelling of the ankles or feet.
These medicines may have side effects:
- hormones such as estrogen
- non-steroidal anti-inflammatory drugs (NSAIDs)
- diabetic drugs
- calcium channel blockers
If a person experiences side effects from medication, they should talk to their doctor.The doctor may suggest lowering the dosage of the drug or switching to another drug altogether. People should not stop taking medications without consulting a doctor.
Swollen legs and ankles during pregnancy
When a woman is pregnant, some swelling is normal. The swelling can be worse if the woman is on her feet during the day.
However, sudden or severe swelling in the legs, ankles, or feet may be a sign of preeclampsia.Preeclampsia is a condition characterized by high blood pressure during pregnancy. This can threaten the safety of the woman and the fetus.
Other potential signs and symptoms of preeclampsia include:
- edema on the face and hands
- vision changes
- infrequent urination
- abdominal pain
- nausea and vomiting
Preeclampsia subsides after delivery. A woman should talk to her doctor about the symptoms she is experiencing so that the doctor can help determine the best treatment.
When to see a doctor
A person should see their doctor if they experience any of the following symptoms in their feet and ankles:
- sudden tumor
- unexplained tumor
- additional symptoms, including shortness of breath, fever and pain
A doctor can help diagnose major conditions. In most cases, treating the underlying condition will help relieve swelling in the legs and ankles.
In some cases, making certain lifestyle changes can help prevent or relieve swelling in the feet and ankles. These lifestyle changes include:
- Check your feet frequently for bruises, cuts and scrapes, especially if you are diabetic
- doing regular exercise
- Eat healthy foods that promote heart, kidney, and liver health
- Avoid contact sports that can injure feet and ankles
Swollen feet and ankles may be the result of a benign cause or a potentially life-threatening condition.
A person should see their doctor if the swelling is sudden, unexplained, or with additional symptoms.
It is not always possible to prevent swelling of the legs and ankles. However, there are steps a person can take to reduce the risk of such problems. These include exercising regularly, following a healthy diet, and protecting your feet from injury whenever possible.
90,000 REASONS FOR BILATERAL ANKLE SWEELING – MEDICAL
Edema is the leakage of fluid from blood and lymph vessels into soft tissue. Increases in total body water, decreased vascular blood flow, changes in blood chemistry, inflammation, and positional factors can contribute to fluid seepage into tissues. Feet and ankles are especially prone to swelling because gravity tends to build up fluid in these areas of the body.
Is this an emergency?
If you experience severe medical symptoms, seek emergency help immediately.
Prolonged sitting or standing
Muscle activity in the legs helps to propel blood and lymph fluid up and out of the legs.Prolonged standing or sitting can cause fluid to accumulate in the lower extremities due to gravity and a decrease in the driving force of the leg muscles. Prolonged sitting while traveling by plane, train, or car can cause significant bilateral ankle swelling. Likewise, people who have to stand mostly still during the workday may experience recurring episodes of ankle swelling. Positional edema often resolves after a night’s sleep. Lying down increases the reabsorption of fluid from the tissues back into the bloodstream.
- Muscle activity in the legs helps propel blood and lymph fluid up and out of the legs.
- Prolonged standing or sitting can cause fluid to build up in the lower extremities due to gravity and reduced motive power in the leg muscles.
The total volume of circulating fluid increases by about 50 percent during pregnancy. An increased amount of fluid causes slight swelling throughout the body. Gravitational forces enhance this natural adaptation to pregnancy, often causing noticeable swelling in the feet and ankles. Edema of the lower extremities is especially pronounced in late pregnancy, when the enlarged uterus compresses the venous and lymphatic vessels in the pelvis and abdominal cavity. Although bilateral ankle swelling is common during pregnancy, the sudden onset of severe swelling can signal the onset of preeclampsia, a dangerous complication of pregnancy.
- The total volume of circulating fluid increases by about 50 percent during pregnancy.
- Gravitational forces enhance this natural adaptation to pregnancy, often causing noticeable swelling in the feet and ankles.
Obesity usually causes marked bilateral swelling of the foot and ankle. In a 2006 article published in the journal Circulation, Dr. Paul Poirier and colleagues report that lymphatic overload, inactivity, and cardiac changes associated with obesity contribute to fluid accumulation in the soft tissues of the lower extremities.
Heart failure usually causes bilateral swelling of the foot and ankle 1. In a 2005 article published in the American Family Physician, Dr. James O’Brien and colleagues explain that the decreased pumping capacity of the heart seen in heart failure is often causes increased renal water retention. 3. Increased water content in the body causes edema. Treatment with diuretics can control this symptom in many patients with heart failure.
Acute and chronic renal failure can cause edema of the lower extremities. Protein loss through damaged kidneys and general water overload in the body cause fluid to leak into soft tissues. Although gravity usually causes the most severe swelling of the lower extremities, renal failure can cause swelling throughout the body.
