Swollen legs are a common problem. Mostly in the evening, the ankles or the whole leg swells, it feels tired and heavy. Both women and men are affected.
What are swollen legs?
Swollen legs are caused by water accumulation in the tissues (edema). This water leaks out of the vascular system of the legs and becomes lodged in the surrounding tissues. Rarely do people think about what caused the swollen legs; usually, thick and tired legs are accepted as the result of a busy day. But the question of the reason is quite important, because the cause of swollen legs may lie in a serious disease. Swollen legs are caused by water accumulation in the tissues (edema). This water leaks from the vascular system of the legs and is deposited in the surrounding tissue. The amount of fluid is greater than the body is able to remove and thus the swelling occurs. Edema does not only occur in the legs but can occur anywhere in the body, depending on the disease. Swollen legs indicate a disorder that either affects the venous system itself or has an effect on the venous system.
Causes
Swollen legs occur when there is a change in pressure between vessels and tissues. On the one hand, this can happen due to overloading, sitting or standing for long periods of time, lack of exercise, but also due to the genetic predisposition to weak veins. During pregnancy, swollen legs are caused by a change in hormonal balance. However, swollen legs are also caused by certain diseases and should therefore be examined by a doctor in all cases. Heart diseases such as heart failure (cardiac insufficiency) or a heart valve defect have swollen legs as a typical symptom. Vascular occlusions or vascular inflammations also cause swollen legs. Furthermore, edema is caused by certain medications, such as cortisone.
Diseases with this symptom
- Kidney weakness
- Pulmonary embolism
- Heart failure
- Heart muscle inflammation
- Venous insufficiency
- Progressive systemic scleroderma
- Renal inflammation
- Acute renal failure
- Cirrhosis of the liver
- Hormone fluctuations
- Drug allergy
- Pleural effusion
Diagnosis and course
Swollen legs should be examined by a doctor in any case to find out whether there is an underlying disease, whether the veins are pathologically changed or whether there are other causes of swelling. Both the patient’s medical history and the course of occurrence of swollen legs are important. For a diagnosis, the external appearance of the legs must first be considered, because varicose veins or skin varicose veins, so-called spider veins, are an indication of venous disease. A typical and very simple examination is to press on the swollen tissue with a finger. If a dent remains for a while, this is an indication of water retention. Furthermore, ultrasound examinations and a phlebography, i.e. vein examination by injected contrast medium, provide more detailed information about the condition of the veins. If the pathological changes are not treated, they progress and the symptoms can worsen. Thus, if left untreated, swollen legs can lead to open legs, thrombosis or even embolism.
Complications
Various complications can occur in connection with swollen legs. If swollen legs are not properly treated and cared for, open sores can develop (necrosis, leg ulcers/open leg and gangrene). Due to reduced blood flow, the wounds heal poorly. Surgery may even be necessary, and in the worst case, amputation is unavoidable. If swollen legs are due to venous disorders, there is a risk of thrombosis because the blood flows slowly. In the case of thrombosis, a blood clot clogs the vessel, consequently the vein can no longer properly dispose of the tissue. Further swelling occurs as the blood takes other routes, overloading other veins. The affected extremity may turn brownish or bluish and the tissue hardens. Blood circulation remains disturbed.Varicose veins often form and, in rare cases, may burst. Consequently, there may be a large loss of blood. In addition, water retention in the tissue (edema) can also develop. If the thrombus in the vein wall detaches, a stroke, heart attack or pulmonary embolism can occur. In a pulmonary embolism, the detached thrombus is washed into the lungs with the bloodstream. The heart is suddenly overloaded and there is a risk of cardiac arrest. More severe pulmonary embolisms often result in immediate death.
When should you see a doctor?
