What Is Pitting Edema?

what is pitting edema; pitting edema is swelling in the body caused by excess fluid build-up. when pressure is applied to the affected area, a pit or indentation occurs
what is pitting edema; pitting edema is swelling in the body caused by excess fluid build-up. when pressure is applied to the affected area, a pit or indentation occurs

Pitting edema is a condition where an indentation, or pit, is left on the skin when sustained pressure is applied to an area of a person’s body that’s affected by edema. Fortunately, there are treatment options for people that present with pitting edema that can help provide relief and reduce swelling that’s associated with this condition.

So, what is pitting edema compared to non-pitting edema, and should you be worried about pitting edema? It’s best to get a proper diagnosis from a doctor, but understanding pitting edema can help you identify any symptoms and encourage you to find the right interventions. In this article, we’ll cover what pitting edema is, what causes pitting edema, how it’s treated, the risk factors, and more.


Pitting Edema Definition

Pitting edema occurs when an indent is left after a finger is pressed down on the area of the body affected by edema. Edema itself is a condition where excess fluid accumulates in the body’s tissues, leading to swelling that typically affects the extremities, such as the arms, legs, hands, and feet, but can occur anywhere in the body. Several conditions can cause pitting edema, so it’s important to visit a doctor to get a diagnosis and create a treatment plan that works for you.
what is pitting edema; pitting edema is swelling in the body caused by excess fluid build-up. when pressure is applied to the affected area, a pit or indentation occurs

Pitting vs. Non-Pitting Edema

Edema can be classified as pitting or non-pitting. The main difference between pitting edema and non-pitting edema is the indentation. With non-pitting edema, no indentation is left after pressure is applied to the swollen area. Edema is considered pitting edema when pressing your finger on the area leaves an indentation. Pitting can be an indicator of the severity of edema, so it’s important to identify this sign to receive a proper diagnosis.


What Causes Pitting Edema?

There are several factors that can cause pitting edema, and understanding the potential causes can help you reduce your risk of edema. Take a look at what causes pitting edema below:
causes of pitting edema; poor circulation, pregnancy, medications, standing for extended periods, chronic venous insufficiency, deep vein thrombosis, congestive heart failure, cirrhosis, kidney damage

  • Poor circulation: Poor circulation can lead to fluid pooling in your lower extremities, which can lead to the pain and swelling associated with edema. Poor circulation can be caused by weight, lack of exercise, smoking, and more.
  • Pregnancy: Some people develop pitting edema during pregnancy, which typically goes away when the pregnancy is finished.
  • Medications: Certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and high blood pressure medication, can cause changes in blood flow, leading to edema.
  • Standing for extended periods: People who stand in one place for extended periods of time, such as cashiers, may develop edema as a result of fluid pooling up in the lower extremities.
  • Chronic venous insufficiency: CVI can develop when veins are unable to overcome the force of gravity and return blood to the heart. This can be a result of a weak calf muscle pump or when veins become damaged or lose efficiency due to age. This disruption of blood flow can lead to edema or swelling in the legs, which can be painful.
  • Deep vein thrombosis or blood clot: Deep vein thrombosis, also known as a blood clot, is a life-threatening medical condition where a blood clot forms in one of your deep veins and causes damage to the vein. Blood clots typically occur in the leg but can occur anywhere with a deep vein, such as the arm or pelvis. If you think you may be experiencing a blood clot, seek medical attention right away.
  • Congestive heart failure: People with a history of heart failure may have pitting edema, as well as pulmonary edema and abdominal edema, in some cases. A specialist can provide more details about treating edema that results from heart failure.
  • Cirrhosis: Cirrhosis can eventually lead to a backup of blood in the portal vein, which can lead to high blood pressure in that vein. Eventually, the portal vein may leak fluid out into the abdomen and may even cause peripheral edema.
  • Kidney damage: Kidney damage can make it difficult for your body to filter out fluids, which can lead to excess sodium and fluids in your body. This increased fluid retention can be the root cause of pitting edema.

It’s important to keep in mind that pitting edema may or may not be a result of lymphedema. Consulting with your doctor or a lymphedema specialist can help you get the proper diagnosis.

