Edema is an abnormal accumulation of fluid in the tissues of the body which can cause severe pain. Edema usually starts slowly, but the onset can be sudden. The Lakeland pain management doctors at the Novus Spine & Pain Center vein clinic specialize in treating edema, which is a common problem that can be the sign of a serious condition.
Although edema can affect any part of the body, it is most apparent in the feet, ankles, legs, hands, and arms. The word “edema” comes from a Greek word meaning “swelling.” There are different causes and types of edema, which mostly relate to an underlying disease or condition.
“Edema” is the medical term for swelling or puffiness that is caused by fluid retention. The condition usually occurs in the legs, ankles, or feet. But it can also occur in the hands, face, or other parts of the body. In the late 1800s and early 1900s, the condition was called “dropsy.”
Pregnant women and older adults more commonly suffer from edema than others; however, it can happen to anyone. In addition to pregnancy, edema can be caused by medications, infections, and many other medical conditions. Edema can affect a small area, or the entire body.
There are different types of edema that can affect the muscles, bowels, lungs, eyes, and even the brain. Each one can indicate a range of further health conditions.
Anasarca is a severe form of edema in which there is a widespread accumulation of fluid in all tissues and cavities throughout the body, and not just a certain part.
Angioedema is swelling underneath the skin. Unlike hives, which affect the surface of the skin, angioedema affects the deeper layers of the skin and can often affect the face.
Hereditary angioedema is a rare genetic condition that causes the capillaries to release fluids into surrounding tissue, resulting in edema.
Cerebral edema is an accumulation of excess fluid in the brain. It is usually the result of a head injury, a blocked or burst blood vessel, or a tumor or allergic reaction.
Dependent edema usually occurs in the legs when a person is standing, and in the buttocks and hands if a person is lying down. Dependent edema is “dependent” on a person’s position and affected by gravity.
Lipedema is a disorder of the fatty tissue that causes swelling of the legs and hips, and can lead to lymphedema.
Lymphedema is swelling in the arms and legs due to damage of the lymph nodes (tissue that filters substances that travel through the lymphatic fluid).
Macular edema is a swelling of the retina of the eye which is a serious complication of diabetic retinopathy.
Papilledema is a swelling of the optic nerve of the eye from pressure inside the skull and around the brain (intracranial pressure).
Pedal edema is the gathering of fluid in the feet and lower legs making it difficult to move, because there may be less feeling in the feet. This type of edema is more common in older adults and pregnant women.
Peripheral edema is swelling in the legs, feet, and ankles, but it can also happen in the arms. The condition can make it difficult to move the swollen body part.
Pulmonary edema is the collection of fluid in the air sacs of the lungs. This condition makes it difficult to breathe, and worsens when lying down. The heart may beat faster and the patient may feel suffocated.
Edema can occur in other parts of the body as well, but these are more common. The focus of this article is mostly on the legs, ankles, and feet.
What Causes Edema?
Edema occurs when small blood vessels leak fluid into nearby tissues. If the extra fluid builds up, the surrounding tissue swells. This can happen almost anywhere in the body. Many things can cause fluid to build up and produce swelling, such as a twisted ankle, a bee sting, or a skin infection. In some cases, like an infection, the edema is helpful as it brings more infection-fighting white blood cells to the swollen area.
Mild cases of edema may result from:
Prolonged sitting or standing, especially in hot weather.
Overeating salty foods.
A poor diet in general.
Having premenstrual signs and symptoms.
In some cases, however, edema may be a sign of a more serious underlying medical condition. Edema can be the result of an imbalance of substances in the blood. Other causes include:
Allergic reactions. In response to an allergen, nearby blood vessels leak fluid into the affected area. Edema is a part of most allergic reactions.
Blood clots. Any blockage that prevents blood from flowing, such as a clot in a vein, can cause edema. As pressure increases in the vein, fluids can begin leaking into the surrounding tissue.
A cyst, growth, or tumor. Any lump can cause edema, if it presses against a lymph duct or a vein. As pressure builds up, fluids can leak into surrounding tissue.