It may be due to lack of exercise or extremely warm weather when swollen legs occur. Another common cause of swollen legs is standing or sitting for long periods during the day. Such phenomena are so-called physiological edema, which disappear again overnight. In addition, preventive measures against such water retention in the legs help – for example, compensatory gymnastics, cycling, treading water or elevating the feet. However, if all this is obviously not the case, anyone affected by swollen legs should immediately consult their family doctor. There are numerous possible causes for swollen legs, including several serious conditions that require urgent treatment. These include, for example, various heart diseases, high blood pressure, kidney disease, thyroid disorders, diabetes mellitus or liver disease. Swollen legs can also be caused by chronic circulatory disorders as well as congestion of lymphatic fluid. Swollen legs can also occur during pregnancy. In addition to his examination methods, the attending physician will inquire about any medications taken that may have swollen legs as a side effect. Swollen legs often create a high level of suffering for those affected. The unaesthetic appearance, the limited mobility caused by the swollen legs and possible pain can lead to depression in the patient. He should then also directly address his attending physician about this.
Treatment and therapy
Initially, the patient himself can contribute a few things to an improvement. Swollen legs should be cooled and elevated. Elevation allows the excess fluid to drain away, and the swelling is reduced. At night, patients should always keep their legs elevated. But also during the day, long periods of standing or sitting should be avoided. Alternating showers are a remedy, as are diuretics, i.e. draining medications, and lymphatic drainage. If there is a genetic weakness of the veins, special vein gymnastics are recommended. This mainly trains the calf muscles, which are needed to pump the blood back toward the heart. Sports such as hiking, Nordic walking, cycling or swimming help with swollen legs. Compression stockings are also recommended. These are specially fitted and exert pressure on the venous system, which causes the vessels to constrict and thus the venous valves to close better again. The metabolism in the legs also functions better as a result, which counteracts swollen legs. There are four different classes of compression stockings, they differ in the strength of the material and thus in the pressure they exert on the tissue. Finally, there is still the possibility of surgically treating the veins so that they no longer cause swollen legs.
Outlook and prognosis
The reason for swollen legs is usually water retention in the tissues. If this storage of water is not treated, the result is increased swelling of the legs. The skin is then subjected to a lot of strain and stretching. It is then very sensitive to touch. Even slight impacts can therefore cause damage to the skin. It can easily burst open, leading to the formation of wounds. These wounds must then be treated carefully to prevent infection and to ensure that they heal as quickly as possible. In addition, the patient’s freedom of movement is restricted. Walking is also painful, as the legs feel heavy and the skin is uncomfortably tight. The use of drainage medications, diuretics, can counteract the development of swollen legs. They should not be taken regularly, as they can lead to various side effects regarding the patient’s water balance.Taking such medication then leads to an increased urge to urinate on the part of the affected person in order to flush the excess water out of the body. A regular occurrence of swollen legs may indicate various organ damage, such as damage to the kidney. This circumstance should be urgently examined and evaluated by a doctor.
Prevention
To prevent swollen legs, it is recommended to avoid standing and sitting for long periods of time, to exercise frequently and to drink enough. For example, instead of taking the elevator, walk up the stairs or take a walk now and then. Cycling is a good workout for healthy veins, and a healthy diet also has a preventive effect. Alcohol in excess should be avoided.
What you can do yourself
Swollen legs and feet are often caused by long periods of standing and sitting. Elevating the legs brings relief and should be repeated as often as possible. Those who work in sales and cannot avoid standing for long periods of time should change positions as often as possible. Nevertheless, water retention in the legs must be medically examined, because it can indicate kidney and heart problems or lipedema. Strong leg veins promote the return of blood to the heart, so that less water can be stored. This can be promoted by vein stockings, for example. Regular leg exercises also support the muscles and strengthen the veins. Deep abdominal breathing also strengthens the reflux mechanism. Here, the alternation between inhaling and exhaling creates a negative pressure that stimulates blood circulation and facilitates the drainage of water. Since the problem is aggravated by heat, cool compresses help. Staying in the sun should always be avoided. Excess weight aggravates existing suffering, therefore weight reduction is recommended. Kneipp water jets and treading water have also proven successful. Cold water has a decongestant effect and can strengthen the veins. Exercise is good in any case and reduces water retention in the legs. Competitive sports are not necessary for this. Stress can exacerbate the problem, so relaxation exercises, plenty of sleep and a balanced diet are recommended.
