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Leg Edema Treatment

If you are suffering from leg edema, try these remedies and medications to reduce swelling.
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Leg swelling is caused by abnormal fluid retention in the tissues of the lower extremity. The medical term for leg swelling from excess fluid is edema.

The common causes of leg swelling, such as prolonged standing or sitting or an injury, are relatively harmless in the long term.

The less common causes of leg edema include diseases which cause thickness of the layers of skin, such as eosinophilic fasciitis and scleroderma.

Edema may affect both legs and may include the calves or even the thighs. Due to the effect of gravity, swelling is mainly noticeable in the lower part of the body.

What Are The Causes of Water Retention? 

Leg edema, caused by the accumulation of fluids in tissues, is known as peripheral edema. Several body systems, including the circulatory system, the lymphatic system and the kidneys, help maintain the appropriate balance of fluids in the body. A problem with any one of these systems may contribute to the retention of fluids. 

Leg edema can be caused by several factors: acute kidney failure, chronic kidney failure, cardiomyopathy, hormone therapy, heart failure, prolonged standing, nephrotic syndrome, or thrombophlebitis. 

While different factors can contribute to the development of leg edema, all types of edema are caused by the interplay of two forces (hydrostatic pressure and oncotic pressure) and the involvement of the six factors listed below.

  • Increasing hydrostatic pressure
  • Reducing oncotic pressure in the blood vessels
  • Increasing oncotic pressure in the tissues
  • Deterioration of blood vessel walls and the permeability of the vessels which causes oncotic pressure to fall and fluids to leak out into the interstitial spaces
  • Malfunctioning lymphatic system which fails to return fluids to the lymph nodes and so causes them to pool in extracellular spaces
  • Change in the fluid retention properties of tissues which is caused by the accumulation of hydrophilic molecules in the tissues

Hydrostatic pressure is the pressure generated by fluids while oncotic pressure is generated by plasma proteins in the blood vessels.

These six factors can be caused by a long list of agents including drugs, diseases, diet and lifestyle.

Other Causes of Leg Swelling 

Leg edema may also be caused by others factors such as achilles tendon rupture, broken ankle/broken foot, osteoarthritis, infection or wound in the leg, broken leg, baker's cyst, and sprained ankle. 

Certain medications may also cause swelling in the legs. These include antidepressants, MAO inhibitors, blood pressure medicines, birth control pills or hormone replacement therapy. 

Home Remedies to Treat Leg Edema 

Exercise and Massage

Elevate your legs with the help of a pillow to support your knees and ankles while lying down. This can help you get rid of water retention. Also consider getting enough leg exercise as this will pump fluid from your legs, back to your heart. 

Beside exercise to treat leg edema, you should also consider leg massage. Leg massage is also referred to as manual lymphatic drainage.

Before a leg massage session, the leg is usually elevated above the level of the heart for 10 to 15 minutes. This is to allow gravitational pull to drain some of the fluids away from the feet.

The actual massage involves using gentle but firm strokes to push the fluid back. These strokes should start from the toes and move up towards the ankles and then up the lower legs towards the groin.

If the leg edema is extensive, a massage therapist should be consulted. A seasoned massage therapist should be versed in the art of rehabilitating swollen limbs especially if it limits movement. A professional knows about the map of the lymphatic system in the lower legs and should deliver quicker results.

It is only when the leg edema is well controlled and the swelling lessened that massaging at home should be considered.

Diet

Follow a low-salt diet to reduce fluid retention and swelling. There are several foods that you must avoid, such as white flour foods, processed foods, sugary foods and drinks, coffee, black tea, and alcohol.

The sodium in salt is chiefly responsible for water retention and leg edema. It encourages the reabsorption of water in the kidneys and also contributes to high blood pressure.

Although coffee contains caffeine, a diuretic, it may still lead to leg edema if the body assumes the uncontrolled diuresis will lead to dehydration. This causes thirst craving and also the activation of the renin-angiotensin-aldosterone system.

By increasing thirst, the body drives us to drink more water which will be retained by the action of the aldosterone secreted in the kidneys.

Compression Stockings

You may wear compression stockings to avoid buildup of fluids. The support stockings stimulate proper circulation and reduce swelling associated with edema.

Compression stockings are especially helpful in treating leg edema especially when they are coupled with moderate exercise (and even massage).

These stockings are made of elastic materials. They also provide varying amount of pressure depending on the severity of the edema.

Compression stockings generate their highest pressure at the ankles. Because the ankle is a joint between the foot and lower leg, the constriction in the blood vessels causing leg edema is usually highest there.

By applying pressure on the foot and upper leg, compression stockings improve blood flow and energize the lymphatic system to drain the fluids pooled in the leg.

Avoid wearing tight clothing and lose weight if you need to. Furthermore, never discontinue any medicines which you think may cause swelling, without first talking to your doctor. 

Medications to Treat Leg Edema 

Over-the-counter diuretics are the most common medications used for the treatment of leg swelling. They stimulate the kidney to remove excess water from the body. 

Some of the common diuretic medications used to treat leg edema are acetazolamide (diamox); bumetanide (bumex); chlorothiazide; furosemide (lasix); hydrochlorothiazide (hydrodiuril); methyclothiazide; and metolazone (zaroxolyn). 

Loop Diuretics

The loop diuretics are especially effective especially for patients who also suffer from liver cirrhosis, renal impairment, heart failure and nephrotic syndrome.

However, loop diuretics have low specificity when it comes to inhibiting the reabsorption of minerals. Therefore, they flush away useful nutrients such as potassium and calcium along with sodium and water.

Since potassium is the mineral most affected and because it is very important to cardiovascular health and the nervous system, potassium supplements are advised when taking loop diuretics especially when other types of diuretics cannot be used.

There is a formulation of Lasix which includes a potassium salt. Lasix-K, as it is called, supplies Furosemide, the diuretic, as well as potassium as a supplement.

Thiazide Diuretics

The thiazides are all chemically similar and they have the same mechanism of action.

Thiazides act at the distal convoluted tubules of the kidney nephrons. They, however, also deplete potassium along with sodium as they prevent reabsorption of water. However, the thiazides spare calcium.

Thiazides are effective diuretics but they should not be used to treat leg edema for pregnant women and people who also suffer from gout and diabetes.

Potassium-sparing Diuretics

The diuretics in this class are not chemically related like thiazides or even share a common site of action like loop diuretics. However, they all spare potassium.

Therefore, potassium-sparing diuretics are recommended when hypokalemia (low potassium levels) is to be avoided.

There are generally two types of potassium-sparing diuretics. Some of these (spironolactone, for example) inhibit aldosterone which is released by the renin-angiotensin-aldosterone system (a system activated by a feedback loop in the brain to promote water retention).

Others (amiloride, for example) simply block sodium channels in the nephron to prevent the reabsorption of sodium and water.

When to Contact a Medical Professional 

If you have a heart disease or kidney problem, and the swelling gets worse, call your doctor immediately. You must also consult your health care practitioner before taking any medication if you are pregnant and have more than just mild swelling in your feet. 

To learn more about the various treatment options for edema, read these articles: Acupuncture for Edema, Edema Massage, and Drugs For Edema.

Next Article: Get Rid of Water Retention - 7 Treatments!
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