Swollen Legs & Painful Feet

Inflammation, Joint disorders | February 18, 2018 | Author: Naturopath

kidney, cardiovascular

Swollen Legs & Painful Feet

Ever seen your ankles puff up like balloons? Fluid can accumulate beneath the skin, causing swelling and discomfort in the legs, ankles and feet. When this happens after no injury has occurred, it may be a condition is called “oedema”. Oedema frequently affects older people and pregnant women, but it can happen to anyone and may be a symptom of an underlying health problem.

Oedema is characterised by swelling in the limbs (usually legs and feet), with shiny skin that looks “stretched” over the swollen areas. It's important to see a doctor to confirm the diagnosis and rule out any associated conditions that require treatment.

In The Pits? 

There are two major categories of oedema: pitting and non-pitting. They have different causes and need to be treated entirely differently.

Pitting Oedema

The most common type of oedema is pitting oedema, caused by fluid accumulation in the cutaneous area of the skin. To confirm that you have pitting oedema, look for an indentation after you press your finger against the swollen tissue for 15 seconds. If the flesh doesn't “bounce back” immediately, you may have pitting oedema. This type of oedema responds well to anything that helps move fluid out of the body, such as diuretics, movement, and a low sodium diet.

Non-Pitting Oedema

If there is no indentation after you have pressed your finger against the swollen tissue, you may have non-pitting oedema. This is sometimes a symptom of damage to the lymph system and may respond to remedies that move lymphatic fluid, or it may be due to a serious infection. Speak to your doctor as soon as possible if you think you may have non-pitting oedema.

Causes of Swollen Legs

Pitting oedema of the legs, ankles and feet occurs when fluid escapes from the capillaries and is pushed into the surrounding tissue. It struggles to flow back into the circulation so it  “pools” in the interstitial spaces in tissue and causes swelling. Oedema occurs when there is high pressure within the capillaries and the walls of the vessels are weakened:

High Capillary Pressure

Pressure within blood capillaries may be high due to many reasons:

  • Gravity. Circulation relies on the heart and the skeletal muscles to pump fluids throughout the body, so remaining still for long periods of time causes circulatory stagnation. Standing or sitting for too long, especially in hot weather, allows gravity to pull fluid downwards into the legs, increasing pressure within the capillaries.
  • Lung disease can increase the pressure in the blood vessels between the heart and lungs. This then puts pressure on the heart and entire circulatory system, and causes extra pressure in the legs where circulation most struggles to fight against gravity.
  • Pregnancy or obesity can cause a physical compression of a major blood vessel called the “vena cava”, also leading to pressure in the heart and throughout the circulation [5].
  • Kidneys can struggle to maintain an ideal volume of plasma in the blood, adding to capillary pressure. This is often caused by too much sodium in the body and not enough water.
  • Congestive heart failure can cause fluid buildup in the lungs and other parts of the body as the heart is unable to adequately pump circulation. The feet and legs are often the first places to experience visible changes.

The pressure can cause damage to the vessels, or the capillaries may be damaged for other reasons:

Vessel Damage

  • The walls of the capillary blood vessels become weakened and permeable from extended pressure, or from damage by toxins such as cigarette smoking.
    This permeability allows fluid to flow, unregulated, into the surrounding tissue.
  • The tiny valves inside the veins of the legs can become weakened and are unable to pump blood back up to the heart, leading to a back-up of fluid in the lower limbs, adding to the high capillary pressure.
  • Smoking is the major cause of vessel damage.

Medications, hormonal changes and surgeries can contribute to oedema of the legs and feet.

​CAUTIONCAUTION

Oedema can be a sign of serious illness. Speak to your doctor as soon as possible.

Seek medical attention IMMEDIATELY if you experience:

  • Fever
  • Shortness of breath
  • Low/no urine output
  • Heat or redness in affected limb
  • Intense pain
  • Sudden increase in swelling
  • Chest pain
  • Swelling in abdomen
  • Swelling in just one leg [1]

Speak to your doctor if you are pregnant as oedema may be caused by a serious condition called preeclampsia.

NOTE: Deep vein thrombosis is a dangerous condition that can lead to embolism and stroke, and is often brought on by long periods of standing or sitting, such as taking a long-haul flight. It usually presents with oedema in just one leg, accompanied with pain. Seek medical attention immediately if you have oedema in one leg.

Natural Therapies for Swollen Legs & Painful Feet

Use Gravity

Water always flows downhill – so prop your feet up and allow gravity to do the work.

Resting with your legs elevated above the body allows the accumulated body fluids to circulate out of the interstitial spaces and towards the eliminatory channels.

Spend at least 10 – 20 minutes with your feet and legs above the level of your heart to move fluid out of your swollen limbs [2].

When you're not resting, move around as much as possible. Keep your heart rate up and avoid standing or even sitting for extended periods of time. The more the heart pumps, the more blood and lymph will move through the limbs and carry the excess liquid out of the tissue and back into the circulation to be excreted [3].

Essential Oils

Applying essential oils topically to your swollen feet, legs and ankles can promote circulation to (and away from) the area, reducing swelling and alleviate soreness. Mix 2 – 3 drops of one or more of these essential oils with a carrier oil (e.g. sweet almond oil or jojoba oil) and massage into the swollen tissue to move fluids and reduce inflammation [8] [9] [10] [11]:

  • Grapefruit
  • Geranium
  • Fennel
  • Juniper
  • Rosemary
  • Lavender

NOTE: Speak to a qualified aromatherapist before using essential oils during pregnancy.

