SWELLING/EDEMA
OF THE FOOT AND LEG

Swelling of the lower extremities occur when too much fluid is retained in the legs and feet. It is usually caused by diet, venous insufficiency, kidney problems, and/or heart conditions. Swelling is also commonly associated with Diabetics. In most cases, swelling appears on both sides (though it can be just one). You may also notice that during the day, or as you stand up more, the swelling will worsen. This is because fluid is being insufficiently returned (or removed), and standing positions allow gravity to further pull fluid down into the legs and feet. Symptoms may be pain or discomfort as a result of extra fluid pushing against the nerves. In more extreme cases, the fluid volume exceeds what the skin can hold in. As a result, blisters or general weeping of the lower extremities will appear. 

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Diet:
Diet can sometimes cause extra swelling. Sodium is a big driving factor and can cause the body to retain fluid. At the same time, extra fluid within the same space means that the heart will have to work harder to circulate all the fluid around. This can lead to high blood pressure and increased overall wear and tear (which leads to earlier heart disease).

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Venous Insufficiency:

Veins are responsible for bringing 'used', or oxygen-poor blood back up to the heart. Within the veins are little valves which prevent the back-flow of blood back down the extremity. Over time, these valves can get a bit 'leaky' which allows more blood to pool and collect in the extremities. In turn, increased blood pooling means increased fluid in the extremities, creating swelling. You may also notice some darkened spots appear in the feet and legs (almost looks like a tan that you didn't intentionally get). These spots are iron deposits left over from red blood cells which have pooled there for a long time.

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Kidney Issues:

Kidneys are responsible for excreting (getting rid of) excess fluid within the body. Through a complex filtration system, the kidneys allow undesired matter and fluid to pass through while retaining essential fluids and cells. In some cases, the kidney may not be getting rid of the fluid quickly enough. In turn, this causes a back up (think of it like a traffic jam) of fluid within the body. The result is swelling, although it tends to be more uniform. However, due to gravity pull you may notice the majority of your swelling end up in the legs and feet. 

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Heart Conditions:

The heart plays a vital role in keeping the blood/fluid circulating throughout the body. Think of the heart as the most important pump in the world. The most commonly associated heart condition is known as congestive heart failure, though a number of other conditions may cause similar issues. Congestive heart failure means that the heart is having difficulty pumping all the blood and fluids around the body. If the heart itself isn't pumping as effectively, then fluid will start to back up throughout the body and cause swelling. Of course, there is a much more serious underlying condition in this case, but swelling may be a sign/symptom and early detection will generally lead to better treatment outcomes.

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Treatment generally starts with an evaluation and finding the underlying cause of swelling. We typically offer compression therapy for the lower extremities which is designed to keep swelling down (provided the heart is healthy enough to handle the extra fluid). We also offer wound care for those who have blisters or wounds that have broken open as a result of the swelling. There are some underlying causes that we cannot fix ourselves. However, we work with some great primary care and specialists.

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For more information, feel free to get in touch with us.