Dr. Sanjay Deb

Swelling or edema of the legs and hands is a very common condition and can be due to various types and reasons. The medical term is peripheral edema, the arms and legs being the peripheries. It is often due to fluid retention and in some cases, could also be due to blockage of fluid movement or excessive fluid in the body.

It can also be sudden or gradual – swelling that happens suddenly is usually due to prolonged standing or walking which leads to poor venous return. Gradual swelling is more a cause for concern and implies underlying disease.

At a cellular level, there is leakage of fluid into the surrounding tissue, which causes puffiness. In order for the kidneys to maintain fluid balance, they accumulate more fluid, which gets into a vicious cycle with both intracellular and extracellular fluid accumulation.

There are many causes for edema, but the following could be specific to vascular issues.

1. Prolonged sitting or standing: When there is long periods of inactivity due to sitting with feet down or standing, there is fluid accumulation in the feet. Over a period of time, it could also affect the valve function and worsen the condition, causing it to be a chronic issue. Let's take a look at some of the common causes:
2. Pregnancy: The hormones lead to overall body fluid retention, and so feet swelling is very common with pregnancy. The good news is that it subsides soon after delivery.
3. Blood clots in the legs can affect blood flow, leading to swelling
4. Heart failure
5. Varicose veins, where there is a vascular issue leading to swelling
6. Liver cirrhosis, which causes ascites and feet swelling as the main symptoms
7. Lymphedema: Any improper lymph circulation also leads to hand and feet swelling
8. Any tumor or infection along the path of circulation can lead to fluid accumulation, due to impaired blood/lymphatic flow.

Symptoms:

1. Skin gets stretched, shiny, and loses hair
2. There could be dimpling, where if the skin is pressed for about 10 seconds and released, it could take time to return to normal
3. Stiffness of the surrounding joints
4. Weight gain
5. Fullness of nearby veins
6. Increased blood pressure

Treatment: This would depend on the cause of the edema.

• In transient cases, lifting the legs up often helps in release of the edema.
• Underlying liver or heart conditions need to be treated to relieve the edema. Diuretics, which promote expelling of fluid from the body, are often used to reduce edema.
• The infection or tumor or growth along the path of the blood vessels tree needs to be treated either with medications or surgery.
• In cases where there are vascular issues, surgery may be required. 

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Always make sure that you use the therapeutic hot agents when the injury is in the chronic stage. They can also be used prior to physiotherapy or exercise to decrease muscle tension and increase flexibility.