Friday, August 29, 2014
Sunday, September 07, 2008 judi, Community Member, asks

Q: How to treat edema in the legs and feet

I've had bad edema in my legs and feet. The doctor has ruled out a DVT but my skin feels very tight and hard and I have painful, fluid-filled blisters. The pain is really bad, it almost feels like a burning feeling from the inside out. Could anyone shed some light on this?

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Answers (4)
Martin Cane, M.D., Health Pro
9/11/08 3:57pm

judi,

 

Thanks for your question. 

 

Sorry to hear that you're having problems.  I'd like to address each issue separately.  The rash, blisters, and itching are due to the excess fluid in your legs.  A major concern of mine is the possibility of developing an infection of the soft tissues of the legs, called cellulitis.  This occurs more frequently in patients with edema (excess fluid).  So, getting the fluid down will help avoid this situation, as well as the rash, blisters and itching.  Cellulitis should be considered if you develop a fever, redness and warmth of the legs.

 

The weight gain is also due to extra fluid retained in your legs.  A liter (just a little more than a quart) of water weighs 2.2 lbs, so you carrying a considerable amount of water in your legs.

 

As for the cause, there are several things to consider.  Rightfully, your doctor has checked you for DVT (deep vein thrombosis), which can cause swelling of the legs.  For both legs to be involved, I would want to rule out an obstruction of the inferior vena cava, the major vein in the abdomen and chest, which can be done by abdominal ultrasound or CT scanning.  Other problems to be checked:

 

-         Medication side effects - drugs like calcium channel blockers used for  hypertension (such as Norvasc and Procardia), can cause significant swelling.

 

-         Cardiac Function - be sure the pumping action of the heart is OK.  If insufficient, back pressure develops and fluid is forced out of the blood vessels into the tissue. 

 

-         Protein and kidney status - if the protein levels in the blood are very low, this could cause swelling.  Some forms of kidney disease can result in high losses of protein in the urine. 

 

-         Did you have any injury to your legs or lower abdomen?  Did you have any abdominal surgery or radiation therapy to your lower abdomen?  All of these could cause damage to the major veins leading to the inferior vena cava or the vena cava itself.  Your doctor should consider getting a CT scan of your abdomen if all of the above is negative.

 

-    Unfortunately, some people have a condition known as venous insufficiency. 

In this condition, the valves in the leg veins, which normally prevent back  flow are no longer functioning and fluid, therefore, builds up in the legs.  This is very difficult to treat, using diuretics and elastic stockings.   

 

 

As for treatment, the obvious answer is to determine the cause, which will direct your treatment.  Until then, diuretics will help get the fluid down, but your doctor will have to keep an eye on your electrolytes, which can become depleted with diuretic therapy.  Leg elevation, as you have discovered, is another key factor in treatment.  Ideally, keeping your legs at the same level, or higher, than your heart will promote fluid to be eliminated. 

 

I hope this has been helpful.

 

Best wishes.

 

Martin Cane, M.D.

 

 

 

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pob424, Community Member
8/27/09 4:44am

i found this informative and interesting !i dont really think i have high blood pressure...it was 130 over 80 last taken ,but when i was in the hospital they said it was high and sky high when i was really upset ...Hence,my problem was that my legs were very swollen and started gaining fluid a year ago with a lot of weight gain.My legs began a red rash on the inside of my calf on the right one,near a leg injury where i was kicked and had a dent in my leg for years.It was warm to the touch  and very tender.the left red spot was smaller...about 1/5th the size(it was only the size of a cookie..there was no swelling in this leg and it was on the shinbone area.i thought it began because at night my legs lay together at that spot and are painful to lower leg bearing all the weight,as i am a side sleeper.I also thought it was due to shaving without cream and going in hot tub(legs were burning!) and getting infections in the legs.Three doctors thought it was cellulitis and i had two doplars two months apart both negative.i was on 5 different antibiotics and the heat/tenderness and shooting pains stopped but the hardness that formed is still there .my legs feel tight and feel like they shudder when i exhale,sneeze,or cough....like circulation is getting cut off kind of feeling for a split second ..then i try to exhale again and i dont feel it..its with the big exhales,so it happens a few times an hour at least.there are some places in my leg where it is pitted and i can put a dent in with my finger...feels like stretch armstrong doll when you pushed your finger in it dents the spot of your finger...weird too,and .I am so tired of the discomfort and actually the lack of diagnosis.i got my doc to finally say this may be something else and referred me to a vascular surgeon.i am only 42 and this has ruined my spring/summer and i dont want it to continue.i am going out of my mind with the tightness and feeling like my muscless have a grip around my bones...Please give me any advice.908-333-7057 Denise

