Your legs swell for lots of reasons. To treat your symptoms, we need to know what those reasons might be. In this post, we review some of the most common causes as well as treatments to help with swelling.
Swelling of the legs and feet is a relatively common medical problem, and it becomes even more common as you get older. But swelling (or edema) still isn’t normal, and it needs evaluation and treatment right away.
At Vayu Advanced Wound Clinic and Hyperbarics in San Antonio, Texas, Manjulatha Badam, MD, CWSP, UHM, helps our patients manage leg swelling by first determining the cause, so we can customize and target treatment.
If you have swollen legs, here’s what Dr. Badam wants you to know.
Causes of Leg Swelling
Most leg swelling occurs when fluids don’t drain properly from your lower limbs. This often happens due to issues with the lymphatic system, veins, or organs that regulate fluid balance. Here are the most common medical conditions behind leg swelling:
Lymphedema
One of the leading causes of persistent leg swelling is lymphedema. This condition occurs when the lymphatic drainage system — a network of vessels and nodes that transports lymph fluid — is damaged or blocked. As a result, lymph fluid builds up in the tissues, causing swelling.
Lymphedema may develop due to:
- Cancer treatment (such as radiation or lymph node removal)
- Infections
- Trauma or surgery
- Certain cancers that impair lymph flow
Chronic Venous Insufficiency
Chronic venous insufficiency (CVI) happens when the valves in your veins don’t function properly. Instead of blood flowing efficiently back to your heart, it pools in the veins of your legs, leading to edema, heaviness, and sometimes skin changes or ulcers, often known as Venous Ulcers.
This condition is common in people who:
- Spend long hours standing or sitting
- Have a history of blood clots
- Are older or have a family history of vein disease
Varicose Veins
While often considered a cosmetic concern, varicose veins can contribute to leg swelling. These enlarged, twisted veins cause blood to flow less effectively, increasing fluid retention in the lower limbs.
Peripheral Artery Disease
Peripheral artery disease (PAD) results from narrowed arteries that reduce blood flow to the limbs. Although PAD more commonly causes pain or cramping during walking, it can also contribute to swelling, especially when combined with venous issues.
Kidney Disease
Your kidneys play a crucial role in filtering excess fluid from the body. When kidney function is impaired — whether due to chronic disease or acute injury — fluid can accumulate in the legs, ankles, and feet, resulting in noticeable swelling.
Heart Failure
Congestive heart failure can also lead to edema, especially in the lower legs. When the heart isn’t pumping efficiently, blood backs up in the veins, increasing pressure and pushing fluid into surrounding tissues.
Liver Disease
Conditions such as cirrhosis can impair the liver’s ability to produce proteins like albumin, which help keep fluid in your bloodstream. When albumin levels are low, fluid leaks into surrounding tissues — a process that often causes leg swelling.
Worry Indicators: When Is Swelling Serious?
While leg swelling may seem like a minor inconvenience, certain symptoms can indicate a serious underlying issue. Be especially alert if you notice:
- Sudden swelling in one leg (could signal a blood clot)
- Pain, redness, or warmth in the swollen area
- Swelling accompanied by chest pain or difficulty breathing
- Skin changes, such as darkening or ulcers
- Swelling that doesn’t improve with rest or elevation
These signs should never be ignored. If you experience any of them, seek medical attention promptly to rule out serious complications.
Recognizing the Signs of Edema
Edema is the medical term for swelling caused by fluid trapped in your body’s tissues. In the legs, signs of edema may include:
- Puffiness or tightness in the skin
- Skin that retains a dimple (pitting) after pressing
- Heaviness or aching in the legs
- Reduced range of motion
- Stretched, shiny skin
If these signs persist, especially in both legs or from the knee down, it’s time to consider an evaluation to determine the underlying cause.
Treating Leg Swelling
The treatment options for leg swelling vary to some degree, depending on the underlying cause. These are some of the options we use to help our patients relieve symptoms and prevent more serious complications.
Lifestyle Changes
Leg swelling frequently responds to lifestyle changes, like elevating your legs while you’re resting, reducing the amount of sodium in your diet, and getting more exercise to help your legs drain naturally. If you’re very overweight, losing those extra pounds can help, too.
Compression
Wearing compression stockings or socks helps reduce leg swelling by promoting circulation and preventing fluid buildup. While over-the-counter compression socks are available, prescription socks allow the amount of pressure to be customized to your needs.
Medication
Depending on what’s causing your swelling, you might benefit from diuretics or other medicines to reduce fluid retention or aid in fluid drainage.
Treatment of Underlying Causes
If your leg swelling is associated with a disease, like heart failure, chronic venous insufficiency, or diabetes, optimizing your treatment for that disease may also play a role in your treatment.
Look Out for Ulcers
One more note: Leg swelling puts pressure on your skin and stretches it. The extra strain on the skin tissue can lead to skin sores or ulcers that don’t heal well.
The delay in healing leaves these sores open to serious infections. If you have slow-to-heal ulcers, we may recommend hyperbaric oxygen therapy to provide additional healing support.
Find Out Why Your Legs Are Swollen
While temporary leg swelling typically is nothing to be concerned about, if you have chronic, persistent, or recurring swelling, it could be a sign of a serious medical problem. Early treatment is important for preventing serious complications.
To learn what’s causing your leg swelling and how we can help, call us at 210-651-1112 or book an appointment online with us at Vayu Advanced Wound Clinic and Hyperbarics today.
FAQ: Understanding and Managing Swollen Legs
What causes swollen legs from the knee down?
Swelling from the knee down is often due to chronic venous insufficiency, lymphedema, or heart/kidney disease. Fluid collects in the lower legs when veins struggle to return blood to the heart.
Why are my legs swollen?
Your legs may swell due to fluid retention (edema), poor circulation, kidney issues, heart problems, or even certain medications. A medical evaluation is essential to determine the exact cause.
What causes swollen legs from the knee down in the elderly?
In older adults, swelling is commonly linked to venous disease, heart failure, or reduced mobility, which limits circulation and drainage of fluids.
Is swelling of the legs dangerous?
It can be. While mild swelling may be harmless, persistent or painful swelling can indicate serious conditions like blood clots, infections, or organ dysfunction. Always get evaluated if swelling is unexplained or severe.
How do you get rid of swollen legs?
Treating swollen legs depends on the cause but often includes leg elevation, compression socks, reducing salt intake, taking prescribed medications, and treating any underlying conditions.
What drink is good for swollen legs?
Water is best. Staying hydrated helps your body flush excess sodium and reduce water retention. Herbal teas with anti-inflammatory properties, like dandelion tea, may also be helpful.
What are red flags of leg swelling?
Red flags include:
- Swelling in only one leg
- Skin that’s warm, red, or tender
- Shortness of breath or chest pain
- Unexplained weight gain
- Sores that don’t heal
These may indicate serious medical conditions requiring immediate attention.
Will drinking water help swelling in legs?
Yes. Drinking plenty of water helps your kidneys function properly and can reduce fluid retention, particularly if high sodium levels are a factor in your swelling.