- Acute and chronic renal failure can cause swelling of the lower extremities.
- Although gravity tends to cause the most severe swelling in the lower extremities, kidney failure can cause swelling throughout the body.
90,000 Reasons for Water Retention – 10 Common Reasons for Water Retention Swelling Body
is a general health problem that significantly affects the daily activities of patients. Water retention – medically called edema – is a collection of excess fluid that seeps into the tissues of the body.The leak will lead to swelling in the entire body (Generalized swelling), or more localized edema, such as swelling of the legs, feet, and ankles, or fluid retention in the abdomen, face, hands, arms, and around the lungs.
Although there are many different conditions and diseases associated with the term water retention or edema, there are several more well-known causes of water retention. And here are some of them:
1. Arthritis Arthritis
which means inflammation of the joints, is described as inflammation of one or more joints, involving mechanical damage to the cartilage resulting in joint pain, swelling and limited movement.It can affect any joints in the body from the hip, heel, spine, shoulder, knee, and thumb.
There are over 100 different types of arthritis, but the most common are: osteoarthritis, rheumatoid arthritis and gout. Different types of arthritis show different symptoms. Common symptoms of arthritis include: persistent joint pain, fever, tenderness, swelling, stiffness, redness, joint defects, joint, and unexplained weight loss, inflexibility of the joint.
2. Renal Disorders
Some forms such as kidney failure and glomerular disease will lead to swelling throughout the body, as well as localized tumors in the abdomen, ankles, legs and swelling of the legs. This is because the kidneys have lost their normal functions, including the effective elimination of salt and water from the body. This will in turn cause the body to retain fluid and, over time, accumulate in the tissues of the body.
3. chronic lung disease
chronic lung disease is a generic term for persistent lung disorders that impair lung function.Severe chronic lung diseases will cause water retention in the body include fluid retention in the lungs (pulmonary edema), ascites, neck, face, ankle and leg edema. Chronic lung disease such as chronic obstructive pulmonary disease (COPD), smoke inhalation trauma, acute respiratory distress syndrome (ARDS), lung cancer, mesothelioma, etc. may cause pulmonary edema, abdominal edema / ascites, fluid retention in the neck and face, swelling of the ankles and feet.
4. Liver cirrhosis
Liver cirrhosis usually causes abdominal fluid retention.It also causes low protein albumin synthesis in the liver and results in fluids in the legs and abdomen.
5. congestive heart failure, cardiomyopathy disease and heart valve disease
congestive heart failure impedes normal blood circulation and often leads to water retention. The two most common causes of water retention in a patient’s congestive heart failure are: (1) blood flow backs up to the heart and leaks into the lungs and veins; (2 kidneys retain fluids due to insufficient blood flow.Cardiomyopathy and heart valve disease are a variety of heart diseases and lead to heart failure.
6. Excess sodium intake
In people who are more sensitive to sodium, excess sodium intake will raise blood pressure and lead to water retention especially in the lower extremities, such as swelling of the ankles and feet.
standing or sitting for too long in one position due to occupation necessity or after long journeys can lead to fluid retention in the legs.It usually gets worse at high temperatures.
In some cases, the developing uterus in pregnant women can press the superior vena cava, leading to fluid retention in the legs. Hormone imbalance and increased blood flow are also responsible for water retention during pregnancy. In the most affected areas, swelling during pregnancy, in the lower extremities, especially the ankles and feet.
9.Side effects of certain medications
Certain medications such as anabolic steroid, calcium channel blockers, Levitra, methadone, etc.can interfere with normal bodily functions and lead to swelling especially in the legs, feet and ankles.
10. Venous insufficiency
Venous insufficiency is a disruption of blood flow in the veins of the legs due to damage to the veins, itself or the valves, causing fluid to back up and leak into the surrounding tissue. This disorder is one of the most common causes of water retention in the legs.
Review the list of reasons for water retention and decide if you are truly experiencing one or more.Remember that many illnesses take years to appear after the symptom does. Therefore, you should talk to your doctor if you have any questions regarding water retention in any part of your body. Your doctor is the one who can only tell you exactly what is causing your swelling and which treatment options will work best for you.
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90,000 What are the best edema treatments?
The best treatment for edema generally depends on the location of the edema and its cause.Swelling, which is usually caused by inflammation, usually works well with anti-inflammatory drugs. In most cases, trauma swelling responds well to ice packs.
The type of edema due to fluid retention is often referred to as edema. Swelling can occur in any part of the body, most commonly the legs and ankles. Leakage of fluid into the tissues of the extremities can cause swelling and swelling. In this case, the doctor may prescribe treatment for edema.
