Having swollen feet or hands is called “edema”, a term derived from the Greek verb meaning “to swell”. An estimated 4.4 million people in the U.S. have edema; although swelling can occur in and around the eyes or brain, the most common edema is peripheral, concentrating in the upper and lower extremities.
Edema may be general or localized and can appear suddenly, but mostly its appearance is subtle, where a person can wake up with one morning with puffy eyes or a patient has gradually gained weight. This swelling of hands, arms, ankles, feet, and legs is caused by fluid retention and is usually linked to the lymphatic system.
When tiny blood vessels leak fluid into the surrounding tissue, the area begins to swell, due to increased pressure or capillary damage. These leaking capillaries can cause the kidneys to accumulate higher than normal levels of salt and water to compensate for capillary fluid loss. As a result, more blood circulating in the body in turn causes further capillary leakage, producing extra swelling, as this becomes a vicious cycle.
The swelling of hands and feet can be caused by various reasons, and one of them is physical exertion in high temperatures, where the body becomes less efficient at removing fluid from tissues, especially the ankles. Edema in the legs can be due to blood clots, varicose veins, cysts/growth/tumors, or lymphedema, where the body cannot get rid of excess fluid from tissues. Along the same lines, if a person has experienced a burn, the body reacts by retaining fluid, causing the localized area to swell. Other conditions, such as allergies (e.g. reaction to MSG), or arthritis causes inflammation to the lining of joints which results in swelling.
Edema can also be caused by diseases such as kidney disease, where the organ is unable to eliminate enough water and salt from the blood. People with heart failure cannot pump blood properly, and it accumulates in the limbs, causing edema. A person with chronic lung disease accumulates fluid in the lungs, and this results in pulmonary edema. Patients with liver disease also have fluid retention, especially in the abdominal cavity.
Women are more susceptible to edema than men, due mostly to fluctuating hormonal levels during the phases from womanhood, from pre-menstrual to menstrual, pregnancy, and menopausal cycles. Before a female has her period, the hormone progesterone decreases and this causes water retention. Women on contraceptive pills may also retain fluid caused by estrogen, and it is not uncommon for a female to put on weight when first put on the pill.
Pregnant women typically have swollen hands and feet due to retention of salt and water, again due to release of hormones. At the same time, an enlarged uterus can cause obstruction of the femoral veins, leading to edema. Since a pregnant woman’s blood clots more easily, there is risk of DVT (deep venous thrombosis), causing edema. There is also risk of induced high blood pressure, called Eclampsia, which causes pregnant women to have swelling in the hands and feet. During and after menopause, where there are further hormonal fluctuations, fluid is retained; women on HRT (Hormone Replacement Therapy) can also experience edema.
Swelling can also be caused by taking certain medications such as NSAIDS (non-steroidal anti-inflammatory), estrogens, vasodilators (drugs that open blood vessels), calcium channel blockers, chemotherapy and some diabetic drugs.
That said, there are several things a person can do to alleviate swelling. Exercise is something everyone can and should do, as any kind of physical activity helps pump fluid from the legs to the heart. To help with swelling in the legs, a person can also wear support stockings, and elevate their legs above the heart, whenever one is lying down.
One should avoid sitting or standing for long periods of time. Whenever possible, stretch arms and legs. Even if one has restricted movement either traveling by car or air, always induce some kind of circulation by rotating the ankles, lifting legs up and down while sitting to get the blood flowing. Whenever possible, get up and walk about a bit, even if it is up and down the airplane aisle. For extra long trips, wear loose-fitting footwear such as slippers or sandal, so one’s feet are not bound too tightly.
If being overweight is a problem, lose weight, eat a low-sat diet, and avoid extreme temperatures such as taking a hot bath, shower, or saunas. In cold weather, dress warmly. Getting a massage from a professional masseuse can help work the movement of fluid towards the heart to help with better circulation.
At the same time, having swollen feet and hands may be indication of a more serious health problem. If one is short of breath or feeling chest pain/pressure/tightness, may be at risk for a heart attack. If one has a fever or one’s leg is warm to the touch; if there is history of liver disease; or if one is pregnant and there is a sudden increase in swelling, one should see a doctor.
A patient will be asked about his/her medical history; his/her current state of health; how long signs/symptoms have existed; permanent or intermittent signs; whether a patient has had edema before. Underlying causes to severe swelling in the lower extremities can be diagnosed by various tests: CBC blood tests, ECG, chest or extremity x-rays, liver and heart function tests, or urinalysis.
Long-term edema can bring about complications that make walking difficult, sometimes with an awkward gait. Edema can cause stiffness, pain, plus the swollen part can become infected. Poor blood circulation can cause arteries/veins/joints to lose their elasticity, not to mention ulcerations of the skin and scarring between layers of tissue. At any point, the aim is to make one as comfortable as possible by practicing home treatment and using professional care to address issues of swollen hands and feet.