Varicose Vein and Other Venous Disorders Services

1. Chronic venous insufficiency. Leg swelling (oedema / water retention) associated with chronic venous insufficiency is very common. It accounts for 90% of the cases of leg swelling. It is commonly seen in patients with long-standing varicose veins, previous history of deep vein thrombosis and iliac (pelvis) vein compression. When the valves within the veins fail to work properly or there is blockage to the normal blood flow in the veins, blood will pool in the leg resulting in increased pressure in the veins. Fluid in the blood may leak out leading to build-up of fluid in the tissue of the lower legs. Sometimes this swelling is evident only at the end of the day while some swelling may persist throughout the whole day. Swelling almost always decreases with leg elevation, so it may be less prominent in the morning.
2. Gravity can contribute to the accumulation of fluids in the feet, ankles and lower legs, particularly with prolonged standing or sitting, especially in hot weather.
3. Lymphedema– blockage of lymph system
4. Congestive heart failure, a condition in which the heart can no longer pump efficiently, causes fluid accumulation in the lungs and other parts of the body. Swelling is often most visible in the feet and ankles.
5. Pregnancy can cause oedema in the legs as the uterus puts pressure on the vena cava. Fluid retention during pregnancy can also be caused by a more serious condition called preeclampsia.
6. Malnutrition, kidney and liver disease can lead to low protein levels in the blood, resulting in leg swelling. The proteins help to hold salt and water inside the blood vessels so fluid does not leak out into the tissues. If a blood protein, called albumin, gets too low, fluid will leak out into the tissue, leading to oedema, especially in the feet, ankles and lower legs

Leg swelling of any cause can make the legs to feel heavy and interfere with walking. Severe leg swelling can interfere with skin blood flow, leading to ulcers on the skin. In general, the skin above the swollen area will be stretched and shiny.

The treatment of leg swelling should focus on the underlying cause. You should see a doctor to determine how and who should manage your leg swelling. For example, if the venous insufficiency is due to varicose veins, Endovenous Thermal Ablation (e.g. Radiofrequency Ablation) or Endovenous Non-thermal Ablation (e.g. Clarivein) will fix the problem.

No matter what the cause of leg swelling, any swollen area of the body should be protected from pressure and injury. The skin over swollen legs can be fragile. Any trauma to the skin may result in prolonged wound healing and the wound is also likely to get infected.