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