Leg Swelling (Edema) in the Elderly: Causes and Treatment

Updated on October 17, 2017
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Pandula is a medical doctor by profession and is also a health informatics expert with a PhD from the University of Oslo, Norway.

Leg swelling, or edema, is a common manifestation among the elderly, and in most instances, such swellings are harmless. However, in certain instances, the leg swelling may be an early sign of a more sinister underlying medical problem requiring investigation and intervention. Therefore, it is important for both the patient as well as the caregivers to recognize leg swelling, obtain necessary medical advice, practice reduction methods for swelling, and identify instances where urgent medical advice should be sought.

What causes leg swelling among the elderly?

With the aging process, the circulatory power, or the ability of the circulation to forcefully deliver blood to the peripheral tissues and back towards the heart, diminishes. As a result, more fluid accumulates in the peripheral tissues, giving rise to leakages of accumulated fluid into the surrounding tissues. Usually such accumulations are seen at the most dependent site, and the ankles and feet are the most vulnerable sites in humans. Apart from these sites, fluid can also accumulate at the knees and even within the hips, depending on the cause and the nature of the fluid leak.

Apart from the normal age-related circulatory dysfunctions, dysfunctional organs in the body can also give rise to leg swelling. For instance, when the heart is unable to pump adequately, it may result in the accumulation of fluids in the lower extremities, while a failure of the kidneys will give rise to more fluid buildup within the body as its excretion ability could be greatly diminished.

At the same time, local causes can also give rise to swelling of the legs and these include formation of blood clots in the legs as in the case of deep vein thrombosis, infections such as cellulitis, and inflammatory conditions such as arthritis. Traumatic injuries to the feet and the legs can also give rise to swelling of the legs and fractures could be one such instance which particularly affect the elderly population due to their increased susceptibility to falls and bone breakage.

How to treat leg swelling?

At first, elevating the leg to a higher position than the heart while laying down should settle the edema or the swelling. Keeping a pillow or two under the ankle should be enough in this regard. Wearing compression stockings or tubes should also be useful as it can exert a sustained pressure over the blood vessels and therefore prevents the accumulation of fluids in the lower extremities.

In some instances, the doctors may prescribe a medicine to expel excess fluids from the body via urine and these are called diuretics. While mild diuretics may be given in most instances, strong diuretics may be used when the doctors think there is a possibility of easing the pressure on the heart and the kidneys through the use of such medicines.

Anti-inflammatory medications can also help reduce the edema to a certain extent, although there actions are mostly indirect. In case there is a suspicion of blood clot formation, the doctors will carry out further investigations and may prescribe the use of blood thinners to prevent further clot formation. Similarly, in the event of an infection, antibiotics may be necessary along with painkillers as such swellings are usually associated with pain.

Dietary restriction of salt containing foods or added salt is another method of reducing the accumulation of fluid and in some instances, where the kidneys are not able to excrete beyond a certain volume, patients may have to restrict themselves to limited amount of fluid intake.

Lastly, exercises and certain massaging techniques may also be necessary to alleviate a leg swelling. This must be undertaken only after consulting a medical practitioner, as certain exercises may actually make matters worse.

What are the danger signs of leg swelling?

When a leg swelling is associated with shortness of breath, chest pain, distended abdomen, yellowish discoloration of the skin, poor urine output, fever, reddening of the skin over the legs, pain over the swelling, movement difficulties in the joints, etc., one should seek the advice of a medical practitioner before engaging in any other management strategy.

