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Lymphology/Lymphedema

What is lymphedema?

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Lymphedema, or lymphatic obstruction, is a long-term condition in which excess fluid accumulates in swelling tissues (edema).

The lymph system is an essential part of the immune system and important to immune function. Within the lymphatic system the fluid called lymph circulates. Usually a blockage of this pathway causes lymphedema.

Lymphedema typically affects the legs or arms. In certain cases, it can involve both arms, or both legs. Some patients may experience headache, genitals or chest swelling.

Lymphedema is incurable but it can be managed with the proper treatment.

Important facts about lymphedema

Here are some of the primary points about lymphedema. In the main article, there is more explanation and facts to help.

  • Experts believe primary lymphedema is caused by genetic mutation.
  • Secondary lymphedema can be caused by other conditions such as infections and inflammatory diseases.
  • In some cases, lymphedema can lead to skin infections and lymphangitis.
  • Protecting the skin can help reduce the risk of lymphedema.

Treatment

Swelling is a typical symptom of lymphedema and commonly affects legs and arms.
Swelling is a typical symptom of lymphedema and commonly affects legs and arms.

Incurable lymphedema. Treatment can however help to reduce swelling and pain.

Complex decongestive therapy (CDT): This begins with a period of intensive therapy, during which the patient requires regular treatment and preparation. This is followed by the rehabilitation process when enabling the patient to take on their own treatment using the methods they were taught.

The four components of CDT are:

  1. Remedial exercises: These are light exercises aimed at encouraging movement of the lymph fluid out of the limb.
  2. Skincare: Good skincare reduces the risks of skin infections, such as cellulitis.
  3. Manual lymphatic drainage (MLD): The lymphedema therapist uses special massage techniques to move fluid into working lymph nodes, where they are drained. The lymphedema therapist also teaches several massage techniques that can be used during the maintenance phase.
  4. Multilayer lymphedema bandaging (MLLB): Wrapped over muscles surrounding lymph vessels and nodes to help the fluid move through the lymphatic system.

There is no central pump (heart), as opposed to blood circulation. The aim is to use bandages and protective clothing to stabilize the muscles and allow them to transfer fluid out of the part of the body affected. Patients will also be taught how to correctly apply their own bandages and compression garments so MLLB can continue throughout the maintenance time.

Historically, surgery has had poor outcomes compared with non-operative lymphedema treatments. A modern surgical technique using liposuction has turned out to be more effective though. It removes fat from the affected limb which leads to less swelling.

Causes

A CT scan
A CT scan can reveal blocked areas in the lymphatic system contributing to lymphedema.

Mutations can cause primary lymphedema in some of the genes involved in developing the lymphatic system. These defective genes interfere with the production of the lymph system, thereby weakening its capacity to adequately remove fluid.

Secondary lymphedema has many potential causes, including:

  • Cancer surgery: Cancer may spread through the body via the lymphatic system. Sometimes surgeons remove lymph nodes to stop the spread. There is a risk the lymphatic system may be affected, leading to lymphedema.
  • Radiation therapy: The use of radiation to destroy cancerous tissue can sometimes damage nearby healthy tissue, such as the lymphatic system; this can result in lymphedema.
  • Infections: Severe cellulitis infection may damage tissue around the lymph nodes or vessels. This may lead to scarring, increasing the risk of lymphedema. Some parasite infections can also increase the risk of lymphedema.
  • Inflammatory conditions: Conditions that cause tissue to swell (become inflamed) may permanently damage the lymphatic system, such as rheumatoid arthritis and eczema.
  • Cardiovascular diseases: These are diseases that affect blood flow. Some patients with cardiovascular diseases have a higher risk of developing lymphedema, such as DVT (deep vein thrombosis), venous leg ulcers, and varicose veins.
  • Injury and trauma: More rarely, severe skin burns or anything that results in excessive scarring may raise the risk of developing lymphedema.

Symptoms

Lymphedema affects the lymphatic system. This system has three main functions:

  • Draining excess tissue fluid: It balances the fluid in the blood and the fluid in the tissues. This is known as fluid homeostasis.
  • Fighting infection: It provides immunity by assisting the body’s immune defense against foreign bodies, such as bacteria.
  • Absorbing fats: It absorbs lipid nutrients from the intestine and transports them to the blood.

In the long term, a disturbance to the lymphatic system will weaken its ability to properly remove fluid. This can result in excess fluid building up in body sections.

