Venous edema

Are you experiencing leg swelling, particularly in the evening and on warm summer days, that usually disappears when you elevate your legs? Does your leg size return to “normal” and you are able to put your shoes on again in the morning after a night’s sleep? These might be the first signs of venous disease. In this case, you should visit a doctor for proper diagnosis and to check for underlying causes.

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If the volume of your legs is constantly increased, and pressure on the affected part leaves an indent, you have edema. The cause could be venous or lymphatic. A doctor’s consultation will provide the correct diagnosis. However, compression therapy is the basic therapy for edema of any cause.

What is venous edema?

Edema is defined as a perceptible increase in the volume of fluid in the skin and subcutaneous tissue. Applying pressure on edema will leave an indentation that remains on the skin after the pressure is released.

Venous edema usually occurs in the ankle region, but it may extend to the leg and foot.

What causes venous edema?

There are many causes of edema, such as standing or sitting for long periods of time, physical inactivity, chronic venous disease, lymphedema, heredity, pregnancy, surgery, and trauma.

Edemas of venous origin develop when venous valves don’t close properly and blood stagnates in the veins, thereby preventing the blood vessels from properly functioning.

For an affected person, there is often no visible difference between venous edema and lymphedema. In any case, if you experience swelling, you should visit your doctor for correct diagnosis and treatment.

What can I do about venous edema?

Have you observed edema in your legs? Does the swelling usually disappear when you elevate your legs? Are your legs “back to normal” in the morning after a night’s sleep? These might be first signs of venous disease.

If this applies to you, you should visit a doctor to obtain a proper diagnosis and check for underlying causes. The doctor will ask about your symptoms, e.g. swelling in the legs, but also about the presence of varicose veins, skin changes, or skin ulcers that might be related to a venous disorder. By means of ultrasound, the doctor can visualize the blood flow and check if the development of your edema is associated with a venous disorder and if the superficial veins or the system of deep veins in your legs are affected. Early diagnosis is essential to prevent disease progression and to avoid more serious complications.

Non-invasive treatment: Compression therapy helps

To help with venous edema, compression therapy with medical compression garments is used as basic non-invasive treatment. In some cases, lymphatic drainage can help as well.

If you are diagnosed with edema, your doctor can prescribe medical compression stockings. The elastic material of the medical compression stocking provides a controlled pressure to the leg and gently squeezes the vein walls together. The strongest pressure is applied at the ankle and decreases going upwards along the leg, thereby easing blood flow back towards the heart, reducing venous pressure, and improving overall circulation.

Are there other treatment options for venous edema?

Venous edema originates from an underlying venous disorder, which can be treated with non-invasive compression therapy, but also with more invasive techniques. Different treatment options include: 

Summary

Edema can be a sign of a venous disorder.

Basic medical knowledge on venous disorders

  • With the term Chronic Venous Disorder (CVD) we describe a long-standing condition involving impaired venous return.
  • If vein valves don’t close properly, a reflux results: the blood leaks downwards and stagnates in the vein, thereby leading to venous hypertension. This condition is known as chronic venous insufficiency (CVI) which may cause edema, skin change, and, in some cases, ulcerations.
  • If left untreated, chronic venous insufficiency can result in the formation of serious disorders, including phlebitis and pulmonary embolism. To distinguish the different manifestations of CVD, the CEAP classification system is used.
  • Acute venous disorders usually occur without pre-existing conditions, but they can also be triggered by chronic venous disorders. In any case, medical treatment is immediately required. Acute venous disorders include superficial thrombophlebitis, deep vein thrombosis (DVT), pulmonary embolism, post-thrombotic syndrome, and variceal bleeding.

 

 

Further reading