Leg, Foot and Ankle Edema — When is it Cause for Concern?

Joseph R. Anticaglia M. D.
Medical Advisory board

Sitting at a computer all day is roughly equivalent to you sitting in an airplane that flies from New York to Paris. If you took your shoes off during the flight, you may have experienced difficulty putting them on because of swollen feet and ankles.

The swelling or puffiness is called edema and it’s due of to excess fluid in the tissues of the body. The capillaries, small blood vessels, leak fluid into the tissues causing the swelling in the feet or ankles. Both of the above examples are usually harmless once you get up and move about. But what if the swelling in the tissues does not go away?

James Hellman, MD Pitting Edema.

Peripheral edema is swelling usually in the lower limbs. It is caused by many conditions and often involves the legs, ankles and feet. But edema can cause problems in almost any part of the body.

A weak heart, because of congestive heart failure, does not pump blood efficiently throughout the body. This can gradually lead to leg edema. People with kidney disease can experience ankle foot and leg edema. Cirrhosis of the liver can bring on leg edema.

Medications associated with edema include corticosteroids, medications for high blood pressure, nonsteroidal anti-inflammatory drugs and calcium channel blockers which relax blood vessels (increase the supply of blood and oxygen to the heart)

Conditions that block the drainage of fluid from a part of the body can cause leg edema as in deep vein thrombosis. cancer or the consequence of cancer surgery.

During breast cancer surgery, lymph node specimens are often sent to the pathology department to determine if the nodes are cancerous. If positive for cancer, the nodes are removed but the lymphatic drainage system has been compromised. Many women post-surgery have to deal with arm swelling after positive lymph nodes have been removed.

Symptoms and Signs of Peripheral Edema:

  • Legs or arms look swollen and start to feel heavy or full
  • Sensation of tightness or pain in the involved area
  • Shoes, jewelry or clothing don’t fit or feel uncomfortable
  • Trouble moving around because on ankle and leg edema
  • The swollen skin looks shiny or feels warm
  • Pitting edema — when you press the swelling it leaves a dent or ‘pit’

Treatment (peripheral edema)

Skin care is important. Consider using topical steroid creams and emollients to the involved area to prevent skin breakdown Wear compression stockings You might need to limit your salt intake Keep moving; do not sit stand for long periods of time without moving Follow the directions of prescription medications.

As noted above, edema can occur in other parts of the body and it’s important to treat the underlying cause. Macular edema of the eye can lead to blindness. Head injury can cause cerebral edema with devastating consequences. Allergic reactions to medications, food or bee stings can be life threatening. Edema can be related to inflammation, as in the case of rheumatoid arthritis or after an injury such as a broken bone. Also, being overweight or pregnant can cause leg edema.

Regardless of the cause, if you have shortness of breath, unilateral leg edema or any questions concerning edema in different parts of the body, consult your physician to arrive at the proper diagnosis and treatment.

References

  1. NCBI; Causes and signs of edema; December 30, 2016
  2. Kathryn P. Trayes et al; Edema. Diagnosis and Management, American Family Physicians, July 15 2013
  3. National Cancer Institute, Lymphedema
  4. National Institute of Health, MedlinePlus. Edema; July 3, 2017

This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.