Pitting Edema Risk Factors

There are several risk factors associated with pitting edema, which is why identifying it in its early stages is crucial. Lifestyle choices are one of the most significant risk factors for pitting edema. For example, there is a higher risk of developing pitting edema if your diet consists of food with a high sodium content that causes you to retain more water. You’re also more likely to develop pitting edema if you live a sedentary lifestyle.

Other risk factors for pitting edema include thyroid conditions and other chronic illnesses. For example, pitting edema can be related to kidney disease or heart disease. Edema can also be caused by lymph fluid, known as lymphedema, which results in the swelling of the arm, leg, head, or neck.

What Are the Symptoms of Pitting Edema?

Recognizing the symptoms of pitting edema can help you seek the necessary interventions to manage and relieve symptoms associated with pitting edema. The most common symptom of pitting edema is when the skin in the affected area is depressed with your finger for several seconds and the indentation does not immediately disappear. However, additional symptoms may be present with pitting edema, such as:

  • Joint pain
  • Decreased range of motion or loss of mobility
  • Warm skin
  • Fatigue
  • Full feeling in the affected area
  • Pain
  • Swelling

These are some of the symptoms you may experience with pitting edema. If you’re experiencing any of these signs, consult with your doctor or lymphedema specialist for a proper diagnosis and treatment plan.


How Is Pitting Edema Diagnosed?

Getting a professional diagnosis is important if you’re experiencing symptoms related to pitting edema. When working with your doctor, they will start by reviewing your medical history to identify potential causes and risk factors of pitting edema. This is an important part of determining the cause of your edema, which allows you to start pitting edema treatment.

A physical exam is also used to diagnose pitting edema based on the depth of the depression and how quickly it rebounds. There are four grades of pitting edema:

  • Grade +1: Indentation up to 2mm, rebounds immediately
  • Grade +2: Indentation of 3-4mm, rebounds in 15 or fewer seconds
  • Grade +3: Indentation of 5-6mm, rebounds in 60 seconds
  • Grade +4: Indentation of 8mm, rebounds in 2-3 minutes

Pitting edema scale; grade, indentation depth, rebound time Source: Missouri.edu Geriatric Assessment Tool Kit
Aside from using the pitting edema scale, doctors and specialists may also use a handful of lab tests to help diagnose pitting edema. Blood tests may be performed depending on the underlying cause of pitting edema, but they can’t detect every potential underlying condition. For conditions blood tests can’t detect, your doctor may use X-rays or an ultrasound exam to diagnose pitting edema.

How Do You Treat Pitting Edema?

Treating pitting edema is an important step in managing the symptoms of this condition and reducing its progression. Pitting edema can be treated with lifestyle changes, elevation, compression garments, and more.

For lifestyle changes, it’s recommended to avoid high-sodium diets and to get regular exercise. Light exercise can encourage the movement of fluids flowing throughout your body and reduce swelling.

Another treatment option is elevating the affected limb. By elevating the limb that’s filled with fluid, you can encourage drainage and reduce some of the swelling. Another lymphedema treatment and management recommendation is wearing compression garments, such as sleeves and stockings. Compression garments encourage blood flow by using gradual compression, which can help reduce swelling and relieve pain.

Pneumatic compression devices are also great at-home management options. Tactile Medical’s Flexitouch Plus system is designed for the upper body, lower body, and head and neck. By stimulating the lymphatic system and encouraging the flow of lymphatic fluid, Flexitouch Plus can help relieve swelling, pain, and other symptoms associated with lymphedema. When wearing the Flexitouch Plus garments, mild, dynamic pressure is delivered in 1-3 second intervals to create a gentle work and release action to direct fluid across the body’s watershed. At Tactile Medical, we’ll work with you and your doctor to find a treatment option that works for you.

Key Takeaways: What Is Pitting Edema?

Pitting edema occurs when the skin is depressed with your finger for a few seconds and an indentation is left that does not immediately disappear. Patients living with pitting edema can experience a decrease in their quality of life, especially if causing pain.

Fortunately, there are several ways to reduce your risk of pitting edema, along with various management and treatment options to reduce swelling and prevent the progression of this disease. If you’re experiencing the signs and symptoms associated with pitting edema, visit a doctor for a diagnosis as soon as possible. At Tactile Medical, we have doctor-prescribed compression devices that you can use to manage your symptoms from the comfort of your home.