Edema in the legs
Fluid in the leg means edema. The edema is usually harmless if it only occurs occasionally and resolves on its own. Regular swellings that are associated with pain must be clarified by a doctor. Suddenly occurring fluid accumulations, possibly combined with heat, redness and sensations, should be treated immediately by a doctor. If breathing-related pain, circulatory problems and shortness of breath occur, the emergency doctor must be called.
Edema in the legs - causes
Edema occurs when fluid leaks into the tissue. Normally, the vessels - both veins, arteries and lymphatic vessels - retain their fluid. This is guaranteed by certain pressure conditions. If the pressure conditions change, the vessels become permeable or proteins are missing, this can be responsible for the appearance of fluid in the legs or other parts of the body. Mechanical drainage obstructions, trauma (for example after operations), allergic reactions or infections can also lead to swelling.
But sitting or standing for a long time, especially in summer, on a long bus or flight, can also be the cause. The blood drops, fluid is secreted into the tissue and the result is swollen legs. However, these swellings usually disappear quickly.
The hormone estrogen binds water in the body. The opponent, progesterone, excretes fluid. If these two are not in balance or if estrogen gets the upper hand, fluid can accumulate in the legs, but also in the hands, stomach and face. This occurs especially in the menopause or in the days before the period. In pregnant women, there is also pressure in the abdominal cavity, which causes many expectant mums to get fat legs.
In the case of infections and injuries, the inflammatory mediators present, such as histamine or prostaglandin, increase the permeability of the smallest vessels, the so-called capillaries, which allows fluid to escape into the tissue, which causes swelling.
With heart failure, the heart no longer works properly. The pumping power is reduced, the blood builds up back in front of the heart, which increases the pressure on the veins, which in turn causes liquid to be squeezed out. Those affected have fat legs during the day. In the initial stage of the disease, the swellings go down at rest overnight. The water is excreted - those affected often have to go to the toilet at night. In advanced stages, however, the swelling persists.
Varicose veins, commonly known as varices, are venous disorders that occur frequently. Women suffer significantly more often than men because of pregnancy and weak connective tissue. Varicose veins are meandering and dilated veins that occur primarily in the legs. The veins dilate due to weakness in the vein wall and / or venous valve insufficiency (the venous valves no longer close properly). The disease is exacerbated by long sitting or standing.
Often the varicose veins have been without symptoms for a long time until the typical symptoms such as tension and heaviness and swelling appear. If left untreated, there is a risk of thrombophlebitis (inflammation of the superficial veins) or chronic venous insufficiency (= chronic drainage obstruction of the leg veins).
By changing the lifestyle, the progression can usually be minimized so that no invasive measures are necessary. Those affected should reduce existing excess weight. Alcohol and smoking are contraindicated. To counteract constipation, whole food, adequate hydration and exercise are important.
Thrombophlebitis (inflammation of superficial veins)
Thrombophlebitis is a medical condition that must be in the hands of a doctor. A blood clot forms in a superficial vein, usually due to existing varicose veins. This inflammation can also develop in healthy veins as a result of trauma or after an injection. Redness, pain and fluid in the leg are typical complaints.
With lymphedema, protein-rich fluid collects in the leg that is stagnant. The mechanism of formation is as follows: If the lymphatic drainage is blocked, the lymph builds up in front of the obstacle. This causes swelling. In the first stage, it is soft, compressible and usually disappears when the legs are raised. In the second stage, the leg tissue multiplies, which also hardens more and more. The tissue is no longer compressible and putting it up does not bring any relief. In the third stage, the volume increases sharply and the skin thickens more and more, which can result in massive edema. Lymphedema is caused by a congenital underdevelopment of the lymphatic vessels, inflammation, tumors, surgery and radiation.
The existing diseases can no longer be reversed, but the symptoms can be alleviated and the progression delayed or even stopped.
Leech therapy is used in some naturopathic practices. This is a gentle bloodletting that leads to decongestion and stimulates blood and lymph flow.
Enzyme therapy is another way to tackle edema. Enzymes, for example contained in pineapple and papaya, are prescribed in high doses. The required amount cannot be supplied through the diet, but must be done via suitable enzyme preparations.
The foot reflex zone therapy, which treats the whole body and can bring it into balance, also has its right to exist here. In lymphedema, reflex zones of the affected lymphatic areas on the feet are treated. However, caution is required with varicose veins. If these are pronounced, foot reflexology therapy should be avoided.
Schüssler salts such as No. 1 calcium fluoratum, No. 4 potassium chloratum, No. 8 sodium chloratum and the supplement No. 22 Calcium carbonicum help to reduce the fluid in the leg. Individual remedies from homeopathy are also prescribed, but must be individually tailored to those affected. Constitutional remedies such as Acidum fluoricum, Arnica, Calcium carbonicum, Lachesis, Graphites, Ledum, Apis and many more can be used here.
In phytotherapy, the following plants have an effect against the fluid accumulation in the legs. Stone clover, horse chestnut, butcher's broom and witch hazel. Ointments containing lymph-stimulating and anti-inflammatory substances such as coneflowers, club moss, pokeweed, marigold and / or celandine also help if they are applied regularly.
In traditional Chinese medicine, certain acupuncture points are regularly needled to combat the fluid in the leg.
In conventional medicine as well as in naturopathy, lymphatic drainage is the method of choice for lymphedema to reduce fluid retention in the leg. This is a special form of massage, in which gentle pressure is used to make the lymph drain. The affected area is then wrapped with special bandages and adapted compression stockings are worn until the next lymph drainage. The whole thing can be supported with suitable lymph ointments.
Hot applications are contraindicated in any case. Cold editions are recommended. Compresses impregnated with a comfrey and / or witch hazel solution provide relief, especially when there is fluid accumulation due to venous diseases. Lower leg castings and treading water also help here.
The diet should be high in fiber and contain little animal protein and sugar. Adequate hydration should be ensured. Frequent elevation of the legs is recommended, especially in the case of venous diseases and first degree lymphedema. Depending on the extent of the edema, it is advisable to wear compression stockings, but always under professional control. Regular, moderate exercise is important for both blood and lymph flow. Anyone who has to deal with fluid in the limbs again and again should have this clarified. Causes must be discovered and dealt with. (sw)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Susanne Waschke, Barbara Schindewolf-Lensch
- Ulrich Herpertz: Edema and Lymph Drainage: Diagnosis and Therapy of Edema Diseases; with 36 tables, Schattauer, 2010
- Gerd Herold: Internal Medicine 2019, Herold, 2018
- Kerstin Protz; Joachim Dissemond; Knut Kröger: compression therapy, Springer, 2016
- Wolfgang Gerok; Christoph Huber; Thomas Meinertz; Henning Zeidler: Internal Medicine: Reference work for the specialist, Schattauer, 2007
- Kerstin Protz; Jan Hinnerk Timm: Modern wound care: practical knowledge, standards and documentation, Elsevier Health Sciences, 2019