One of the most common symptoms encountered in the lower extremity is swelling. In fact, everyone experiences swelling of the lower extremities at some time or another. There are many different reasons for swelling to occur. Some of these reasons are more benign and short lived. Other times, swelling can be a sign of a more serious condition.
What causes swelling?
Swelling of the feet may be due to many factors. These factors can be divided into conditions that cause inflammation (like trauma or infections) and conditions that cause fluid buildup (various systemic conditions).
Some causes of swelling are obvious, such as after a sprained ankle or if there is an infection present in a cut or sore on the affected leg or foot. Swelling in this situation is basically a non-specific response by the body. When there is an injury, infection or sudden change in the body the result is a process called inflammation. Inflammation is the body’s way to mobilize its resources to respond to and address an insult to the body. The visible manifestation of inflammation is swelling and is often accompanied by local warmth and redness. Swelling (inflammation) is a sign that the body is actively working to heal a problem.
Other causes of swelling may not be so obvious. Usually swelling that occurs for no apparent reason could be reason for concern, as it usually indicates a more systemic type of illness that is causing a buildup of fluid in the legs. A number of different systemic conditions that can result in long term swelling of the foot/leg include arthritis, tumors, varicose veins, poor circulation, blood clots, high blood pressure, heart problems, liver problems, kidney problems and diseases of the lymphatic system.
In addition, swelling can occur in the legs and feet that are not the result of a medical condition. This can be caused by:
- Pregnancy
- Prolonged sitting or standing
- Medications
When should swelling be evaluated?
Certain types of swelling should always be evaluated by a physician. This would include:
- Sudden, unexpected swelling.
- Calf swelling in one leg. This is a special concern as it can be caused by the formation of a clot in the deep veins called a deep vein thrombosis or DVT. Increased risk for DVT include smoking, immobilization, sedentary lifestyle and family history of a blood clot. A DVT is a potentially life threatening problem as the clot can dislodge and travel to the lungs.
- Swelling that does not go down overnight.
- Swelling in the legs accompanied by the following symptoms should be evaluated immediately:
- Chest pain
- Shortness of breath at rest or with minimal exertion
- Difficulty breathing when lying flat
- Coughing up frank blood or bloody phlegm
What can be done for swelling?
Swelling is a sign of an underlying problem within the body. Your physician will need to do a complete exam and take a thorough history to help determine the underlying condition causing the swelling. Additional testing may also be ordered to evaluate the cause of chronic swelling, including circulation tests or imaging studies. The best way to treat swelling is to treat the underlying condition. At the same time the chronic condition is being treated, the swelling associated with the condition is often treated with some form of compression therapy.
In conclusion, swelling is caused by a variety of conditions. Your physician can determine and treat the underlying cause while at the same time treating the swelling itself.
If you are bothered by unexplained or a sudden onset of swelling, please contact our office to make an appointment for a consultation at (812) 372-6274.
Dr. Ansgar Olsen, PhD, DPM