Remedies for edema and related edema usually include a prescription drug.Swelling can cause mobility problems and other problems. It is important to see a doctor for treatment of non-trauma related edema, as an underlying medical condition may be present requiring medical attention. Treatment for edema for edema may include diuretics. The doctor may also place the patient on a sodium-restricted diet.
Treatment of edema in acute injuries usually involves the use of ice. This is one of the most effective methods of dealing with edema. Ankle, elbow, and knee sprains are usually treated with ice packs applied 15-20 minutes at a time, several times a day.This can continue for up to 48 hours or as needed. After a few days, heat can be applied instead of ice packs.
When there is swelling and inflammation, pain is likely to be present. In such cases, you can take a pain reliever or anti-inflammatory drug. Ibuprofen is a good choice for inflammation and pain. It is important to note that this medication can cause stomach upset or even bleeding in some people, so caution should be exercised.
Natural anti-inflammatories are also a good remedy for edema. This can include foods known to have anti-inflammatory properties. Berries and dark cherries are good choices. Eating these fruits can also help reduce swelling caused by gout.
One good home remedy for swelling is to drink water from barley. It helps reduce fluid caused by swelling and is a natural diuretic.Avoiding high-salt foods and reducing or eliminating caffeine intake can also help.
Along with the above treatment for edema, resting in the swollen area is an essential part of recovery. If the swelling is on the ankle or leg, it is important not to stand for long. Sitting with a swollen part of your body, usually at the level of your heart, will ease pain and help reduce swelling.
90,000 reasons why legs swell.Methods for the treatment of boat edema.
Ankle edema due to lack of physical activity
Various diseases or pathological conditions of the body can lead to ankle edema. In some cases, the swelling disappears quickly and does not indicate more serious medical problems. Persistent swollen ankles, however, may indicate a medical condition.
Muscle activity helps push blood from the legs to the heart. Periods of prolonged inactivity can lead to accumulation of blood in the lower legs, often causing fluid to seep into the soft tissues and thus causing leg swelling.Long car rides or long air travel can also cause swelling. People whose occupations require prolonged sitting may develop ankle edema, also known as “peripheral edema.” Regular flexion and extension of the leg muscles while sitting and short walking breaks can help reduce ankle swelling associated with prolonged inactivity. People who are overweight or obese may also experience ankle swelling – excess weight puts additional pressure on the legs, as well as on the veins of the abdominal cavity and pelvis.This leads to an increase in pressure in the blood vessels and provokes the penetration of fluids into soft tissues. Lack of physical activity leads to accumulation of blood in the lower body, which further increases the pressure in the veins of the legs. The combined effects of excess body weight and lack of physical activity ultimately lead to ankle swelling. Losing weight and increasing physical activity can help relieve swelling caused by being overweight.
Heart or renal failure
Permanent, painless ankle swelling is a common symptom in people with moderate to severe heart failure.The weakened ability of the heart to pump and move large masses of blood throughout the body leads to an accumulation of blood in the lower extremities, as well as to fluid retention in the kidneys. These factors also often lead to swelling of the ankle, feet and lower legs.
Ankle swelling is also a common symptom of acute or chronic kidney disease. The kidneys must maintain a normal water-salt balance in the body. Kidney disease often causes an abnormal buildup of salt and fluid in the body, which leads to fluid leakage into soft tissues.Limiting salt intake can reduce peripheral edema in people with kidney failure.
Ankle edema – alla_ta – LiveJournal
Ankle edema is a fairly common occurrence. Mostly women and overweight people suffer from swelling.
Edema is manifested by the fact that at the end of the day, especially in the heat, the ankles swell a little, and when pressed with a finger on the leg, a white spot remains. In the morning, fingers can swell and bend badly, so it is better to refuse to wear rings.Many other problems can develop, depending on the severity of the swelling.
The ankles swell with a sedentary, sedentary lifestyle and overweight.
People whose occupations require prolonged sitting may develop ankle edema, also known as “peripheral edema”.
Regular flexion and extension of the leg muscles while sitting and short walking breaks can help reduce ankle swelling associated with prolonged inactivity.
People who are overweight or obese may also experience ankle swelling – being overweight puts additional pressure on the legs, as well as on the veins of the abdominal cavity and pelvis.
This leads to an increase in pressure in the blood vessels and provokes the penetration of fluids into soft tissues.
Lack of physical activity leads to accumulation of blood in the lower part of the body, which further increases the pressure in the veins of the legs. The combined effects of excess body weight and lack of physical activity ultimately lead to ankle swelling.
Losing weight and increasing physical activity can help relieve swelling caused by being overweight.
To prevent this from happening, try to take at least a few steps every 30-40 minutes on the road, and during a long flight, people over 40 years old should not be hurt to bandage their feet and legs with elastic bandage .