Lymphedema raises the risk of infection and other complications, as lymphocytes are unable to enter areas of the body where swelling takes place.

Types

Two main forms of lymphedema exist:

Primary lymphedema – often called congenital lymphedema. At birth or shortly after puberty the lymphedema is apparent. This form of lymphedema is rare and affects around 1 in every six thousand people.

Secondary lymphedema – caused by something else, such as an illness , accident, trauma, or cancer that affects the lymph system.

Lymphedema may be a side effect of treatment for cancer, such as radiation therapy or the removal of the lymph nodes, which may weaken the lymph system. This type of lymphedema is more common.

Lymphedema symptoms include:

  • swelling of either a part or the whole leg or arm, including the fingers or toes, ranging from slight changes in limb size to severe swelling
  • difficulty wearing jewelry or watches or fitting into clothes or shoes
  • swelling in the head or neck
  • a heavy or tight feeling in the arms or legs
  • the range of motion of the limb is restricted
  • discomfort or aching in the affected limb
  • a tingling sensation in the affected limb, like pins and needles
  • recurring skin infections
  • thickening and hardening of the skin
  • blisters or wart-like growths on the skin
  • severe fatigue

Tests and diagnosis

A doctor may attempt to rule out any potential causes of swelling, including a blood clot or an infection not affecting the lymph nodes.

For example , if the patient is at risk of lymphedema, if they have recently had cancer surgery or treatment that involves the lymph nodes, the doctor might diagnose lymphedema based on the symptoms.

If there isn’t an obvious cause for the lymphedema, some imaging tests may be ordered. To take a closer look at the lymphatic system , the following imaging techniques can be used:

Lymphoscintigraphy may also be used – a radioactive dye is injected into the lymphatic system. The nuclear scanner displays the movement of the dye through the lymphatic system and can detect any blockages.

Exercises

People with lymphedema are advised to follow a healthy lifestyle which includes regular movement and exercise.

In certain situations, however, professional support may be required for safe and successful exercise.

A study found that if they do gentle lifting exercises, women who are at risk of lymphedema after breast cancer surgery would not have a higher risk of lyphedema in the arm. Such exercise can reduce the risk of lymphedema, the researchers add.

The types of exercises that might be useful are the ones that:

  • enhance flexibility
  • practice stretching
  • build strength

Aerobic exercise which focuses on the upper body, helps with weight loss and promotes deep breathing is also recommended.

It should be checked if any heaviness or form changes, texture or other changes in the limb. It may be an indication the current level of exercise is too high.

Experts believe that during exercise , the muscles act as a pump, moving the lymph to areas where it is needed.

But there is still insufficient evidence to support any particular form of lymphedema exercise. Women who have had breast cancer surgery are encouraged to seek out a specialist physical therapist or other health care provider who would be able to help them gradually build up exercise.

Complications

Some problems can be caused by frequent episodes or untreated lymphedema. Including:

Skin infections: Lymphedema is normal with frequent episodes of cellulitis. Cellulite is a bacterial infection of the deeper layers of the skin and the layers of fat and soft tissue under the skin.

Lymphangitis: An inflammation of the lymph vessels may develop and is typically caused by a Streptococcus bacterial infection when infectious. It can spread to the skin and adjacent soft tissues if left untreated, causing cellulitis, or into the bloodstream , causing bacteremia.

Psychological effects: The presence of lymphedema can be impaired and this can have a psychological impact , particularly in those who have had cancer. Lymphedema raises the risk of Depression.

Prevention

The affected limb is more vulnerable to skin infections because there is decreased supply of lymphocytes (which combat infection).

If the patient takes steps to mitigate the risk of skin cuts and grazes, their risk of subsequent infections can be decreased considerably. Might improve with the following measures:

Avoiding hot showers
Avoiding hot showers, steam rooms, and saunas may help prevent symptoms of lymphedema.
  • After cancer treatment, avoid heavy activity with the affected limb; rest it while recovering.
  • Avoid sun beds, steam rooms, and saunas.
  • Do not take very hot baths or showers.
  • Do not wear tight-fitting clothes.
  • Do not wear tight-fitting jewelry.
  • Don’t go barefoot outdoors.
  • Look for changes or breaks in the skin.
  • Keep your skin supple by moisturizing it every day.
  • Make sure footwear fits properly.
  • To prevent developing athlete’s foot, use an anti-fungal foot powder.
  • Use gloves when gardening.
  • Keep nails short.
  • When going outside in an area where there may be insects, use insect repellent.
  • When out in the sun, use a high factor sun block.
  • When you have a cut, treat it immediately with an antiseptic cream. And keep the area clean.
  • Raise the affected limb above the level of the heart whenever possible.
  • Avoid blood pressure checks, blood draws, or injections in the affected limb.

