Peripheral Edema: Symptoms, Causes & Treatment

Peripheral edema is a swelling that occurs when fluid accumulates in the tissues of your extremities. It typically affects the legs, ankles, and feet. This condition can be accompanied by mild to severe discomfort, which impacts daily activities and quality of life, making it essential to understand its causes, recognize its symptoms, and explore treatment options to manage it effectively.

Keep reading to learn everything you need to know about peripheral edema.

• Key Takeaways
• What Is Peripheral Edema?
• Common Causes of Peripheral Edema
• Symptoms of Peripheral Edema
• Peripheral Edema Treatment
• Wrapping Up: Understanding Peripheral Edema

Key Takeaways

• Peripheral edema is a condition that occurs when too much fluid accumulates in the tissues of your arms, legs, ankles, or feet rather than being properly circulated through your body.
• This condition can result from lifestyle factors, medical conditions, medications, or temporary situations like pregnancy or injury.
• Early recognition of symptoms can help prevent progression and complications.
• Treatment approaches range from simple lifestyle changes to medical interventions.

What Is Peripheral Edema?

Peripheral edema causes swelling due to the accumulation of fluid in the tissues of your extremities, resulting in noticeable swelling that typically affects your legs, ankles, and feet, although it can also occur in your arms and hands. This condition develops when your body’s circulatory system cannot effectively move fluid back toward your heart, causing it to pool in the interstitial spaces between cells in your limbs.¹

Unlike generalized swelling, which affects the entire body, peripheral edema specifically targets the extremities and often appears more pronounced in dependent areas, where gravity naturally pulls fluid downward. The fluid that accumulates can’t be adequately drained by the lymphatic vessels and nodes.

This type of edema primarily affects the periphery of your body rather than central organs or tissues. Untreated edema can worsen over time and lead to complications, making early recognition and treatment important.

Common Causes of Peripheral Edema

Understanding what triggers peripheral edema can help you recognize risk factors and take steps to address them. Causes of peripheral edema fall into three main categories: lifestyle and temporary factors, underlying medical conditions, and medications that can contribute to fluid retention.

Lifestyle and temporary causes

Several everyday situations and lifestyle factors can lead to peripheral edema, which often resolves once the underlying cause is addressed. These include:¹

• Prolonged sitting or standing: Extended periods of immobility prevent your muscles from effectively pumping blood and fluid back toward your heart. This is commonly experienced during long flights, desk jobs, or occupations that involve standing, where movement is limited.
• High salt intake: Consuming excessive sodium causes your body to retain more water, leading to fluid accumulation in your tissues. Your kidneys work to maintain proper sodium balance, but too much salt can overwhelm this system.
• Obesity: More weight puts more pressure on your circulatory system, which can impair proper fluid circulation. The extra weight also increases the workload on your heart and lymphatic system. If chronic, this can further lead to lymphedema.
• Pregnancy: Pregnancy comes with hormonal changes that can lead to fluid retention. The growing uterus also puts pressure on blood vessels, especially in the lower extremities.
• Injury: Trauma to tissues can cause localized inflammation and fluid accumulation as part of your body’s natural healing response. This type of swelling is typically temporary and resolves as healing progresses. However, if chronic, this can lead to lymphedema.
• Allergic reactions: Certain allergens can trigger inflammatory responses that cause fluid to leak from blood vessels into surrounding tissues, resulting in localized swelling.

Medical conditions

Various health conditions can disrupt your body’s ability to maintain proper fluid balance, leading to peripheral edema as a symptom.¹

• Heart failure: When your heart cannot pump blood effectively, fluid backs up in your circulatory system and begins to accumulate in your extremities. This creates a cascade effect where poor circulation leads to increased fluid retention.
• Kidney disease: Your kidneys regulate fluid balance in your body, so when they’re not functioning properly, excess fluid and sodium build up in your tissues. This can result in swelling throughout your body, including your extremities.
• Liver disease: Your liver produces proteins that help maintain proper fluid balance in your blood vessels. When liver function is compromised, these protein levels drop, allowing fluid to leak into surrounding tissues.
• Chronic venous insufficiency: This happens when the valves in your leg veins don’t work properly, preventing blood from flowing back to your heart efficiently. The resulting blood pooling leads to increased pressure and fluid leakage into tissues.
• Lymphedema: This condition develops when your lymphatic system cannot adequately drain fluid from tissues, often due to damaged or disrupted lymph vessels and nodes. The fluid accumulation results in progressive swelling that requires ongoing management.
• Lipedema: This condition involves the disproportionate accumulation of fat and fluid in your legs and sometimes arms. People with lipedema often experience pain and may develop secondary lymphedema.
• Cellulitis: This bacterial skin infection causes inflammation and fluid accumulation in affected tissues. The infection can spread quickly and requires prompt medical treatment to prevent complications.
• Cancer and cancer treatment: Tumors can block lymphatic drainage, while cancer treatments like surgery or radiation can damage lymph vessels and nodes. This disruption can lead to fluid accumulation in the affected areas.
• Blood clots (deep vein thrombosis): Blood clots block blood flow and cause fluid to back up in the affected limb.