– Try to lose weight. A large belly leads to an increase in intra-abdominal pressure and, as a result, compression of the iliac veins, through which blood flows from the lower extremities.
– Ankle edema is a sign of the development of nephropathy in pregnant women and requires compulsory treatment.
– If the ankles are swollen only on one side, then most likely the cause is deep vein thrombophlebitis of the lower extremities and consultation of a qualified vascular surgeon is required.You can recommend sitting more often with your legs raised higher, but this will not solve the problem.
– Swelling of the ankles can be temporary, passing if you have chronic varicose veins of the legs . It is especially noticeable in the morning. During the day, after active walking, the edema may disappear, and in the evening it may appear again.
The condition can improve wearing tight tights, even better in the morning, without getting out of bed, bandage your shins with an elastic bandage.
– If the eyelids are swollen at the same time as the ankles, then this is a sure sign of kidney problems. A detailed study is required.
The kidneys must maintain a normal water-salt balance in the body.
Kidney disease often causes abnormal accumulation of salt and fluid in the body, which leads to fluid leakage into soft tissues. Limiting salt intake can reduce peripheral edema in people with kidney failure.
– If swelling of the ankles is accompanied by edema of the abdomen, the appearance of spider veins on his skin, jaundice, then liver failure makes itself felt.
– If the ankles are swollen, shortness of breath appears, with the slightest physical exertion, the skin turns pale, then the heart is to blame – this is how heart failure manifests itself. It is necessary to be treated by a cardiologist.
– Special case – ankle edema due to trauma. Complex joints are located in the ankle area, in the formation of which many bones and ligaments are involved.
The vascular and nervous network is well developed here. It is difficult even for an experienced traumatologist to establish the nature of the injury.Therefore, with traumatic swelling of the ankles, it is often suggested to take an X-ray.
To understand if there is swelling, you need to press your finger on the front of the shin bone. In case of swelling, marks will remain on the skin.
There is a surgical method to remove excess fat from the ankles. But you can also get rid of fat on the ankles with the help of accentuated physical activity on the foot – jumping rope.
During jumping, the foot moves, the fat begins to be consumed by the muscles, both fat and swelling go away.
If you have a tendency to retain water in your body, then even from being idle on a hot day, your ankles can look like grapefruit.
Shoes can cause significant swelling in the ankle area.
This applies to shoes that are too loose or too tight. Worn out, fragile or inappropriate footwear is adversely affected.
Edema can also be associated with circulatory disorders and vascular disease. In case of venous insufficiency – weakness of the valve apparatus – due to the accumulation of blood in the vessels and a violation of the outflow of fluid, ankle edema develops.
About tissue tek also occurs as a result of heart failure of various origins.
This also happens with high blood pressure, heart attacks or diseases accompanied by a weakening of the heart muscle.
Other common causes of persistent swelling in the ankle area include diseases of the lymphatic system and kidneys, diabetes, gout and rheumatoid arthritis.
Swelling due to infection
In diabetics and people with loss of sensation, swelling of the legs can be a sign of infection.
Because the damaged nerves do not send pain signals, the patient may not notice how the ulcers or suppurations are progressing. People with similar problems should check their feet daily for inflammation and ulcers, and see a doctor in time.
Sometimes blood clots (thrombi) form in the veins of the legs, which can block the flow of blood from the feet to the heart, causing the legs to swell.
Thrombosis occurs in the superficial or deep veins. Deep blood clots can block one or more major veins.
The danger of blood clots is that they can break off and travel to the heart or lungs with the flow of blood.
Pain in one leg, swelling, temperature should alert you. Discoloration of the affected leg is also possible . Thrombosis requires compulsory medical attention.
Ankle swelling during sleep may indicate water and salt accumulation caused by heart failure .
With diseased kidneys, the excretion of fluid from the body is disturbed, it accumulates, and edema appears.
Liver diseases lead to a failure in the production of the protein albumin, which keeps blood from flowing from the vessels into the tissue, and edema is also formed.
In this case, first of all, the legs and arms swell due to the action of gravity, but the chest and abdomen can also accumulate fluid. If additional alarming symptoms appear – high blood pressure, shortness of breath, heaviness in the chest – call an ambulance
Side effect of medication
Many medications taken can provoke swelling of the feet and ankles as an unwanted side effect.
These medicinal preparations include:
Hormones – estrogen and testosterone – used in contraceptives and hormone therapy;
Steroids and anabolic steroids;
Calcium channel blockers (antagonists of calcium ions), usually in the composition of cardiovascular drugs, but the modern range of use of these blockers is very wide;
Antidepressants and medicines for diabetes.
If you suspect that the swelling of the legs is caused by taking prescribed medications, contact your doctor.Sometimes the benefits of treatment with this drug are much greater than the intensity of the swelling, but the swelling can be very serious.