Capitol Vein Blog

Thursday, March 24, 2011

What Can Cause Leg Swelling?



We have a fair number of patients who see us because of leg swelling, which is thought to be due to venous disease. The direction of blood flow in leg veins should normally go from the lower leg to the upper, against the push of gravity. We know that weakness in the veins can lead to reversal of flow in the veins and subsequent leg swelling due to excess pressure. Ultrasound is the perfect diagnostic tool, and when backflow occurs, treatment of the veins with VNUS Closure is an excellent option.
However, not all leg swelling is venous in origin. A diagnostic ultrasound is the key tool to exclude a vein cause. One common condition that can cause leg swelling unrelated to venous disease is lymphedema. Either one or both legs may be affected.

Lymphedema is due to a backup of lymph fluid in the lower legs and may be due to prior leg injury, infection or surgery. When there is no predisposing cause, it is known as primary lymphedema, usually an inherited problem. Lymph is a normal body fluid that is transported in fine little channels, usually running parallel to the vein. Like venous blood, lymph normally ascends the leg against the push of gravity. If the tiny lymph channels are deficient or inadequate to transport the volume of lymph fluid, then swelling may occur, leading to lymphedema.

There is no magic “cure” for lymphedema, as no surgery or medication is effective in developing new lymph vessels. The best management techniques are:

1) the use of graded medical support hose
2) maintenance of a normal body weight
3) keeping a good exercise program that stimulates blood flow in the legs.

If symptoms progress, an evaluation by a certified physical therapist experienced in decongestive therapy (manual lymphatic drainage) can be beneficial. The National Lymphedema Network is an excellent resource.

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