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      sandy h 2 weeks ago

      I have fibromyalgia. Pain is normal to an extent. But I now have swollen thighs, edema calfs, hips,knees, and top of right foot and hips and bottom ache like a bad toothache. Top of foot was an odd pain. Went away after about 5 days. I look like I'm going to give birth at anytime most of the time. Sometime my stomach sags down with the swelling. I stay thirsty. I crave ice. I eat ice like a kid would candy. My iron is fine, I'm not diabetic, not anemic, . I'm 58 in march, female. Depression, anxiety, fibromyalgia, COPD, stopped smoking about 4-5 yrs ago, sciatica, may drink 6-8 drinks a year if any. Psoriasis on scalp. Help??!! Thanks

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      Dr Pandula 4 weeks ago from Norway

      Dear Lucy, there can be many reasons for the ankle swelling. In elderly people, it is worth excluding the most serious of causes such as heart failure, kidney failure or even liver problems. Supporting the legs while seated and use of compression stockings might help reduce the swelling. However, need to get rid of excess fluid and this needs investigations. Hope this helps. Pandula

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      Lucy 4 weeks ago

      My mother 84 years old feet are swollen very bad and now they are bruised on one side ,what does that mean

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      Pandula 7 weeks ago

      Dear Maggie,

      Hard to tell from the description an exact cause. Most often it may be multi-factorial given that you have pain in both legs. Did you gain weight recently? or did you change your lifestyle?

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      Maggie 7 weeks ago

      both feet, ankles and legs hurt a lot very day. started t two months ago .

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      Dana 2 months ago

      Above heel on right foot, painful and aches really bad. Don't wear heels. What causes this pain?

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      Murali 2 months ago

      My father is suffering from Swelling and pain in the knees and foot. 65 year old man. May I know the remedies or useful checkups.

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      Murali 2 months ago

      Thank you so much for the information....

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      dr.arshad_shifaclinic@yahoo.com 4 months ago

      Good knowledgeable article

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      Thanks taking the time to share your valuable info! 4 months ago

      Thanks for taking the time and effort to share your valuable info! Laughed at the comment posted about sitting at the computer adding to the problem!

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      Dhansingh Pardeshi 6 months ago

      This article is very informative and cleared all the doubts I had regarding edema of the legs in elderly.

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      Nkosana Moyo 2 years ago

      What could be the cause of swelling of thighs and a left hand in an 82 year old male who has shown signs of high blood pressure before? What tests need to be done to determine the likely cause of this condition?

    • Perspycacious profile image

      Demas W Jasper 2 years ago from Today's America and The World Beyond

      And, don't wait until you have all of those symptoms to get expert professional help!

      On your My Account page (upper right) start adding "About The Author" information to your Hubs. It will serve you well.

      Are you still in Norway and now practicing medicine?

    • S Jayaseeli profile image

      Lourdes Jayaseeli 2 years ago

      It was very useful! Thanks a lot! Wasn't lengthy like I dreaded.

    • jellygator profile image

      jellygator 4 years ago from USA

      Very nice job! Had problems with this for several years, and it started before I was 40. Your article does a good job of describing treatments in an easy-to-understand way.

    • pandula77 profile image
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      Dr Pandula 4 years ago from Norway

      Very true WriterFox! Inactivity for a prolonged period does make the fluid to accumulate in the feet. Thanks for your comments!

    • Writer Fox profile image

      Writer Fox 4 years ago from the wadi near the little river

      This sounds like a difficult condition to treat. Leg swelling can happen in people who spend too much time in front of their computers, too.

    • pandula77 profile image
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      Dr Pandula 5 years ago from Norway

      I also agree. But, specially when you travel long-distances in a cramped up economy cabin, that may be the only way of travelling :) However, frequent exercises should be use to avoid getting leg swelling.

    • pandula77 profile image
      Author

      Dr Pandula 5 years ago from Norway

      That could be true because certain class of anti-hypertensives known as 'calcium channel blockers' can cause a mild leg swelling. However, it should settle in most patients with continued use. Thanks for pointing out.

    • Rain Defence profile image

      Rain Defence 5 years ago from UK

      A useful tip is to never sit with crossed ankles. I don't get any lower leg issues now I stick to this although it's a hard habit to break.

    • rjsadowski profile image

      rjsadowski 5 years ago

      A useful hub. I have some minor swellimg in my legs which my doctor be;ieves is related to a blood pressure medicine that I take which reduces blood pressure by causing your veins to expand.

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