Diet, body weight, and obesity

The heavier a patient is, the greater the stress on swollen areas. A healthy diet aimed at an ideal body weight may help to relieve the lymphedema signs and symptoms.

Outlook

Lymphedema is not cured, it is a progressive condition. To some degree the outlook will depend on the severity of the symptoms.

Following a healthy lifestyle, including a balanced diet and exercise or movement, will help minimize fluid accumulation and promote lymph flow. Seek the advice of your doctor on the right choice for you.

Blood / Hematology

A comparison of CLL and multiple myeloma

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Both multiple myeloma and chronic lymphocytic leukemia are blood cancers that attack white blood cells. However, there are important variations between both cases. These distinctions pertain to the tumors’ symptoms, diagnosis, and therapy, as well as the outlook for people.

Cancers of the white blood cells include multiple myeloma and chronic lymphocytic leukemia (CLL). The body of a person with CLL creates an excessive amount of aberrant B cells. Multiple myeloma is a cancer that starts in a person’s plasma cells. Antibody-producing B cells are this type of B cell.

Having multiple myeloma and chronic lymphocytic leukemia at the same time is extremely rare, but it does happen.

This post compares the causes, symptoms, diagnoses, and people for various disorders, as well as the outlook for those who suffer from them. It will also cover whether multiple myeloma can progress to CLL and whether it is possible to have both illnesses at the same time.

Causes

multiple myeloma infamale
Offset Images

Multiple myeloma and CLL are both caused by an overabundance of B cells that grow in the bone marrow’s stem cells. The immune system’s B cells play an important role.

Causes of Multiple Myeloma

A 2021 review found that multiple myeloma is a kind of blood cancer that disrupts the production of plasma cells in the bone marrow. Scientists are still baffled as to what causes this ailment.

Multiple myeloma is caused by genetic mutations, but the exact cause is unknown. Nonetheless, there is some evidence that the following characteristics are risk factors for multiple myeloma:

  • radiation exposure
  • exposure to insecticides or organic solvents
  • obesity
  • alcohol consumption

CLL causes

CLL, another type of blood cancer that starts in the bone marrow, has a hereditary component, according to a 2021 study. It does, however, share some risk factors with multiple myeloma. These are some of the risk factors:

  • radiation exposure
  • tobacco smoking
  • exposure to benzene, although more research is necessary to confirm this

Differences

If a person has a parent or sibling who has CLL, their chances of getting it are five to seven times higher. This risk is decreased in people with multiple myeloma. If they have a first-degree family who has the disease, they are four times more likely to have it.

Despite the fact that multiple myeloma appears to run in families, the majority of people who develop the disease have no relatives who have had it.

Symptoms

Because multiple myeloma and CLL are slow-growing tumors, the first symptoms may take a long time to develop.

Both conditions have a lot of symptoms in common.

Overlapping symptoms

Why are the symptoms so similar?

Both multiple myeloma and chronic lymphocytic leukemia (CLL) start in the bone marrow. They promote excessive B cell growth, which interferes with the function of other, healthy blood cells.

Low blood count and bones

Multiple myeloma and chronic lymphocytic leukemia (CLL) can also affect the bones. Multiple myeloma, on the other hand, is more likely to induce symptoms like:

  • painful bones
  • weak bones
  • fractures

Multiple myeloma and CLL can cause a low blood count as a result of their effects on the bone marrow, which can lead to:

  • dizziness
  • weakness
  • shortness of breath
  • reduced resistance to infection
  • excessive bleeding

Calcium in the bloodstream

Hypercalcemia, which occurs when too much calcium enters the system, can cause additional symptoms of multiple myeloma and CLL. Hypercalcemia is more common in MM than in CLL, where only a few cases have been described. Hypercalcemia can result in the following symptoms:

  • weakness
  • confusion
  • abdominal pain
  • dehydration
  • extreme thirst
  • kidney problems
  • constipation
  • muscle aches
  • cramping

Kidney damage

Finally, both multiple myeloma and chronic lymphocytic leukemia (CLL) can induce severe kidney damage in their latter stages. This can result in:

  • shortness of breath
  • weakness
  • itching
  • leg swelling
  • kidney failure
  • electrolyte disturbances

Diagnosis

Blood tests and biopsies may be used in the diagnosis of multiple myeloma and CLL.