Head trauma. Brain tumors and a block in fluid drainage in the brain (hydrocephalus) can cause cerebral edema.
High altitude. Altitude, combined with physical exertion, can increase the risk of edema. Acute mountain sickness can lead to high-altitude pulmonary edema or high-altitude cerebral edema.
Hyponatremia (low blood sodium). When sodium levels in the body are low, water tends to enter cells, causing them to swell. Sometimes called “water intoxication” because it is due to the consumption of excess water without adequate replacement of sodium.
Illness. Serious illnesses that can cause edema include:
Liver issues, such as cirrhosis.
Severe allergic reactions.
Inadequate lymphatic system. The body’s lymphatic system helps clear excess fluid from tissues. If the system is damaged (as a result of cancer treatment, for example), the lymph nodes and lymph vessels draining an area may not work correctly causing edema.
Low albumin. Sometimes called hypoalbuminemia. The albumin and other proteins in the blood act like sponges to keep fluid in the blood vessels. Low albumin may contribute to edema, but it’s not usually the only cause.
Prolonged immobility: People who are immobilized for a long time can develop edema in their skin. This type of edema can be due both to fluid pooling in gravity-dependent areas and the release of antidiuretic hormone from the pituitary.
Obstruction of flow. If fluid drainage in any part of the body becomes blocked, fluid can back up. A blood clot in a deep leg vein can cause leg edema. A tumor blocking the flow of blood, or blocking lymph (the fluid that circulating throughout the lymphatic system), can also cause edema.
Varicose veins.Varicose veins are enlarged, knobby rough and twisted veins, most commonly found in the legs and feet. Veins that bulge as the result of damaged valves increase the pressure in the vein, which increases the risk of fluids leaking into the surrounding tissue.
Medications. Many medicines can cause edema, including:
Calcium channel blockers.
Corticosteroids (like prednisone and methylprednisolone).
Certain diabetes medications.
High blood pressure medications.
NSAIDs (such as ibuprofen and naproxen).
Pramipexole (treats Parkinson’s disease).
Edema is not contagious. You cannot catch it from other people, and it is not genetic.
What are the Symptoms of Edema?
The symptoms of edema depend on the amount of swelling and the location. If there is swelling in the legs, ankles, or feet that is not related to an injury, it could be edema. Edema can cause swelling of the face and hands, too. The swelling can be in all of these areas at once, or in only one area. The swelling, or “puffiness,” can cause an uncomfortable feeling. The swelling may even restrict the range of motion in the ankles and wrists.
In addition to swelling, a person with edema may notice:
Stretched and shiny skin.
Skin that retains a dimple after being pressed for a few seconds.
Individual symptoms depend on the underlying cause, the type of edema, and where the edema is located.
Leg edema can make the legs feel heavy and affect walking. If the edema is related to heart disease, the legs may weigh an extra 5 or 10 pounds each. Severe leg edema can interfere with blood flow, leading to ulcers on the skin. Common causes of leg swelling include:
Congestive heart failure.
Medication side effects.
In some cases of edema, applying pressure to the swollen area by depressing the skin with a finger will cause an indention or a “pit” to remain for a while after releasing the pressure on the skin. This condition is pitting edema. If the skin tissue springs back to its normal shape immediately after releasing the pressure, it is non-pitting edema.
Any form of pressure, such as from the elastic in socks, can induce pitting with this type of edema and can be normal. Almost everyone who wears socks all day will have mild pitting edema by the end of the day. Pitting symptoms can help determine the cause of the edema.
How is Edema Diagnosed?
To diagnose edema, a doctor will first perform a physical exam and ask about the patient’s medical history. In many cases, this information is enough to determine the underlying cause of the edema. In some cases, X-rays, ultrasound exams, magnetic resonance imaging (MRI), blood tests or urine analysis may be necessary to determine the cause of the edema.
How is Edema Treated?
