Swollen Feet and Legs

The medical term for swelling is edema. There are numerous reasons for why you may have swollen feet, ankles, and legs. Some of the causes include:
• Pregnancy
• Certain medications that cause fluid retention, such as hormonal therapy
• Obesity
• Kidney failure
• Congestive heart failure
• Venous Insufficiency
Of the causes listed above, venous insufficiency is one of the most common causes for aging patients. The venous system is made up of many veins that function to pump deoxygenated blood and excess fluid back to the heart. The veins have valves, which assist in getting the blood back to the heart by preventing backflow. However, in the case of venous insufficiency, the valves in the veins begin to malfunction and now longer are able to prevent the backflow. The fluid will then accumulate in the feet, ankles, and legs due to the gravity pulling the fluid backwards through the faulty valves.
Edema is treated non-surgically. Some of the treatment options include:
• Elevating your feet: This is one of the easiest ways to treat edema. You should elevate your feet above the level of your heart any time you are sitting or laying down. By having your feet elevated above your heart, gravity will work to let the fluid drain back through the venous system properly.
• Diet: Try to avoid foods that are high in salt, as the salt will cause the body to retain more fluid.
• Compression stockings: There are different types of compression stockings. There are open toed and closed toe and then the amount of pressure the stocking provides is prescribed based upon the individual. Compression stockings should be worn during the day and removed at night. It is very important that before you get out of bed in the morning you put the compression stockings on first. This is because if you wait for putting them on after breakfast, gravity is already working to pull the fluid into the feet. The compressions stockings function is to prevent fluid accumulation and is not able to get rid of the fluid that has already accumulated. Many patients find it difficult to put their compression stockings on since they can be very tight; however, there are various devices that can assist with putting the stockings on. In addition, there are some stockings that have side zippers, which allow for easier application.
• Compression dressings: Patients who have severe edema due to venous insufficiency, will commonly have lower extremity ulcers. These ulcers may form due to the high level of fluid that is retained. The skin can be thought of as a balloon; it can only stretch and accommodate so much fluid until it becomes too full and pops. Compression dressings are commonly used for these patients. The patient will wear the dressing for one week and then return to the Boulder Foot and Ankle for a compression dressing change; often times specialty wound care products will also be used to help better heal the ulcer.
• Lymphedema pumps: These are pumps that go around your legs and work the fluid out of the lower extremities. Your doctor will advise on how long the pumps should be worn each day.
• Diuretic/water pill: These medications help to get rid of the excess fluid that is being retained within the body. You will notice when taking this medication, that you will urinate more frequently.
If you notice that only one of your legs is swollen, red, and the back of your calf is painful, seek medical attention immediately, because these are signs of deep vein thrombosis (blood clot), which is a medical emergency

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