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Have you ever looked down at your feet and been shocked to see they are swollen? Maybe it’s just a little bit, just enough to notice. Maybe it’s bad enough that when you remove your shoes, you can see the deep creases they left in your swollen skin. Or maybe you find it impossible to get your shoes on at all.
Maybe the swelling is uncomfortable, or maybe you can’t feel anything unusual. But you can sure see it!
Most of us will experience swelling of the feet and ankles at some point, even before we reach our golden years. It can be the result of many things, but most commonly occurs in adults who are on their feet for long periods at a time. In most cases, putting your feet up for a while and getting some good sleep are enough to take care of the temporary problem.
So what’s the big deal?
Swollen feet or legs in seniors and the elderly can be a whole other ballgame, one rife with concern. Here’s what you need to know about this swelling of the legs and feet, known as peripheral edema.
What Is Peripheral Edema?
Edema is fluid buildup somewhere in the body. Peripheral edema is fluid that has built up in the extremities, which is usually the legs and feet but might also be the arms and hands.
Sometimes the swelling occurs with no other symptoms at all, while other times, there are many other troubling symptoms accompanying the swelling. Sometimes it doesn’t hurt at all, while other times, it can be quite uncomfortable. It might happen slowly, over a period of several weeks or months, or it might show up in a matter of days.
Edema happens when the small blood vessels in the body leak their fluids into the tissues around them. That extra fluid is what creates the swelling. There are many reasons for this, which we’ll talk about below.
When you have peripheral edema, you might feel a sensation of fullness or heaviness in the part of the body that’s affected. The skin will look puffy or swollen. If you press on the skin with your fingertip for several seconds, it might actually leave a “dent” in the skin that persists for a few minutes. The affected area might feel tight or warm to the touch. You might have trouble moving any joints that are affected. And you might feel discomfort. Sometimes, even wearing clothing over the area can be uncomfortable.
And while it often affects the body equally – meaning that if one leg is swollen, for instance, the other leg will be too – it can also be unilateral, meaning that it happens on only one side of the body.
What Puts Seniors at Risk for Peripheral Edema?
The most significant risk factor for peripheral edema is age. Seniors are especially prone to it and often develop it as a result of other underlying conditions. According to the PLOS ONE journal, up to 20% of adults over the age of 54 have peripheral edema, making it a common problem among the elderly.1
You are also at risk for peripheral edema if you:
· Are female – women tend to have this problem much more often than men do.
· Have obesity, diabetes, or high blood pressure.
· Tend to be inactive and live a sedentary lifestyle.
· Have mobility problems that make it tough for you to get around or move from one position to another.
What Causes Peripheral Edema?
According to the National Library of Medicine, the most common cause of peripheral edema is insufficient blood flow through the veins of the extremities. Also known as venous insufficiency, it happens when the veins have trouble returning blood to the heart. This is most common among those over the age of 50.2
If you are dealing with anything that can obstruct or reduce blood flow, getting good care from your doctor is key. You should also do what it takes to keep yourself as safe as possible, as a problem with blood flow can lead to other issues, such as weakness or dizziness – and those problems can lead to falls. Senior alert systems are a great idea and one to consider the moment you learn that there are blood flow issues to address.
But what actually causes insufficient blood flow?
There are many reasons why you might experience significant or long-term swelling in your legs and feet. Some of these can be treated very easily, while others indicate a need for serious medical intervention. Here are some of the things that can cause the problem:
· Deep vein thrombosis. This is caused by a blood clot that forms in the veins of the leg. In this case, you will notice swelling on one side of the body and not the other.
· Congestive heart failure. Also known as CHF, this condition can cause many problems with blood flow as your heart struggles to pump enough blood to all parts of your body.
· Pericarditis. This is a swelling of the tissues around the heart, which can make it more difficult for the heart to do the work of sending blood where it needs to go.
· Vitamin deficiencies. Not getting enough nutrition can show up in various parts of the body, including swelling of the legs and other extremities. Thiamine deficiency is a good example.
· Diseases of the liver. Problems such as liver cirrhosis or liver failure can lead to swelling everywhere.
· Kidney problems. Any impairment of kidney function can cause blood flow problems.
· Cellulitis. This is a serious infection in the deep layers of the skin.
· Pulmonary hypertension. This is a specific type of high blood pressure that affects the arteries in the lungs and heart. You are more likely to have this problem if you have obstructive sleep apnea.
· Lipedema. This refers to a buildup of fat in the legs that might not be proportionate to the rest of your body.
· Myxedema. This is an unusual type of hypothyroidism that can lead to all sorts of problems.
· Lymphedema. The lymphatic system is part of your immune system. One purpose of it is to drain fluid from all around your body. That fluid can accumulate in the tissues, usually settling in the legs.
Certain medications can also cause swelling of the lower extremities. In fact, this is a fairly common issue, so it’s important to let your doctor know if you experience swelling after you begin taking a new medication; they might be able to switch you to something different and alleviate the problem.
Just a reminder: switching medications can lead to all sorts of side effects that could then lead to a higher risk of falls or medical emergencies, which is why an emergency button alarm for seniors and elderly adults is a great idea. It allows you to reach out for help 24/7 if needed.
Medications that can cause peripheral edema include those for high blood pressure or Parkinson’s, some heart medications, antidepressants, muscle relaxers, testosterone or estrogen, and even non-steroidal anti-inflammatory drugs (NSAIDs). There are many others that can cause this issue, so remember to speak to your doctor right away if the swelling occurs within days or weeks of starting a new medication.
What to Do About Peripheral Edema
In some cases, the cause is obvious – such as a new medication – and your doctor can help with that.
In other cases, however, your doctor may want to do a physical exam and then perhaps other tests. For instance, they might order an ultrasound of your kidneys if you are at risk for kidney problems, or an ultrasound of the veins of your leg if the swelling is on one side and they suspect deep vein thrombosis.
The treatment for edema will depend upon the underlying cause. Sometimes the cause is an ongoing issue such as congestive heart failure. In that case, medications to drain the fluid can help.
According to the Mayo Clinic, some lifestyle changes can help too:3
· Elevating your legs can make the veins work more efficiently. Elevate your legs above the level of your heart several times a day, and put pillows under your legs when you sleep.
· Exercises that move the muscles of the affected area can help move the fluid around and reduce the swelling. Talk to your doctor about which exercises to try.
· Compression stockings or sleeves might help, especially if the peripheral edema comes and goes.
· Reduce salt in your diet. Too much salt in the body can make you retain more fluid.
· Firm yet gentle massage that moves the fluid from the limbs toward the heart might help reduce the swelling.
Finally, it’s important to protect your skin while you deal with peripheral edema. Use lotion or cream to keep the skin supple, as dry or cracked skin is prone to infection. Treat any cuts or scrapes right away. Always wear socks on your feet to further protect them.
And you should protect senior whole health as well by choosing an affordable medical alert necklace or pendant, wristband, or bracelet that is right for you. Peripheral edema can lead to a feeling of heaviness or discomfort in the legs, which can make it difficult to move around. When that happens, you are at a greater risk of falls. An ounce of prevention is worth a pound of cure, especially when it comes to your personal safety.