Diagnosis of multiple myeloma

Doctors can confirm a diagnosis of multiple myeloma if a person meets two criteria, according to the American Cancer Society (ACS). To begin, a biopsy must either show that plasma cells make up at least 10% of a person’s bone marrow or that a plasma cell tumor exists. Second, at least one of the following conditions must be achieved:

  • blood tests have revealed high blood calcium, anemia, or an unbalanced concentration of proteins called light chains
  • tests have identified poor kidney function
  • imaging tests have revealed holes in the bones
  • plasma cells make up more than 60% of the bone marrow

CLL diagnosis

The American College of Surgeons also outlines how doctors can diagnose CLL. A range of tests, including blood work and biopsies, can be used to diagnose multiple myeloma. The following are examples of results that indicate the existence of CLL:

  • blood contains too many lymphocytes, a type of white blood cell
  • presence of CLL cells in the bone marrow
  • evidence of CLL-causing genetic mutations, such as chromosomal changes
  • cancer cells in the lymph nodes

Treatment

Both multiple myeloma and CLL have a variety of therapy options. The specifics will differ from person to person based on the severity of their ailment and their body’s ability to endure potentially aggressive cancer therapies.

Watchful waiting

Treatment may not be essential until the person develops CLL or multiple myeloma symptoms. This strategy is known as “watchful waiting.”

It can take years for a person with multiple myeloma or CLL to develop symptoms.

Stem cell transplant

Multiple myeloma and CLL patients may benefit from a stem cell transplant. After a harsh form of treatment, doctors extract stem cells from a person’s blood and reinject them to help the body recuperate.

Cancerous cells can also be recognized as foreign for stem cells, which causes them to attack them.

Other common treatment options

In terms of treatment, multiple myeloma and CLL are very similar. The following are some therapy possibilities for both conditions:

Outlook

Many things can influence a person’s outlook in any situation. Some of characteristics, such as a person’s therapy receptivity, will vary substantially. Others, such as the impact of a disorder on a person’s mental health, can be difficult to quantify.

The 5-year relative survival rate is an important and valuable outlook indicator. This metric compares the chances of a person with a specific condition living 5 years after obtaining a diagnosis to someone who does not have the condition.

Multiple myeloma has a 5-year relative survival rate of 54 percent. It’s 87.2 percent for CLL. This, however, can vary depending on the severity and stage of the disease.

Scientists are making substantial medicinal advancements that are improving the prospects for people suffering from these conditions.

Can multiple myeloma turn into CLL?

Significant myeloma and CLL have multiple genetic similarities, according to a 2018 study.

Because of this overlap, some of the genetic mechanisms that generate multiple myeloma can also induce CLL. There is no scientific proof, however, that either condition can become the other.

Is it possible to have both at the same time?

It is possible for someone to have both multiple myeloma and CLL at the same time. Scientists believe this is highly uncommon, with about 0.26 percent of people with multiple myeloma also having CLL.

Conclusion

CLL and multiple myeloma are both cancers of the blood. However, they have differing effects on white blood cells.

CLL and multiple myeloma can share several symptoms due to their similarities. For each, people may undergo similar diagnostic testing, and some treatment options are similar. The outlook for people with these illnesses, as well as the amount to which heredity plays a role in the likelihood of developing them, are significant disparities.

