Swollen or swollen legs are linked to fluid stagnation in the lower limbs. Several causes, benign or more serious, can be associated. Here’s how to deflate them.
Swollen or swollen legs are a symptomatic manifestation of a disorder of the body. They can be caused by a renal, venous or cardiac insufficiency, pregnancy, liver problem or taking certain medications. When the swelling of the legs is accompanied by other signs such as pain, fever or shortness of breath, do not not wait to consult. What causes swollen legs? Why the legs swell when you get pregnant? What are the treatments? What to do ? And by plane?
What are the symptoms ? One or two legs?
“THE “big legs” or phenomenon of swollen legs are manifested by localized edema on the lower limb(s). It is usually linked to a increased fluid inside the tissues : water, proteins or liquids that transport the cells in case of infection. This obstruction is called edema. Most often, it appears gradually. The edema is a symptom, the sign of a dysfunction of the organism. He can be mild or more serious depending on its underlying cause“says Prof. Laurent Chiche, vascular surgeon. In general, swelling affects both legs uniformly. “After the night and the elevation of the legs, they are often less swollen in the morning. As the day progresses, with gravity and movement, the swelling appears and becomes more prominent in the evening. It can be accompanied by a feeling of heaviness in the legs, even pain, redness or tingling” says Dr. Claire Lewandowski, a doctor specializing in general medicine.
What causes swollen legs?
“The cause will depend on the type of edema, if it is located on one side only, we will then look for a unilateral venous or lymphatic cause, linked to the vessels. Either because there is a obstruction to liquid flow which stagnates in the leg in the case of a thrombosis for example. You must know that some swellings practically disappear when lying down” says Professor Chiche. The most common causes of swollen legs are:
► venous insufficiency, when the blood is not sufficiently reabsorbed by the vessels because these are too dilated or ineffective. In this case, the veins do not correctly play their role of pump to the heart.
► heart failure when the heart muscle loses muscle strength and fails to contract normally. When it mainly concerns the right part of the heart, it slows blood circulation, and in particular venous return, and leads to an accumulation of fluid in the vessels, particularly in the lower limbs. These edemas predominate in the evening in the lower limbs and in the morning on the face.
► a renal pathology when the edemas of the lower limbs are voluminous. They appear either in a context kidney failure, that is, the kidney does not remove enough fluid from the body. This problem may appear following kidney damage in a context of diabetes, damage to the kidney or kidney arteries in himself.
► a liver problem.. This is particularly the case in the person who suffers from a hepatic cirrhosis following chronic alcohol consumption, for example. Some diseases like hemochromatosis or Wilson’s disease can also hurt the liver and cause this kind of edema.
► medications like the anti-inflammatories, corticosteroids or certain cardiological treatments.
► there pregnancy. Lower limb edema is more common during the third trimester. The adrenal glands of pregnant women produce a greater quantity of aldosterone and cortisol, which are the hormones responsible for water retention. In addition, progesterone, a hormone secreted since fertilization, causes dilation of blood vessels which will make venous circulation less effective, especially in the legs. “Pregnancy causes compression of the vena cava, the main vein in the abdomen that brings blood from the lower limbs back to the heart. However, this compression obstructs the flow and causes dysfunction of the underlying veins.“adds the vascular surgeon.
► In the 2nd part of the menstrual cycle, after ovulation and until the onset of menstruation, progesterone dominates. This female sex hormone dilates blood vessels, especially leg veins, which can promote leg swelling.
► If the legs are swollen because of a poor diet, too rich in salt, the patient should adopt lifestyle and dietary measures (healthy diet, limited in salt, physical activity).
► The lymphatic drainage promote venous and lymphatic circulation and reduce swelling due to stagnation of blood and lymph.
► If the cause is detected venous insufficiency: we recommend wearing compression stockings, tights or socks elastic of the lower limbs to prevent the veins from swelling. You can also make surgery to destroy diseased veins by thermal endovenous techniques (we send heat which will destroy the surface of the vein)
► If the patient suffers from a cardiac, renal or hepatic pathology, the medical treatment put in place will depend on the cause. Medication diuretics promote the elimination of water by the kidneys for example.
► The pressotherapy reduces the risk of complications swollen legs and especially lymphatic oedema.
It is possible to prevent the appearance or worsening of swollen legs eating enough proteinwhile having regular physical activity (like walking every day for example), quitting smoking and avoiding prolonged standing or sitting too long. “Physical activity will serve to activate the calf muscle pump so that it drives the blood towards the deep venous network and towards the heart“explains the vascular surgeon. We also advise against wearing heels, floor heating or even pants too tight. Sleep with your legs elevated (by placing a cushion under the mattress for example) can relieve the legs at the end of the day.
What foods should you avoid when you have swollen legs?
Limit salt intake (industrial, highly processed foods, crisps, charcuterie, cheeses, salt shakers, etc.), foods high in sodium and excess weight when prone to swollen legs.
“While traveling by plane, avoid crossing your legs and get up regularly to walk down the hall. do not forget to drink plenty of water to avoid dehydration“advises Dr. Lewandowski.”Wear some pantyhose or compression stockings contains the venous network of the legs so that the veins do not dilate” advocates the vascular surgeon.
When to consult?
As soon as you observe suggestive signs such as a edema that appears suddenlyassociated to :
- a localized pain
- of the fever,
- A shortness of breathbreathing difficulties,
- if you cough up blood,
- pain on the right side (liver)
- of the heart trouble (palpitations, chest pain)
- a red hot leg
“In the cases mentioned above, it is necessary to consult quickly” warns Professor Chiche.
Who to consult for swollen legs?
THE doctor remains the first point of contact. Depending on the cause, he may direct him to a doctor or vascular surgeon, angiologist, cardiologist, nephrologist or hepatologist For example.
What exams for swollen legs?
The first step is the clinical examination. “The bucket sign is often used by the doctor : he presses his finger on the leg: if the mark remains for a few seconds, it is a sign of edemasays Dr. Lewandowski.A blood test tests markers of heart, liver or kidney failure. An echodoppler can be useful to look for dysfunctions of the vessels and in particular the veins” adds Professor Chiche.
Is leg edema dangerous?
The main risk of leg edema is the ulcer, that is, sores on the legs that can take a long time to heal. There orange peel skin and weight gain are also part of the consequences of leg edema. “When the edema reflects a chronic or venous pathology, when it is unilateral, it remains relatively benign. The most serious edemas are those that do not disappear when you go to sleep, those that affect both legs or those that accompanied by other signs such as pain“ notes the vascular surgeon.
Thank you to Pr Laurent Chiche, vascular surgeon Head of the Vascular and Endovascular Surgery Department at the CHU de la Pitié-Salpêtrière in Paris and to Dr Claire Lewandowski, doctor specializing in general medicine.