What is Leg Swelling?
Swelling is simply fluid building up in the body’s tissues. The fluid is spread out among the cells. It is not like a fluid collection that can be drained with a needle. When you press in on swollen tissue the fluid moves away and leaves a dent in the overlying skin. This fills back in as the fluid returns. When the legs are elevated the fluid flows deeper into the body and the swelling appears to go away. When the legs are below the heart, the swelling returns. For some it is noticeable only at the end of the day. For others it starts as soon as they get up.
The medical term for swelling is edema. It can be very hard to tell what causes edema even with lots of medical testing. Swelling due to vein problems is called Phlebolymphedema and needs the veins treated.
Problems With Leg Swelling
It can be very hard to tell what causes edema even with lots of medical testing. Edema can be a part of many medical conditions.
- Your medical doctor should work you up to exclude medical causes like Kidney, Heart, Liver, Thyroid, etc.
- Medications can cause leg swelling.
- Often a basic ultrasound is done (lying down) to rule out a blood clot in your leg (DVT). This is nearly always negative, but it doesn’t mean there are not other vein problems.
- “Fluid pills” may be tried to reduce the swelling.
- You may be given a diagnosis of Lymphedema.
- You may be told the only treatment is leg elevation and compression garments.
- If this doesn’t help you’re told: “There’s nothing else we can do for you”.
Diagnosing Leg Swelling
We may be able to help you. A much more thorough investigation of the veins needs to be done. Undiagnosed vein problems are a very common cause of swelling. Some of our diagnostic tools include:
Detailed Leg Vein Ultrasound
- Lying down to rule out DVT
- Standing to evaluate for reflux in the deep and superficial system
Detailed Abdomen and Pelvic Ultrasound
- Looking specifically at the veins.
- Highly specialized study, requires special training.
- Not taught in ultrasound school.
- Routine ultrasounds are not enough.
- MUST be done at Vein or Vascular specialist.
- Injection of x-dye into veins
Intra Venous Ultra Sound (IVUS)
- A tiny ultrasound probe is put into the veins and imaging is done from the inside to precisely measure for vein blockage
What is Lymphedema?
Lymphedema is another type swelling of the tissues. It is due to problems with the lymphatic system or from injury to it like lymph node removal during surgery. It often has a different appearance than edema from other sources. For more information on lymphedema, click here.
Leg Swelling Treatment
Even if the underlying cause of the swelling cannot be found or corrected, there is still hope. Some non-surgical treatment options are the following:
- Compression garments, hose or socks
- Wedge pillow to correctly elevate your legs
- An adjustable bed a prescription may help get this for reduced cost
- New medications that are not diuretics and work directly on the veins are available
- Complete Decongestive Therapy (CDT) a type of physical therapy that uses massage and wrapping.
- Pneumatic pumps similar but more sophisticated than those applied in the hospital to prevent blood clots
In patients with swelling due to heart failure, lying down and elevating the legs can lead to severe shortness of breath and worsening of heart failure.
Schedule a Consultation
For more information on leg welling, call 704-544-5245 to schedule a consultation with Vein Specialists of the Carolinas.