Sources

  • https://www.ncbi.nlm.nih.gov/books/NBK534764/
  • https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.3019
  • https://seer.cancer.gov/statfacts/html/clyl.html
  • https://rarediseases.org/rare-diseases/chronic-lymphocytic-leukemia/
  • https://www.medicalnewstoday.com/articles/cll-vs-multiple-myeloma
  • https://www.cancersupportcommunity.org/chronic-lymphocytic-leukemiasmall-lymphocytic-lymphoma
  • https://pubmed.ncbi.nlm.nih.gov/25659943/
  • https://www.cancer.org/cancer/chronic-lymphocytic-leukemia/detection-diagnosis-staging/how-diagnosed.html
  • https://www.cancer.org/cancer/chronic-lymphocytic-leukemia/if-you-have-chronic-lymphocytic-leukemia.html
  • https://www.ncbi.nlm.nih.gov/books/NBK470433/
  • https://www.cancer.org/cancer/multiple-myeloma/causes-risks-prevention/risk-factors.html
  • https://www.cancer.org/cancer/chronic-lymphocytic-leukemia/detection-diagnosis-staging/signs-symptoms.html
  • https://www.cancer.org/cancer/multiple-myeloma/detection-diagnosis-staging/signs-symptoms.html
  • https://www.myeloma.org.uk/understanding-myeloma/related-conditions/smouldering-myeloma/
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637973/
  • https://www.cancer.org/cancer/multiple-myeloma/detection-diagnosis-staging/survival-rates.html
  • https://www.cancer.org/cancer/multiple-myeloma/detection-diagnosis-staging/testing.html
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165759/
  • https://www.nature.com/articles/s41408-018-0162-8

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Bones / Orthopedics

What is a ganglion cyst?

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Ganglion cysts are small sacs that are benign and filled with blood. They usually form on or close to a joint, or a tendon cover.

Typically these cysts form on the wrist but they can appear on the elbow, ankle, foot, or knee. Under the the skin they appear like tiny lumps.

Ganglion cysts aren’t cancerous and typically are harmless. If they cause discomfort, difficulty moving the joint or if the person feels unsightly, a doctor can remove them.

Ganglion cysts often affect people aged 15–40, and occur more often in women than in men. They are very popular, but doctors are not very aware of them. One study’s authors describe these as “enigmatic.”

What is a ganglion cyst?

Ganglion cysts
Ganglion cysts are benign lumps that often go away on their own.
Image credit: Kulzerwi, 2006

Ganglion cysts also turn up on the wrist’s neck. They are lumps that contain fluid in circular or oval shape.

This form of cyst can vary from pea size to golf ball size. The cyst on a stalk below the skin resembles a water balloon.

Ganglion cysts aren’t a major medical threat. But, if one presses on a nerve it may cause pain.

Those cysts may also make certain movements difficult depending on their size and position.

Symptoms

A ganglion cyst often forms around a joint, and by visually inspecting it, a doctor may usually identify one.

We can be flexible or heavy, and under the skin we should be able to move freely.

Location: Typically such cysts occur on the top or back of the hand. Or, they can appear on the wrist’s palm hand, on the finger base palm, or on the end joint of a finger. They can also develop on a foot, an ankle or a knee.

Pain: Ganglion cysts may or may not be painful, depending on whether a nerve is being pushed on.

Size: This can range from a pea to a golf ball.

The area surrounding the cyst can feel numb. If a cyst develops on the hand or on the wrist, the individual may lose control.

Causes

Doctors do not know what is causing cysts in the ganglion. They can form when a joint leaks to synovial fluid.

A ganglion cyst tends to attach to an underlying joint capsule or tendon sheath. They normally grow where a joint or tendon boosts out of place, naturally.

Risk factors

A young lady discussing her health condition with doctor
Ganglion cysts are most common in females aged between 15 and 40 years.

Risk factors tend to include:

Age and sex: ganglion cysts can affect anyone at any time, but they occur more commonly in females aged 15–40.

Overuse: People who use those joints regularly may have a greater risk of developing ganglion cysts. For example, female gymnasts may be particularly vulnerable to developing these cysts.

Joint or tendon injury: In an region that has suffered damage, at least 10 percent of ganglion cysts occur.

Trauma: They may form following a single incident or reoccurring small injuries.

Formation

Experts do not know exactly how ganglion cysts form.

However, it appears that:

  • Joint stress may play a role, as the cysts often develop in sites of overuse or trauma.
  • They may develop following a leak of synovial fluid from a joint into the surrounding area.

How or why this happens is not entirely clear.

Diagnosis

A doctor usually shines a light into the cyst to see if the contents are either transparent or opaque. The liquid should be clear and thick inside a cyst of the ganglion.

Imaging scans, such as an X-ray, ultrasound or MRI, will help a doctor determine the nodule’s cause and rule out any issues.

Treatment

A ganglion cyst does not generally require care, as long as it does not cause any irritation or pain. Without intervention, up to half can vanish, but some take many years to resolve altogether.

If the cyst is pressing on a nerve and causing pain, a doctor may prescribe some sort of treatment.

