Why Are Your Legs Swelling? Causes, Risks, and What You Can Do About It.

I’ve been asked this question by my patients, my followers on social media, and many of you: 

“Why are my legs and feet swelling suddenly?” 

My answer will almost always be “See your doctor.” Because you may need to share your recent medical history and have some tests to diagnose exactly why you’re experiencing this.

Caused when tiny blood vessels (capillaries) leak fluid, swelling—known as edema in medicine—can affect several parts of the body, including the brain, lungs, lymph nodes, and eyes. But it’s most likely to show up in the legs and feet, so that’s the focus for today. 

Not only does this type of swelling, called peripheral edema, produce discomfort and, well, frustratingly puffy legs, ankles, and feet, but it can also be a sign of more serious problems. The extent and severity of edema depend upon the underlying cause or medical condition.

Edema can affect anyone, but the condition most often affects people who are pregnant and adults who are aged 65 and older. 

Here are the most common symptoms of edema:

• Swelling or puffiness of the tissue right under the skin
• Stretched or shiny skin
• Skin that holds a dimple, also known as pitting, after it’s been pressed for a few seconds
• A feeling of leg heaviness
• Difficulty walking if your legs, ankles, or feet are swollen

There are many potential causes and risk factors for edema, some of which can be prevented and others not; the most common include:

• Sedentary lifestyle. When you don’t move enough, your body retains fluid, which tends to collect in the extremities including the lower legs, ankles, and feet.
• Pregnancy. To maintain optimal health for the fetus and placenta, the body tends to retain more sodium and water than normal, which can cause swelling.
• The menopause transition. Yes, add edema to the potential havoc wreaked by fluctuating levels of estrogen and progesterone. The adrenal glands are crucial for maintaining the body’s water balance; during perimenopause and postmenopause, low levels of these hormones affect the adrenal glands and sodium levels, resulting in swelling.
• Nutritional issues. Excess sodium intake can increase the amount of fluid retained by the kidneys, increasing pressure in the capillaries and promoting fluid leakage. Many processed foods contain overwhelming amounts of it.
• Certain medications. High blood pressure meds and pain medications such as NSAIDS (nonsteroidal anti-inflammatory drugs) are common culprits.
• Injuries. Whether the injury is acute like a broken bone or chronic, such as repetitive stress or recurring pain from past physical trauma, it starts the same way: with pain, then swelling.
• Overweight/obesity. Carrying excess weight can lead to a condition called lipedema, a hallmark symptom of which is swelling.
• Dehydration. As I mentioned in last week’s newsletter, this happened to me; Korey recommended I drink more water. If you don’t consume enough H20, your body compensates by retaining the fluid it needs.

So, how do you treat edema—and can you prevent it?

First and foremost: If the swelling is severe, new, or persistent, seeing your doctor for a proper evaluation is important. They might prescribe a diuretic (sometimes called a “water pill”), which helps flush excess fluid from your body, or other drugs that will help treat the underlying cause of your edema. If you are in peri- or postmenopause, ask about whether hormone replacement therapy may help you. 

Finally, contact your doctor immediately if the swelling is accompanied by shortness of breath, irregular heartbeat, and/or chest pain.

That said, there are a few steps YOU can take to prevent fluid retention in your body:

• Put a pillow under your legs when you’re sitting or lying down, to keep them elevated above the level of your heart.
• Do not sit or stand for long periods without moving around.
• Wear support socks or stockings, which put pressure on the legs, ankles, and feet to keep fluids from accumulating. Edema shoes are available for people who experience chronic edema and need adjustable footwear to accommodate swelling.
• When traveling by car or plane: Make sure to take breaks to stand up and exercise your legs to prevent potential clotting in your legs.
• Reduce the amount of salt in your diet. That means reading packaged/processed food labels religiously.
• Get some exercise every day. Even if it’s a walk on a work break or after dinner, moving is an important antidote for edema. Exercise also helps alleviate stress, which—as with so many other health conditions—can amplify the effects of edema.
• Stay hydrated! Aim to drink 2.5 to 3 liters of water daily.

Try my prevention pick: I bought my mom and dad some leg compression devices from Normatec as a Hanukkah present. They can improve circulation, reduce edema, and are great for post-workout aches and pains or for people who are not very mobile—in other words, for older adults as well as fitness enthusiasts. Click the link below to learn more about these products.