Leg swelling is referred to as edema. It’s a common problem, and it represents more than half of new referrals to vascular medicine practices. Edema results from fluid buildup in the tissues, which can happen suddenly or develop slowly, lasting for months or even years. Most cases of edema occur due to harmless conditions; however, it may also be due to a more serious underlying health problem, so you should always seek medical attention.

At Comprehensive Vascular Care, with locations in Novi and Southfield, Michigan, our expert team of vascular surgeons is well versed in the problems that can underlie edema. We want to impress upon our patients the importance of not ignoring swollen legs, so we’ve put together this guide to help you understand what’s happening in your vascular system.

The causes of swollen legs

Swelling in your legs can occur from innocuous causes, such as sitting too long or wearing pants that fit too tightly. These activities force fluid down into your legs, which can’t move back up until after you’re standing or have removed the pants.

Leg swelling can also result from being overweight or obese, as the excess pounds exert pressure on your abdomen and legs. In addition, women can develop swollen legs due to hormone changes during pregnancy or while they’re undergoing hormone replacement therapy to ease menopause symptoms.

Other times, though, swelling can come from an underlying health condition, such as:

• Heart disease
• Heart inflammation (pericarditis)
• Cardiomyopathy
• Kidney disease or kidney failure
• Pulmonary hypertension

Problems with the heart can cause difficulty pushing blood all the way through the circulatory system, and it pools in the legs.

In addition, there are a number of vein-related issues, of varying severity, that can cause fluid buildup and leg swelling. These include:

Chronic venous insufficiency (CVI), aka venous hypertension

CVI may affect up to 40% of people in the US. All veins contain valves that work in one direction only. Once blood passes them by, they close, preventing backflow. If, however, the valves become damaged and can’t close completely, blood can flow back along its path and pool around the valve.

The excess blood creates high pressure in the veins, and this causes fluid to leak into the surrounding tissues. The result may be varicose veins, enlarged, twisted, blue or purple bulges, most commonly found on the ankles, calves, and thighs.

By themselves, varicose veins may be more of an eyesore than a medical problem, but CVI as a whole can lead to leg pain, a feeling of heaviness, swelling, or even ulcers that won’t heal. You should always get varicose veins (or the smaller spider veins) checked out.

Varicose veins can be treated with:

• Exercise
• Sclerotherapy, a liquid irritant that collapses the vein
• Laser ablation, which burns away the damaged vein
• Phlebectomy, removal of the vein through an incision

When necessary, the doctors at Comprehensive Vascular Care perform endovascular surgery to help improve blood flow.

Deep vein thrombosis (DVT)

DVT is a blood clot that forms in the large, deep veins of the thigh or calf, usually producing swelling in just one leg. Swelling develops over a period of hours to days, and it’s accompanied by pain and redness in the leg. DVT may be caused by a combination of pooling blood, an injury to the veins, and conditions, such as sitting for extended periods, that can lead to clotting.

The problem with DVT is that the clot can break off and travel to the lungs, causing a pulmonary embolism, a life-threatening condition. It can also travel to the heart, causing a heart attack, or the brain, causing an aneurysm or stroke.

DVT can be treated with:

• Blood thinners
• Clot-busting medication
• Compression stockings

Your doctor may also choose to put a filter in your vena cava, the large vein in your abdomen. This prevents the clot from traveling to the lungs.

Phlebitis and thrombophlebitis

Phlebitis is an inflammation of a vein, and thrombophlebitis is when one or more blood clots in a vein cause inflammation. The clot can cause pain and irritation, and it may block blood flow through the veins, which leads to swelling. Phlebitis can occur in surface veins (superficial) or in deep veins.

Deep vein thrombophlebitis requires immediate medical attention, so if your legs are swollen, you need to see your vein care specialist to ensure you get the proper care before your condition becomes more serious, as with DVT.

These conditions are usually treated with compression stockings and anti-inflammatory medications, and with antibiotics if you show signs of an infection.

Are your legs swollen and uncomfortable? Don’t ignore the symptoms — you may have a clotting problem that needs medical attention. Contact Comprehensive Vascular Care by calling us at either of our locations or schedule an appointment online today.