Home remedies and tips

The following will help if a cyst causes discomfort:

Adapting footwear: If the cyst is on a foot or ankle, shoes do not rub or irritate it. Wearing soft or open shoes, adding padding, or lacing the shoes in a different way can help.

Immobilization: Moving the affected area can increase the size of the cyst. Wearing a splint or brace will help restrict movement, and this can lead to a diminishing cyst.

Pain relief: Over-the-counter pain medicine, such as ibuprofen, can help if the cyst is painful.

Should I hit it with a blunt object?

A traditional remedy involves hitting a ganglion cyst with a heavy object, like a book.

There’s little evidence, however, that this approach is safe or successful. Doctors don’t encourage people to do so, since the blow could damage underlying body structures.

Dr. Owen Kramer explained to Nccmed:

“It would be a really bad idea to touch some sort of protrusion or nodule, like a cyst of the ganglion, in the hopes it will make clear. This may result in serious injury. “Individuals should therefore not attempt to” pop “their cysts, because this can lead to infection, and the problem is unlikely to be resolved.

If a person has serious pain they should talk about treatment with their doctor.

Removal

Ganglion cysts vanish without care in up to 50 percent of cases. However, if the cyst is large, painful or causes problems, a doctor may recommend removing it with one of the following techniques:

Aspiration: This involves removing the cyst fluid. However, the cyst can form again, since the underlying structure remains. Some people have to go through the process several times.

Surgery: A surgeon can make a small incision and remove the stalk and the cyst. Keyhole surgery, or arthroscopy, is an option, too.

A small study published in 2006 showed that after this surgery, about 30 per cent of cysts returned.

Researchers writing in 2014, however, noted that arthroscopic surgery could be the way forward in solving ganglion cysts. Open surgery can leave a “unsightly scar,” they noted.

Recovery

Pain relief drugs
Over-the-counter pain relief may help with recovery after surgery.

The person should keep the area covered after surgery, and protect it from accidental bumping.

Other tips include:

  • following the doctor’s aftercare recommendations
  • wearing a splint for a few days, if the cyst was on the hand or wrist
  • using over-the-counter pain relief, if necessary
  • keeping the extremity raised to reduce the risk of swelling

If discomfort persists, see the doctor.

Outlook

A ganglion cyst does not pose a significant health concern. However, if it causes any pain or movement restriction, talk to a doctor, who may prescribe a procedure to remove it.

Surgical procedures may leave a scar, and the cyst is at risk of developing again.

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Cardiovascular / Cardiology

Remedies for swollen feet during pregnancy

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During pregnancy many women experience swollen feet. Swelling is common at this time because extra fluid is retained in the body to protect and support the growing fetus.

Swelling of the feet usually occurs later during pregnancy, when the weight of the uterus and fetus places extra pressure on the feet and legs. This pressure can lower the circulation and increase the accumulation of fluid which causes swelling.

Here, we look at the steps women can take to reduce swelling in their home. We also discuss symptoms that might indicate more severe conditions and explain when to see a physician.

Causes

foot swelling during pregnancy
Various home remedies may help reduce foot swelling during pregnancy.

In certain parts of the body swelling is a normal part of pregnancy. It often happens because the body produces extra fluid to help fetus development. Circulation also slows down, which could lead to fluid buildup.

The feet and ankles will swell, because with the growing fetus the uterus expands, putting more strain on the lower body’s veins.

In later stages of pregnancy, or the third trimester, swelling in the feet is more common. This is because the fetus is larger and puts more pressure on the legs and the feet.

Commonly swelling in women who experience swollen feet during pregnancy is:

  • appears gradually
  • is worse in hot weather
  • appears worse by the end of the day
  • lessens when they lie down or raise the feet
  • is equal in both feet

Home remedies

During pregnancy, women may be able to reduce swelling of the feet by taking the following steps at home:

  • avoiding standing for long periods, as this can increase pressure in the legs and feet and cause more swelling
  • elevating the feet slightly to increase blood flow toward the heart
  • raising the legs on pillows while sleeping
  • wearing supportive tights or compression stockings to help improve circulation in the legs
  • keeping active throughout the day, with short walks or gentle exercise
  • limiting salt intake
  • staying hydrated and drinking 8–10 glasses of fluid each day to help prevent the body from holding onto excess water
  • avoiding caffeine, as it is a diuretic, which means that it promotes the increased production of urine
  • wearing loose, comfortable clothing
  • wearing loose socks and comfortable shoes
  • avoiding sitting for long periods
  • staying cool and spending limited time outdoors in hot weather
  • sleeping on the left side of the body, which can help increase blood flow to the heart
  • trying massage or reflexology to improve circulation

Exercises

Exercising foot while resting can help to improve circulation.

