Lower Extremity Swelling May Be Linked to Venous Insufficiency

The abnormal buildup of fluid in the body is called edema. Edema is commonly seen in the feet and ankles, because of the effect of gravity, swelling is particularly noticeable in these locations. Common causes of edema are prolonged standing, prolonged sitting, pregnancy, being overweight, and increase in age.

Swelling in one of your legs may be a sign of underlying venous disease. If both your legs are swollen, the cause is likely related to a systemic issue, meaning dysfunction of a combination of other organs like your heart, kidney, liver. Low protein in your blood can also give rise to swelling of both lower extremities or generalized swelling. Typically if the ankles swell up in the evening or as the day goes on, the cause is likely right heart failure causing retention of salt and water. There may be associated symptoms like numbness or tingling of the lower extremities related to neuropathy, which can be a marker of other diseases like diabetes.

If the swelling is due to underlying venous disease, then more commonly it is present in  only one leg or is much more severe in one leg and may have other associated signs of venous insufficiency like hyperpigmentation /darkening of skin around the ankles or varicose veins in your legs.

Regardless of  the cause of the swelling, if it is causing pain, heaviness, or achiness, the treatment starts with wearing compression stockings. Compression stockings can be knee-high or thigh-high and are typically obtained from a surgical store where they can do accurate measurements of your leg. The compression stockings in this case typically have to be medical grade, meaning they target vein compression equivalent to 20 to 30 mmHg.

The best time to put on compression stockings is in the morning before you get out of bed. They should consistently be worn all day. In the evening you may be able to take the compression stockings off, jump into the shower and then go to bed. You will not need to wear compression stockings while in bed. The compression stockings should not go in the dryer, and ideally should be changed every six months.

If you think you may have underlying chronic venous insufficiency or your legs are swollen, make sure to consult with your doctor.

This column is sponsored by KSC Cardiology, and the opinions expressed herein may not reflect those of  CFHN or its advertisers.

Bio: Dr. Aparajita is a fellowship-trained vascular and endovascular surgeon. She is the co-author of 20-plus journal articles and publications and was recently nominated for an Inspiration Award by the American Medical Association.

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