Edema

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What is Edema?

Simply put, leg edema is leg swelling. When there is increased fluid volume in your skin and subcutaneous tissues, you may notice an indentation when you apply pressure to that area. This tends to increase over the course of the day. It is typically noticed first in the area of the ankle, but can also extend throughout the rest of your leg and even into your foot. Swelling can involve one or both legs. The location of the swelling can tell us a story about the nature of the problem. When the swelling indicates a disorder of the lymphatic system, we call this lymphedema.

Some causes of leg edema due to increased pressure in the veins include:

-Venous Insufficiency (a failure of the one-way valves in your veins). Blood in the veins is supposed to be moving up toward the heart. Over 90% of blood leaves our legs through the deep veins. When the valves fail, which is called venous reflux, a percentage of the blood falls down the legs pulled by gravity. This leads to increased congestion and pressure in the legs that can be felt. Longstanding venous reflux can cause “phlebolymphedema.” When the lymphatic system is unable to adequately drain the fluid that accumulates due to venous insufficiency a protein-rich fluid accumulates in the soft tissues, phlebo-lymphedema.

-Obesity, which increases pressure on the veins and lymphatic channels in the abdomen and pelvis.

-Deep Vein Thrombosis (DVT), clots which obstruct the venous flow back to the heart.

-Compression of the large veins in the pelvis which prevents blood from leaving the legs normally.

-Failure of the calf muscles to pump venous blood out of the legs due to a stroke, vein injury, arthritis which limits mobility, or inactivity.

Chronic leg swelling can also be due to the following:

-Congestive heart failure

-Pulmonary hypertension

-Hypothyroidism

-Liver disorders

-Kidney disorders

-Low protein states (malabsorption, intestinal disease)

-Pregnancy