Before doing the movement with the opposite foot, pregnant women will try to lift one foot off the floor and move it up and down 30 times.

They can then lift one foot off the floor and rotate it eight times in the clockwise direction and then eight times in the anticlockwise direction. They will try this again with the opposite foot.

Medical treatment

Swollen feet are a common effect of pregnancy though they may be painful. Medical treatment is unlikely to be required and many women with home remedies will alleviate the swelling.

However, if an underlying condition causes the swollen feet a woman may require medical attention.

Complications

Swelling can sometimes signify a health problem during pregnancy. Women should immediately contact their midwife, doctor, or health-care team if they experience any sudden or rapid swelling increase.

Preeclampsia

A sudden swelling of the feet may be a symptom of preeclampsia. Woman may also experience a swollen or puffy face, swelling around the eyes or sudden swelling in the hands.

If the swelling in the feet is severe, pressing down into the skin may leave a few seconds of indentation. Some discoloration may also occur in the legs.

Preeclampsia is a disease of health, which can occur during pregnancy or postpartum. Preeclampsia leaves the pregnant women with very high blood pressure and organ issues.

This happens most often after 20 weeks of gestation, or up to 6 weeks after birth. Preeclampsia can progress quickly, and it can be very dangerous for the woman and the fetus without treatment.

To lower the blood pressure, a doctor can prescribe antihypertensive drugs. If the pregnancy has reached 37 weeks or more, healthcare professionals can advise early delivery of the fetus.

Deep vein thrombosis

A blood clot, known as deep vein thrombosis (DVT), can suggest irregular swelling of the feet or legs.

Pregnant women and women who have given birth within the last 3 months have a greater risk of DVT than non-pregnant women. The explanation for this is that during pregnancy, blood clots more quickly to avoid excess blood loss during labor and birth.

The rising fetus often puts pressure on the legs, reducing circulation. During both pregnancy and post delivery recovery period being less mobile than normal can also reduce blood flow in the legs.

A doctor may prescribe a drug called low-molecular-weight heparin to prevent or treat blood clots and DVT. They will inject the drug under the skin.

When to see a doctor

If women have any concerns about swollen feet during pregnancy or are unable to reduce unpleasant symptoms, they should address treatment options with their health care provider.

If they encounter any of the following symptoms they should call their doctor or midwife immediately:

  • a sudden increase in swelling in the feet
  • sudden swelling in the hands or face or around the eyes
  • a severe headache or a constant dull headache
  • blurred vision or seeing “stars” or flashing lights
  • severe pain below the ribs or in the abdomen, especially on the right side
  • nausea, vomiting, or feeling unwell
  • swelling is present at the beginning of the day and does not improve when lying down or raising the feet

The above symptoms can all be signs of preeclampsia, and women who are pregnant may need immediate medical attention to avoid worsening of the disease.

Women should also contact their doctor straight away if they notice that:

  • one foot or leg is more swollen than the other
  • there is pain or heat in the calf or elsewhere in the leg
  • the skin on the leg is red or discolored

DVT could be demonstrated by irregular swelling or pain in the hip. DVT can lead to blood clot moving to the lungs and causing a pulmonary embolism without treatment. It is important to seek medical attention straight away for:

  • difficulty breathing
  • chest pain, which worsens when coughing or breathing deeply
  • coughing up blood
  • increased or irregular heartbeat

Summary

Swelling of the feet is usually a common characteristic of later pregnancy stages and is not a cause of concern. During pregnancy the body absorbs the excess water. Additionally, fetal pressure will decrease circulation in the legs, which causes swelling in the feet.

Home remedies for swollen feet during pregnancy include elevating the feet and wearing loose, comfortable shoes while sitting down. Drinking plenty of water, doing regular gentle exercise, and avoiding standing up for long periods of time can all help.

When pregnant women experience a sudden increase in swelling of the feet, hands, or ears, or around the eyes, they should immediately contact a doctor.

Sudden swelling can be a sign of preeclampsia which requires medical attention. Also, pregnant women should contact their doctor immediately if they have irregular swelling, discomfort, redness, or warmth in one leg, since these symptoms may suggest DVT.

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