Swelling (Edema)

Swelling, medically called edema, is the accumulation of fluid in body tissues, causing them to become larger than normal. Swelling can occur in any part of the body but is most noticeable in the hands, arms, feet, ankles, and legs. It can also occur in the face, abdomen, or other areas.

Swelling can have many causes, ranging from minor issues like standing too long to serious medical conditions like heart failure or kidney disease. Understanding when swelling is a concern and when to seek medical attention is important.

Swelling can present in different ways:

Common Characteristics:

• Puffiness: Affected area looks larger
• Skin stretching: Skin may appear tight or shiny
• Pitting: When pressed, leaves an indentation
• Discomfort: May feel heavy or achy
• Reduced flexibility: Difficulty moving affected area
• Weight gain: If widespread

Common Locations:

• Legs and ankles: Most common
• Feet
• Hands and arms
• Face: Especially around eyes
• Abdomen: May indicate fluid in abdomen
• Other areas: Can occur anywhere

Associated Symptoms (may accompany swelling):

• Shortness of breath (if related to heart/lung)
• Fatigue
• Weight gain
• Reduced urination
• Pain or tenderness
• Skin changes

Call Emergency Services (112 in Sweden) if:

• Swelling with severe shortness of breath
• Swelling with chest pain
• Sudden, severe swelling
• Swelling after injury with severe pain
• Swelling with difficulty breathing
• Swelling of face, lips, or throat (allergic reaction)

For mild swelling:

1. Elevate Affected Area:

   • Raise legs above heart level
   • Use pillows to prop up
   • Helps fluid drain
   • Do several times daily

2. Compression:

   • Compression stockings or sleeves
   • Helps prevent fluid buildup
   • Especially for legs
   • Get proper fit

3. Movement:

   • Gentle movement helps circulation
   • Don't sit or stand too long
   • Walk around regularly
   • Exercise as approved

4. Reduce Sodium:

   • Limit salt intake
   • Read food labels
   • Avoid processed foods
   • Helps reduce fluid retention

5. Stay Hydrated (unless fluid restricted):

   • Drink adequate water
   • Helps flush excess fluid
   • Unless doctor says to limit fluids

6. Massage:

   • Gentle massage toward heart
   • Helps move fluid
   • Don't massage if painful or red

7. Avoid Heat:

   • Heat can worsen swelling
   • Use cool compresses if helpful
   • Avoid hot baths/showers

• Swelling with severe shortness of breath
• Swelling with chest pain
• Sudden, severe swelling
• Swelling of face, lips, or throat
• Swelling with difficulty breathing

• Persistent or worsening swelling
• Swelling not improving with self-care
• Swelling with other symptoms (shortness of breath, fatigue)
• Unexplained swelling
• Swelling affecting daily activities
• Questions about swelling

• Mild, occasional swelling
• Known cause (standing long, minor injury)
• Responds to elevation and rest
• No other concerning symptoms

Evaluating swelling may involve:

1. Medical History and Physical Exam:

   • Description of swelling
   • When it started
   • What makes it better/worse
   • Physical examination
   • Check for pitting

2. Blood Tests:

   • Kidney function
   • Liver function
   • Heart function markers
   • Complete blood count
   • Other tests as needed

3. Urine Tests:

   • Check kidney function
   • Look for protein
   • Other tests

4. Imaging Tests (if needed):

   • X-rays
   • Ultrasound
   • CT or MRI
   • Echocardiogram (if heart-related)

5. Other Tests (if indicated):

   • Heart function tests
   • Other specialized tests

Treatment depends on the cause:

If Due to Injury:

• RICE (rest, ice, compression, elevation)
• Pain medications
• Usually resolves

If Due to Medical Condition:

• Treat underlying condition
• Medications (diuretics if appropriate)
• Lifestyle modifications
• Regular monitoring

General Approaches:

• Elevation
• Compression
• Reduce sodium
• Medications if needed
• Treat underlying cause
• Lifestyle modifications

Prevent swelling by:

• Move Regularly: Don't sit or stand too long
• Elevate Legs: When sitting or lying down
• Limit Sodium: Reduces fluid retention
• Maintain Healthy Weight: Excess weight can contribute
• Exercise Regularly: Promotes circulation
• Wear Compression Stockings: If prone to leg swelling
• Manage Medical Conditions: Control heart, kidney, liver conditions
• Avoid Tight Clothing: Can restrict circulation

Swelling occurs when:

1. Fluid Leaks: From blood vessels into tissues
2. Fluid Accumulates: In tissues
3. Tissues Swell: Become larger
4. Symptoms Develop: Puffiness, discomfort

Causes:

• Gravity: Standing/sitting long periods
• Injury: Trauma causes inflammation
• Heart problems: Heart can't pump effectively
• Kidney problems: Kidneys can't remove fluid
• Liver problems: Affects fluid balance
• Medications: Some cause fluid retention
• Pregnancy: Normal but can be excessive
• Allergic reactions: Can cause swelling
• Infections: Can cause localized swelling
• Other medical conditions: Various causes

• More common with age
• May have multiple causes
• Often related to medical conditions
• May need different approach

• Some swelling is normal
• Usually in legs and feet
• Should be monitored
• May indicate problems if severe

• Heart disease
• Kidney disease
• Liver disease
• May need specialized treatment
• Regular monitoring important

Seek medical care if swelling is persistent, worsening, accompanied by other symptoms (shortness of breath, chest pain), or affects your daily activities. Also seek care if it's sudden and severe.

Yes. Reducing sodium intake can help reduce fluid retention. Staying hydrated (unless fluid restricted) and eating a balanced diet can also help.

It depends on the cause. If due to a medical condition like heart failure, medications (diuretics) may be needed. For minor causes, lifestyle changes may be sufficient.

No. Swelling can be minor (like from standing too long) or serious (like from heart failure). The severity, location, and associated symptoms help determine the cause.

Yes. Regular exercise promotes circulation and can help prevent swelling, especially in the legs. However, avoid exercise if swelling is due to an injury or if your doctor advises against it.