Understanding Leg Swelling: Causes, Symptoms and When to Seek Help

Leg swelling is a common concern that can range from a mild, temporary inconvenience to a sign of a more serious health issue. While occasional swelling often resolves on its own, persistent or severe swelling may signal an underlying medical condition that requires attention.

What Causes Leg Swelling?

Dr. Michael Brown, a board-certified vascular surgeon of Vascular Surgical Associates – Southwest General Medical Group, Inc., explains that leg swelling, also known as edema, occurs when fluid builds up in the tissues of the leg. This fluid accumulation can happen for several reasons, including lifestyle habits, medical conditions and even genetic predisposition.

Here are some of the most common causes of leg swelling:

• Lifestyle factors: Prolonged sitting or standing, especially at jobs that require you to be on your feet for extended periods, can lead to leg swelling. Gravity causes fluid to collect in the lower extremities, particularly when movement is limited. Desk jobs, factory work and nursing are a few examples of professions where leg swelling is common.
   
• Diet and weight: Carrying excess weight in the abdominal area can put pressure on the veins, leading to swelling in the legs. A diet high in salt also can contribute to fluid retention, further worsening the issue.
   
• Medical conditions: Certain medical conditions, such as heart disease, kidney disease and nerve issues stemming from the back, can result in leg swelling. Vein-related problems such as venous insufficiency—when the valves in the veins do not close properly—also can cause fluid to pool in the lower extremities.
   
• Genetics: Family history plays a role as well. If close family members have experienced varicose veins or other vascular issues, you may be more likely to develop similar conditions.

When to Be Concerned About Leg Swelling

Not all leg swelling requires a visit to a doctor. However, there are certain signs and symptoms that should prompt medical attention. According to Dr. Brown, you should consult your healthcare provider if:

• The swelling goes above the ankle and occurs daily
• The swelling is sudden and accompanied by pain
• Only one leg is swollen, especially if the swelling is persistent
• The swelling is severe or accompanied by other symptoms such as redness or warmth, which could indicate an infection or blood clot

If any of these symptoms are present, it’s important to see your primary care physician, who may refer you to a specialist, if needed. Dr. Brown emphasizes that "… if leg swelling occurs abruptly, one day you wake up with significant swelling associated with pain, then that is something that you have to be evaluated for immediately."

How Is Leg Swelling Diagnosed?

Diagnosing the cause of leg swelling often begins with a physical examination and a review of your medical history. For a more detailed look, doctors may use an ultrasound to visualize the veins in the leg. This painless test checks for potential issues with vein valves, which are responsible for ensuring blood flows in the right direction.

Dr. Brown explains that the ultrasound assesses the efficiency of the vein valves. When the valves don’t “snap shut” properly, it’s known as venous insufficiency. Further testing may be required if an issue is detected, particularly if only one leg is affected. In some cases, an advanced ultrasound catheter may be used to look for narrowing or blockages in the veins of the pelvis, which could be the root cause of the swelling.

Treatment Options for Leg Swelling

Once the cause of the swelling is identified, treatment can be tailored to the individual’s specific needs. Dr. Brown highlights several potential treatment options, including:

• Lifestyle changes: Small adjustments, such as taking regular walks and reducing salt intake, can significantly reduce swelling related to sedentary habits.
• Compression therapy: Compression stockings often promote better blood flow and reduce leg swelling.
• Medical procedures: If venous insufficiency is identified, treatments may include vein ablation, where the affected vein is closed off, or vein removal surgery. In some cases, if a blockage or narrowing is found in the pelvic veins, a stent may be placed to restore proper blood flow.

Prevention Tips for Leg Swelling

While some causes of leg swelling can’t be avoided, there are steps you can take to reduce your risk:

• Move often: If you work at a desk, make it a habit to stand up, stretch and walk around every hour.
• Maintain a healthy weight: Reducing abdominal weight can ease pressure on your veins, which in turn helps prevent swelling.
• Stay hydrated and reduce salt intake: Drinking water and limiting salty foods can help balance fluid levels in the body.
• Wear compression socks: Compression socks can improve circulation and prevent fluid buildup for those who stand or sit for long periods.

When Should You See a Specialist?

If your swelling persists despite lifestyle changes, or if you experience severe or sudden swelling, it’s best to seek medical attention. One-sided swelling, especially in the left leg, could indicate an underlying vein condition. As Dr. Brown explains, advances in ultrasound technology now allow specialists to identify previously undetected issues. One of them is iliac vein disease, a condition where veins in the pelvis are narrowed or blocked. This condition is treatable with a stent, which can provide significant symptom relief.

Southwest General’s vascular specialists, including Dr. Michael Brown, are equipped with the latest diagnostic tools and treatment options to help address the root causes of leg swelling. Don't ignore the signs—early intervention can improve your health and quality of life. To request an appointment, call 440-816-6027.