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Geeeenah, Community Member
2/19/14 2:35am

I am going through the same thing but without blisters. I am or was a perfectly health 41 year old who exercised daily. I became pregnant in November, by the the 4th week my thighs began to swell and thought it was just the pregnancy. I had to start wearing compression pants while on the treadmill because the impact of every step would hurt the layers between my muscle and skin. I lost the baby in january and a D&C Jan 7, on Jan 8th gain 13 lbs of fluid in 24 hrs on top of the 10 pounds I already gained in December. I was in so much pain that you couldn't touch me. My dr.s ran 96 total blood test, I had some kidney abnormalities which were retested about a week later and were fine. They did a sonogram of my kidneys and also fine. It's now Feb and my legs and up to my waisthave been swollen since. My ancles ache non stop and have pitted adema, my inner knees are painful to touch, are becoming purpleish in color and are gelatiness like, above that is just swollen that my clothes don't fit. My red and white blood cells are within normal range but barely, if the count goes down any more I will be considered low. I was told I was anemic and my blood pressure is always really low about 80/60 but lately all over the place. They are sending me for testing for Lupus. I don't know if that's better or worse but a diagnosis would at least be a step in the right direction and maybe it will help me break out of this downward spiral I'm heading into. I don't know if they've tested you or sent you to a Rheumatoid Doctor but that that might be a suggestion to check out. If this comes up not Lupus then it's off to Vascular, seems I have a lot of appointments ahead.

 

I hope you find a light at the endof the tunnel soon, I know how frustrating it is.

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Bill, Community Member
1/ 5/13 6:45pm

Judi, as I did a sarch on edema and hard skin I hoped to find an answer since my

wife has a similar condition. Now instead I see you are waiting for an answer. On a visit to a Doc Friday she had no anwers. Will answer if we learn anything. Wife has high blood pressure and prescribed LASIX, a strong diuretic, but no change.

Regrets, Bill

r

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david, Community Member
1/28/13 9:42pm

You have lymphedema and or cellulitis. PERIOD. I had necrotizing fasciitis where my skin on my leg actually was dripping off. Since...everytime I get a cut on leg or cut my thick toenails to short and bleed I get the blisters and water hard red skin,,,even under my stomach...knee pain and soaking blister leakage. That is the real truth no more no less...pray you dont have congestive heart failure....youd be coughing like crazy though. I know more than my doctor at this point.you need compression therapy and constant doctor visits. Im not kidding with you!!!!! stop drinkin booze drink water and elevate legs all the time.......love and luck, dave

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hhartley, Community Member
9/ 6/13 9:21pm

Hi, I don't know if you still get on here or not but I have a question. I have had edema in my abdomen(it looks like I'm 7 mos pregnant and my stomach is hard also), in my legs,ankles, and feet. It's pitted edema in my lower legs. I have had cellulitis at the bottom of my legs quite a few times. I have been going through this since 2009 and had MANY tests done, the first time I swelled I stayed swollen for 7-8 mos and it went away pretty much for a few months and came back, I stay swollen more than not. After dotors eliminating most everything, the research I have done on my own and after speaking with a therapist that is certified in lymphedema, I don't know of anything else it can be besides lymphedema. Any thoughts or questions for me? Thank you

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prisca, Community Member
4/ 7/13 3:30pm

Sound like my leg condition. Check for sjogren's syndrome which makes skin hard and dry, scleroderma, and Reynaud's.  I have all three-Reynaud's in feet and hands. worse in feet.  It's autoimmune and inflammatory. Lichen planus is also often associated and may be causing the blisters.  The scleroderma may present with wierd little blisters that itch or leak fluid. Are you losing hair at all?

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By judi, Community Member— Last Modified: 07/17/14, First Published: 09/07/08