9 reasons you shouldn’t ignore swollen legs

Deep vein thrombosis and varicose of african woman. Girl touching her legs and looking at veins. Sclerotherapy procedure at visiting vascular surgeon doctor

When you put your feet up at the end of the day, you might notice that your legs and feet look puffy or swollen, with the skin stretched tighter than usual. You may even have indentations from your socks. Is this something to be concerned about?

“The swelling may not be serious, but it could be,” says Dr. Ian Hamilton, a medical director for BlueCross BlueShield of Tennessee. “If you develop swelling in your legs on a regular basis, or it lasts awhile, contact your healthcare provider so you can find out what’s causing the swelling and begin treatment if necessary.”

Reasons not to ignore the swelling

Dr. Hamilton: Swelling in the legs occurs because fluid collects in the tissues outside the blood vessels and lymphatic vessels, under the skin. A number of factors can cause this kind of swelling, also known as edema. Some are relatively benign, like prolonged standing or the last weeks of pregnancy.

However, your legs may be swollen as the result of a more serious medical condition.

The swelling could be the result of:

  1. Acute deep vein thrombosis (DVT), or a blood clot deep in a vein in the leg
  2. Venous insufficiency, where the veins in your legs are weakened and have trouble carrying blood back to your heart
  3. Congestive heart failure
  4. Liver cirrhosis
  5. Malnutrition
  6. Sepsis
  7. Severe allergic reaction
  8. Lymph node or lymphatic obstruction due to cancer
  9. Certain medications, such as calcium channel blockers, some seizure medications, certain chemotherapy drugs, and even non-steroidal anti-inflammatory drugs (NSAIDs)

If you ignore the swelling that’s suddenly developed in your legs, you could be ignoring a condition that needs prompt treatment.

How to handle swelling

Dr. Hamilton: If you know for sure that the underlying cause of the swelling is benign, you may be able to make a few lifestyle changes to address it.

  • Wear compression socks or hose
  • Elevate your legs
  • Exercise

Your doctor might also recommend trying a type of massage called manual lymphatic drainage. A physical therapist can perform this type of massage if your doctor decides you’re a good candidate for it.

Ultimately, the treatment will depend on the cause of the swelling. For example, if your doctor diagnoses you with deep vein thrombosis, or DVT, you may need to start taking a blood-thinning medication such as coumadin or heparin. It can take a while—even as long as a few months—for your body to eventually break down the clot. But the medications will allow blood to flow around the clot in the meantime.

Another example: lymphedema caused by a cancer in the pelvis. The recommended treatment will likely focus on removing or reducing the cancer that’s causing the swelling.

Meanwhile, if you have congestive heart failure and develop swelling in your legs and feet, your doctor may put you on a diuretic to help reduce your fluid levels by producing more urine. Your doctor may also recommend watching how much fluid you drink and how much sodium you eat.

When should you call your doctor?

Dr. Hamilton: The sudden onset of leg edema is concerning, and you should get it evaluated as soon as possible. Also, contact your doctor if you’ve developed leg or foot pain, skin discoloration, shortness of breath, or chest pain as well. Your doctor may want to evaluate you for deep vein thrombosis or pulmonary embolism. A pulmonary embolism is a blood clot that forms in another part of the body, breaks off and travels through blood vessels to a lung, where it blocks the flow of oxygen-rich blood.

“Occasional swelling could be just fluid buildup from long periods of standing, wearing tight stockings, being overweight or being inactive,” says Dr. Hamilton. “The important thing is to identify the reason for it. If there’s no obvious reason for the swelling, it’s best to see your health care provider.”

More from Dr. Hamilton on WellTuned.

Jennifer Larson

Jennifer Larson is Nashville-based writer and editor with nearly 20 years of experience. She specializes in health care and family issues.

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