Swelling

Can leg swelling be dangerous?

If swelling suddenly develops in only one limb, a more serious condition could be the cause. Deep venous thrombosis, or DVT, could be cause. DVT can occur during times of more sedentary activity like car or plane rides, after surgery or sometimes with no known cause. It carries a risk of the clot breaking free and travelling to the lungs. Sudden swelling can also be the result of an infection, called cellulitis. Because it is difficult to differentiate between these two conditions, leg swelling in only one leg requires immediate attention by your doctor or the emergency room.

What are the types of swelling?

The most common associated condition with leg swelling is venous insufficiency. Chronic venous insufficiency (CVI) affects more than 25 million adults in the United States alone, and more 6 million with advanced stages of venous disease. Venous insufficiency can be caused by damaged valves in the veins of the leg not able to close completely, allowing blood to flow backward away from the heart and pool in the legs. This results in swelling, as excess fluid escapes into in the tissues of the legs and feet. It is a serious circulatory disorder that usually becomes worse over time. This painful condition can result in disability, pain, leg fatigue and occasionally wounds. The pooled blood can cause skin changes causing the leg to turn brown or red over time. Swelling and varicose veins in younger patients can be hereditary.

If the veins are not the problem, the swelling can be caused by lymphedema. For a variety of reasons, fluid leaks into the tissues causing swelling. The lymph system drains fluid from within your tissues to be filtered by the lymph nodes. The lymphatic system may not be able to drain the extra fluid, resulting in lymphedema of the affected areas. It is commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment. However, it can also result from a blockage in your lymphatic system at the groin as a result of obesity, weight gain or surgery. The blockage prevents lymph fluid from draining well, and the fluid buildup eventually leads to swelling.

Lymphedema is also treated with compression therapy generally applied as wraps and pumps by physical or occupational therapists certified in treating the condition.

These two conditions can occur separately but commonly occur together. The chronic swelling from either condition can lead to damage of the veins and lymph vessels, perpetuating each condition.

Swelling can also be caused by heart and kidney failure but these conditions require specialized attention by your physician for management.

How do you evaluate the cause of swelling?

Evaluating leg swelling is actually easy and painless. An ultrasound can be performed to look at the size of the veins. You will also be asked to stand or cough to see if the valves are keeping the blood flowing in the right direction. If it flows backwards, we call this venous reflux. When it becomes too severe, it needs to be treated.

What worsens vein swelling?

This condition is worsened by prolonged standing and sitting, increased salt consumption, pregnancy and especially worsened by weight gain and obesity. Excess weight from obesity or pregnancy on the pelvis blocks blood drainage from the veins of the legs.

How is swelling due to veins treated?

Venous insufficiency as a result of faulty valves can be treated with compression therapy, leg elevation and ablation, or closure of the leaky vein. Closure of the vein is performed with a small catheter that either burns the vein closed or injects glue to close the vein. If the leaky vein is closed, the blood no longer pools in the lower legs leading to improvement of the swelling, pain, and leg fatigue.

I don’t have swelling but I do have spider veins. Is there anything that can help?

Dr Wishnew can also inject a glue into the small visible veins in the legs. As it is injected, the veins literally disappear.