Water retention, also known as edema, occurs when excess fluids build up in the body. This can cause swelling in the hands, feet, ankles, and legs. Leg swelling from water retention is often most notable in the lower legs and ankles toward the end of the day. There are many potential causes of water retention in the legs, from medication side effects to underlying medical conditions. Identifying the cause is key to determining the appropriate treatment.
What causes water retention in the legs?
There are a number of possible causes for retaining water in the legs:
Medications
Certain medications may lead to water retention as a side effect. These include:
– Blood pressure medications like calcium channel blockers and beta-blockers
– Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
– Estrogen hormones
– Corticosteroids
– Antidepressants
– Birth control pills
Always talk to your doctor if you suspect a medication is contributing to leg swelling. A medication adjustment or change may be warranted.
Diet
Eating too much salty or processed foods can cause the body to retain more water. The extra sodium causes the body to hold onto more fluid in an attempt to dilute it. Going overboard on carbohydrates can also lead to water retention by causing a buildup of glycogen, which then draws in water.
Heart failure
When the heart cannot pump blood effectively, fluid can back up into the legs and cause swelling. This is called peripheral edema. The legs may feel heavy or uncomfortable. Shortness of breath, fatigue, and weight gain often accompany the leg swelling.
Kidney disease
Chronic kidney disease impairs the kidneys’ ability to filter excess fluid from the body. As kidney function declines, swelling in the legs from retention of excess fluid is common.
Liver disease
Like the kidneys, the liver plays a crucial role in filtering fluids. Damaged liver cells allow fluids to accumulate in the abdomen and legs. Leg swelling may indicate cirrhosis or liver failure.
Blood clots
A blood clot in the deep veins of the legs, called deep vein thrombosis (DVT), can obstruct blood flow. This causes swelling and pain the calf or thigh. DVT requires emergency medical care.
Lymphedema
When lymph nodes are removed or damaged, usually from cancer treatment, lymph fluid can accumulate and cause extreme swelling in the arms and legs. This chronic condition is called lymphedema.
Pregnancy
Hormonal changes during pregnancy can lead to fluid retention all over the body, including the legs. Leg swelling is typically worse late in the day and improves with rest and leg elevation.
Being overweight
Excess body weight puts pressure on the leg veins and can cause fluid buildup. Losing weight may help reduce leg swelling.
Sitting or standing too long
Remaining in one position for long periods prevents blood and lymph fluid from circulating properly. This allows fluid to pool in the lower extremities.
Hot weather
Leg swelling can worsen on hot summer days. Heat causes the blood vessels to expand and blood to pool in the legs. Cooling down and elevating the legs can provide relief.
When to see a doctor
Occasional minor leg swelling that resolves with rest and leg elevation is usually not a concern. However, see your doctor if you experience:
– Severe or persistent leg swelling
– Swelling only in one leg
– Swelling accompanied by pain or redness
– Rapid swelling over hours or days
– Leg swelling with shortness of breath
– Swelling related to new medication
Sudden leg swelling or swelling combined with other symptoms can signal a medical emergency like a blood clot, heart failure, or kidney damage. Seek immediate medical attention in these cases.
Diagnosing the cause
To diagnose the reason for leg swelling, the doctor will ask about your symptoms and medical history. Important questions include:
– When did the swelling start? Was it gradual or sudden?
– Which leg is affected? Is the swelling equal in both legs?
– Does the swelling get better or worse throughout the day?
– Do you have any other symptoms like fatigue or shortness of breath?
– Have you started any new medications recently?
– Have you traveled by plane recently?
– Could you be pregnant?
Your doctor will also examine your legs and look for signs of swelling, redness, warmth, or pain. They will check for a difference in circumference between your calves and ankles.
Diagnostic tests may include:
Blood tests
Blood tests can check for problems with your kidneys, liver, or thyroid gland. A complete blood count looks for anemia or infection. The D-dimer test helps rule out blood clots.
Urinalysis
Examining the levels of protein and blood in your urine can provide clues about kidney function.
Imaging tests
An ultrasound uses sound waves to look for blood clots or blockages in the veins. A CT scan provides images of the leg veins. Chest x-rays and echocardiograms check the heart for signs of failure.
Lymphoscintigraphy
This special imaging test tracks the flow of lymph fluid through the lymph system. It helps diagnose lymphedema.
8 ways to reduce leg swelling
While waiting for a diagnosis, the following self-care approaches can help relieve swelling in the legs:
1. Elevate your legs
Lie down and raise your legs above the level of your heart several times per day. This improves drainage of fluid from the legs.
2. Exercise regularly
Physical activity boosts circulation in the legs. Walking, swimming, and biking are ideal low-impact exercises.
3. Stretch your legs
Simple calf and foot stretches improve flexibility and muscle contractions that support fluid return to the heart.
4. Watch your salt intake
Avoiding processed foods and restaurant meals can curb excess sodium which causes fluid retention.
5. Wear compression stockings
Compression stockings or socks apply gentle pressure to the legs to prevent fluid buildup. They are worn during the day and removed at night.
6. Lose weight if overweight
Carrying excess weight strains the cardiovascular system and leads to swelling. Losing even a few pounds can make a difference.
7. Limit time sitting or standing
Take regular breaks to walk around if you have a desk job or retail position requiring long hours on your feet.
8. Increase potassium-rich foods
Potassium aids fluid balance in the body. Load up on fruits, veggies, yogurt, and nuts.
Medical treatments
If lifestyle measures don’t relieve leg swelling, prescription diuretics are commonly prescribed. Diuretics are medications that reduce fluid retention by making you urinate more frequently.
Other medications that may be used include:
– ACE inhibitors to lower blood pressure
– Lymphedema pumps or compression systems
– Blood thinners for blood clots
– Steroids or immune suppressants for inflammatory conditions
Procedures like paracentesis can remove fluid from the abdomen when swelling is caused by cirrhosis. Surgery may help repair damaged valves in leg veins or lymph vessels. Kidney dialysis or transplantation treats kidney failure.
Outlook for leg swelling
The outlook depends on the cause of fluid retention. Mild or temporary swelling often resolves once the trigger is addressed. For example, changing a medication, losing weight, or properly treating heart failure.
Chronic conditions like kidney disease, lymphedema, or varicose veins may require ongoing management. But following your treatment plan can successfully control leg swelling and complications.
Lifestyle changes to promote healthy circulation also help prevent recurrence of swelling in the legs. Be sure to see your doctor if swelling persists or comes back despite self-care measures.
When to see your doctor
Check with your doctor if you have:
– Persistent or worsening leg swelling
– Swelling only in one leg
– Other symptoms like pain, warmth or redness in the leg
– Rapid leg swelling over hours or days
– Shortness of breath with leg swelling
– Swelling started after new medication
Seeking timely medical attention is crucial for an accurate diagnosis and proper treatment to resolve swelling in your legs.
The bottom line
Leg swelling often occurs due to fluid retention, also called edema. Water retention in the legs is common and usually not serious, but can sometimes signal an underlying medical issue needing evaluation.
Causes range from medication side effects and varicose veins to heart failure or kidney disease. Diagnosis involves evaluating symptoms, performing a physical exam of the legs, and medical tests as needed.
Mild leg swelling often improves with self-care techniques like resting, exercising, and elevating your legs. Prescription medications or procedures may be necessary to reduce swelling from chronic conditions.
Monitor leg swelling carefully and see your doctor if it persists, recurs, or worsens. Prompt treatment of the underlying cause can help prevent complications of prolonged fluid retention in the legs.