Medications

Certain medications can contribute to peripheral edema as a side effect by affecting fluid balance or circulation. These include:¹

• Blood pressure drugs
• Steroids
• Hormones (e.g., estrogen)
• NSAIDs
• Antidepressants

Symptoms of Peripheral Edema

Recognizing the signs of peripheral edema early can help you seek appropriate treatment and prevent the condition from worsening. Peripheral edema symptoms typically develop gradually and may vary in severity.¹

• Swelling: The most obvious sign is visible swelling in your extremities, particularly your ankles, feet, and lower legs. This swelling may be more noticeable at the end of the day or after periods of prolonged sitting or standing. In some cases, you might notice edema in one leg more than the other or experience arm swelling that affects daily activities.
• Skin changes: The affected areas may appear stretched, shiny, or discolored. Your skin might feel tight or uncomfortable, and in some cases, edema bruising can occur as fluid accumulation puts pressure on small blood vessels.
• Difficulty putting on shoes or socks: As swelling progresses, you may find it challenging to wear your regular footwear or clothing. Shoes may feel tight, and socks might leave indentations on your skin.
• Pitting edema: This occurs when pressing on the swollen area leaves a temporary indentation, or “pit,” in the skin. Pitting edema indicates that fluid is present in the tissues and can help healthcare providers assess the severity of your condition.
• Heaviness or discomfort: You might experience a feeling of heaviness, achiness, or general discomfort in the affected areas. This sensation often worsens with prolonged standing or sitting and may improve with elevation.

Healthcare providers often use specific techniques for measuring edema to track progression and treatment effectiveness. This may include circumferential measurements of affected limbs or standardized assessment tools to document changes over time.

Peripheral Edema Treatment

Treatment for peripheral edema focuses on reducing fluid accumulation and addressing the underlying cause of the condition. Your healthcare provider may recommend complete decongestive therapy, which is a comprehensive treatment plan that combines multiple approaches. The specific strategies in your plan may vary depending on the severity of your condition and its underlying cause, but several techniques can help manage symptoms and improve your comfort.¹

• Elevation: Raising your affected limbs above heart level for several minutes throughout the day can help gravity assist in moving excess fluid back toward your heart.
• Reduce salt intake: Following an edema diet that limits sodium consumption helps prevent your body from retaining excess fluid.
• Compression: Wearing compression garments, such as stockings or sleeves, provides external pressure that helps move fluid out of your tissues. These garments work by applying graduated pressure that helps your circulatory system move fluid back toward your heart.
• Pneumatic compression devices: PCDs, such as Tactile’s Flexitouch Plus and Nimbl systems, are another option for delivering sequential compression to the affected area to reduce swelling.
• Manual lymphatic drainage: This specialized massage technique involves gentle, rhythmic movements that help stimulate lymphatic flow and reduce fluid accumulation. Learning how to do a lymphatic massage or working with a trained therapist can help manage symptoms.
• Exercise: Regular physical activity, particularly exercises that engage your calf muscles, helps promote circulation and fluid movement. Walking, swimming, and simple exercises can be particularly effective for improving lymphatic drainage.
• Diuretics: Diuretics help your kidneys remove excess fluid from your body through increased urination. However, they should only be used under medical supervision and are typically reserved for cases where underlying medical conditions contribute to fluid retention.
• Treating underlying causes: Treating the root cause of your peripheral edema is crucial for long-term management. This might involve managing heart failure, treating kidney disease, or discontinuing medications that contribute to fluid retention.
  

Wrapping Up: Understanding Peripheral Edema

Early detection and proactive treatment of peripheral edema can improve your quality of life. If you’re experiencing persistent swelling in your extremities, it’s always a good idea to work with a healthcare provider who can create an effective treatment plan.

For individuals with conditions such as lymphedema or chronic venous insufficiency, doctor-prescribed pneumatic compression devices, like Tactile Medical’s Flexitouch Plus and Nimbl systems, can offer effective and convenient treatment options that help manage symptoms and improve daily comfort.