Bilberry

Bilberry is one of the richest sources of anthocyanins – potent antioxidants that have been shown to strengthen blood vessels and prevent capillary permeability [7]. Eating bilberries every day (if you can find 'em!) or regularly taking a concentrated dose of a bilberry supplement may help to reduce severity and frequency of swollen legs. Studies have confirmed that it is safe to take during pregnancy [12].

Rebalance Your Electrolytes

The blood requires a balance of electrolyte minerals in order to keep water in circulation and out of the interstitial spaces where it causes oedema. Eating a low sodium diet could help to reduce how often you experience peripheral oedema, and staying hydrated helps to excrete excess salt out of the body and keeps the circulation moving.

Rebalance Your ElectrolytesHerbal or food-derived diuretics can help to move any extra salt out of the body, too. These herbs can be consumed as a food, as a tea, or in concentrated supplement forms to reduce sodium and improve oedema:

  • Parsley
  • Celery and celery leaf
  • Dandelion herb
  • Hawthorn
  • Juniper [13]

Speak to a qualified naturopath or herbalist for personalised advice on the most appropriate herbal treatments for your condition.

Traumeel

Traumeel is a topical ointment made of diluted minerals and herbs that is indicated for all kinds of swelling, inflammation and musculoskeletal pain. Studies have shown that it is effective against oedema and can speed up healing processes, and can exert a pain relieving effect as powerfully as over-the-counter pain killers [14].

Wear Compression Socks or Stockings

Compressing the tissue of the legs, feet and ankles creates resistance against fluid that might otherwise pool out of the circulation and into the interstitial spaces, causing oedema.

SWear Compression Socks or Stockingstudies have shown that people with a  history of oedema or who are at risk of developing oedema can reduce the severity of swelling by up to 70% by wearing compression socks or stockings, particularly when sedentary [3].

Sure, they're not fashionable but they could save you from some discomfort.

 

Prevention is Better Than a Cure

If you're at risk of oedema or have a history of swollen feet and legs, wear compression stockings during long periods of inactivity and especially on long-haul flights of 7 hours or more. Get up at least once every hour, and exercise your feet and legs while sitting. This will help to “pump” fluid back up towards the heart [4].

Smoking is a major cause of blood vessel damage and congestive heart failure. Speak to a qualified naturopath and your doctor for advice on how to make it easier to quit cigarettes.

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References

[1] Higginson, L. A. J. (2016) Edema. Merck Manual Online Database. http://www.msdmanuals.com/en-au/professional/cardiovascular-disorders/symptoms-of-cardiovascular-disorders/edema

[2] Ely, J. W., et al. (2006) Approach to leg edema of unclear etiology. J Am Board Fam Med., 19:2, 148 – 160. https://www.ncbi.nlm.nih.gov/pubmed/16513903

[3] Carvalho, C. A., et al. (2015) Reduction of Pain and Edema of the Legs by Walking Wearing Elastic Stockings. Int J Vasc Med. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561105/

[4]  O'Brien, J. G. & Chennubholta, S. A. (2005) Treatment of Edema. American Family Physician., 71:11, 2111 – 2117. https://www.aafp.org/afp/2005/0601/p2111.html

[5] Linius, Y., et al. (2016) Vena cava compression syndrome in patients with obesity presenting with edema and thrombosis. Obesity, 24:8, 1648 – 1652. https://www.ncbi.nlm.nih.gov/pubmed/27312050

[6] Trayes, K. P. & Studdiford, J. S. (2013) Edema: Diagnosis and Management. American Family Physician, 88:2, 102 – 110. https://www.aafp.org/afp/2013/0715/p102.html

[7] Chu, W., et al. (2011) Bilberry (Vaccinium myrtillus L.). Herbal Medicine: Biomolecular and Clinical Aspects, (2nd Ed.) https://www.ncbi.nlm.nih.gov/books/NBK92770/

[8] Tumen, I., et al. (2012) A Therapeutic Approach for Wound Healing by Using Essential Oils of Cupressus and Juniperus Species Growing in Turkey. Evid Based Complementary Alternative Med. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175711/

[9] Maruyama, N., et al. (2005) Suppression of neutrophil accumulation in mice by cutaneous application of geranium essential oil. J Inflamm., 2:1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1074347/

[10] Silva, G. L., et al. (2015) Antioxidant, analgesic and anti-inflammatory effects of lavender essential oil. An Acad Bras Cienc., 87:2, 1307 – 1408. https://www.ncbi.nlm.nih.gov/pubmed/26247152

[11] Minaiyan, M., et al. (2011) Effects of extract and essential oil of Rosmarinus officinalis L. on TNBS-induced colitis in rats. Res Pharm Sci., 6:1, 13 – 21. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3203268/

[12] Ulbricht, C., et al. (2009) An evidence-based systematic review of bilberry (Vaccinium myrtillus) by the Natural Standard Research Collaboration. J Diet Suppl., 6:2, 162 – 200. https://www.ncbi.nlm.nih.gov/pubmed/22435415

[13] Tabassum, N. & Ahmad, F. (2011) Role of natural herbs in the treatment of hypertension. Pharmacogn Rev., 5:9, 30 – 40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210006/

[14] Schneider, C. (2011) Traumeel – an emerging option to nonsteroidal anti-inflammatory drugs in the management of acute musculoskeletal injuries. Int J Gen Med., 4, 225 – 234. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085232/

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