The only treatment for edema is to treat the underlying condition. Temporary edema can often be improved by reducing the amount of salt in the patient’s diet and keeping the legs up while seated. To do so, a doctor may prescribe a diuretic (water pill) to help flush salt and extra fluid out of the body by increasing the rate of urine production by the kidneys, which then allows excess fluid in the body to flow back into the blood.
Diuretics can be helpful for edema caused by these conditions or situations:
Pregnancy: Significant fluid retention can be dangerous, and needs to be correctly diagnosed.
Heart failure: Diuretics in conjunction with other medications may help improve heart function.
Cirrhosis: Eliminating all alcohol, reducing salt, and taking diuretics can improve symptoms.
Lymphedema: Diuretics can be helpful during early onset. Compression stockings or sleeves are also beneficial.
Diuretics do not work in cases of medication-induced edema. The medication will need to be changed or discontinued to relive the edema.
Mild edema usually goes away on its own, especially if the patient helps the body eliminate the fluid by raising the affected limb higher than the heart. Edema from a block in fluid drainage can sometimes be treated by getting the drainage flowing again.
A blood clot is treated with blood thinners which break down the clot and help the vein get back to normal drainage.
A tumor that blocks blood or lymph can sometimes be shrunk or removed with surgery, chemotherapy, or radiation.
Here are some self-care techniques can help prevent, reduce, and keep edema from returning. Consult with a medical professional to see which ones are right for you.
Avoid tobacco and alcohol.
Avoid temperature extremes, such as hot baths, showers, and saunas. Dress warmly in cold weather.
Compression. The doctor may recommend the patient wear compression (support) stockings, sleeves, or gloves, usually after the swelling has gone down, to prevent further swelling. These garments keep pressure on the limbs to help reduce discomfort and prevent fluid from collecting in the tissues.
Healthy eating. Avoid packaged and processed foods that are high in salt.
Elevation. Elevating the swollen body part above the level of the heart, several times a day, helps improve circulation. In some cases, elevating the affected body part while you sleep may be helpful.
Grape seed extract may lower blood pressure and help alleviate edema related to varicose veins and poor vein function.
Lose weight, if appropriate.
Massage. Stroking the affected area toward your heart using firm, but not painful, pressure may help move the excess fluid out of that area.
Movement/Exercise. Moving and using the muscles in the affected body part, especially the legs, may help pump the excess fluid back toward the heart. Moderate exercise can help prevent swelling due to inactivity. Avoid sitting or standing still for extended periods of time. Get up and walk when traveling, especially during air travel.
Protection. Keep the affected area clean, moisturized, and free from injury. Dry, cracked skin is more prone to scrapes, cuts, and infection. Always wear protection on the feet if that’s where the swelling typically occurs.
Reduce salt intake. Follow your doctor’s suggestions about limiting how much salt you consume. Salt can increase fluid retention and worsen edema.
It is important to see a doctor if you have edema, especially if you are pregnant. If it is not treated, the skin may continue to stretch which can lead to other health problems. If a person with edema begins to have trouble breathing, call 911 right away.
Is It Possible to Prevent Edema?
Depending on the cause of the edema, you may not be able to prevent it from happening. If edema is the result of health problems, such as congestive heart failure, liver disease, or kidney disease, the swelling can only be managed.
However, there are steps anyone can take to help prevent edema. Doctors recommend staying as physically active as possible and avoiding excess sodium in the diet. The following are some things to do at home to help keep swelling down:
Elevate the legs when seated or lying down.
Wear support stockings if you have edema of the legs. Support stockings are available at most drugstores.
Keep moving. Avoid sitting or standing for long periods of time without moving around.
Limit the amount of salt in your diet.
Untreated edema can lead to:
Painful swelling, with pain that gets worse.
Stiffness and difficulty walking.
Stretched and itchy skin.
Infection in the area of swelling.
Scarring between the layers of tissue.
Poor blood circulation.
Loss of elasticity in arteries, veins, and joints.
Skin sores (ulcers).
Any underlying disease or condition needs treatment to prevent it from becoming more serious.
Novus Spine & Pain Center
The vein clinic at Novus Spine & Pain Center specializes in treating edema. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.