Peripheral Edema: What You Should Know About Swollen Legs

The most common place to see edema, or swelling, is in your feet, ankles and lower legs. Edema is the result of fluid building up in your body. It can happen in any part of your body, but because of the effects of gravity, the fluid usually shows up as painless swelling in your lower extremities. Fluid in this area is called peripheral edema. The old name for edema was dropsy from the Greek word for water, hydrops. The word is no longer used in medicine, but descriptions of dropsy go back to the Ancient Egypt.

"Bloodletting, either by venesection or by leaches, was a popular way to alleviate symptoms from dropsy… Its treatment options were scanty and were aimed to cause 'emptying of the system,' or to relieve fluid retention." —Journal of Cardiac Failure

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Symptoms of Peripheral Edema

Today doctors no longer use the term dropsy, and they don't relieve edema by the old practice of bloodletting. Mild to moderate swelling in the lower legs is common with age and does not always mean you need to be treated. Your legs may feel tight and heavy, and you may notice the skin over your lower legs becoming stretched and shiny. If you press gently on a swollen area for about 15 seconds and it leaves a dent, it is called "pitting edema," and you should let your doctor know about it.

Common Causes of Peripheral Edema

As you get older you are more likely to collect edema fluid in your lower legs if you stand or sit too long. You may notice tightness and swelling after a long flight or car trip. You may notice "sock marks" when you take off shoes and socks after a long day. In most cases these symptoms are not anything to worry about but if edema is pitting and doesn't clear up quickly, alert your doctor.

Here are some more serious causes of peripheral edema:

Venous insufficiency. This happens when the veins in your legs have become weakened and can't return blood to your heart quickly enough.
Congestive heart failure. This is the most common cause of serious peripheral edema. Congestive heart failure occurs when your heart is not pumping well enough to keep blood moving through your system.
Other diseases. Diseases of the lungs, liver, kidney and thyroid can all cause a buildup of fluid that leads to peripheral edema.
Medications. Some types of antidepressant medications and blood pressure medications can cause edema. If you are taking any of these types of medications and you have edema, talk to your doctor about it.

What You Can Do About Peripheral Edema

For mild cases of edema there are several things you can do for yourself:

• Avoid standing or sitting too long. Get up and move around to get a good blood flow going.
• If you have to sit or stand, wear support stockings. These stockings are available in most drug stores and online.
• Elevate your legs as much as possible. When lying down, put a knee wedge pillow under your legs to elevate them above your heart.
• Avoid too much salt in your diet. Ask your doctor about salt restriction and following a low-salt diet like DASH.
• If peripheral edema persists, see your doctor. Your doctor will treat any underlying conditions causing the edema. The most common medication used to treat edema is a diuretic, often called a "water pill."

Warning Signs for Seniors and Caregivers

Edema fluid can also start to collect in your lungs, which is a dangerous stage of congestive heart failure. If you feel short of breath or have chest pain call your doctor immediately or call 911. Call your doctor right away if you have any of these warning signs:

• Fever, redness, swelling, warmth or pain in your leg, which could be symptoms of a clot or infection
• Any sudden increase in edema, decreased urine output or accumulation of edema fluid in your belly
• Any injury to the skin over a swollen leg—these areas are easily infected and take longer to heal

Peripheral edema becomes more common with age, and in many cases you can control occasional edema with home care. But persistent peripheral edema can be a sign of a serious disease like congestive heart failure that needs to be treated. If in doubt, call your doctor. Complications from edema can often be avoided with early recognition and treatment.