Home Chronic Kidney Disease Medications What Is Peripheral Edema? Causes, Types, Diagnosis, Management

What Is Peripheral Edema? Causes, Types, Diagnosis, Management

by BidRx Team
massaging a peripheral edema on a calf

Highlights

  • Peripheral edema is characterized by swelling due to fluid accumulation in the body’s tissues, commonly affecting the arms, legs, feet, and hands.
  • The condition can stem from a variety of sources, including medical issues like heart or kidney disease, venous insufficiency, or factors such as obesity, pregnancy, and prolonged inactivity.
  • Symptoms include swelling, a feeling of heaviness, stretched or shiny skin, and skin that retains a dimple after being pressed.
  • Management involves lifestyle adjustments such as reducing salt intake, staying active, using compression garments, and managing underlying health conditions.
  • Medical consultation is advised if there is persistent or worsening swelling, pain, tenderness, difficulty in mobility, signs of infection, or if swelling appears asymmetrically.

If you notice sore, swelling ankles after sitting too long, or difficulty removing rings from puffy hands on a hot day, you may be experiencing peripheral edema. This common condition is caused by fluid that builds up, and this swelling can range from a little temporary puffiness to serious swelling that impacts your daily life.

Anyone can develop edema, but it may signal underlying health issues that may require medical attention.

What Is Peripheral Edema?

Edema is the medical term for swelling — specifically, swelling that’s caused by fluid trapped in the body’s tissues. It can also be due to factors other than fluid, such as inflammation or injury.

While edema can affect any part of your body, when it affects the hands, arms, feet, ankles, and legs, it’s called peripheral edema. Peripheral edema causes visible puffiness and discomfort in the affected areas.

A wide range of factors can lead to edema, including medical conditions, medications, and environmental factors. Symptoms can be mild and temporary or severe and chronic, depending on the underlying condition. Chronic and severe symptoms often indicate more serious underlying conditions that require medical intervention.

nurse taking a senior's blood pressure

Subtypes of Peripheral Edema

Peripheral edema is one of several types of edema that include pulmonary, cerebral, macular, and angioedema.

Peripheral edema can be classified into the following subtypes:

  • Lymphedema. Swelling caused by a blockage or damage to the lymphatic system, which can occur due to cancer treatment, surgery, or an inherited condition. It most commonly affects the arms and legs.
  • Venous edema. Swelling caused by impaired venous return, often due to venous insufficiency, deep vein thrombosis, or prolonged sitting or standing. This type of edema is often related to blood flow, and some people experience gravity-related venous edema after sitting or standing in one position too long.
  • Lipedema. A chronic disorder characterized by symmetric enlargement of the legs due to abnormal deposition of subcutaneous fat and fluid. Unlike other types of peripheral edema, lipedema does not typically respond to elevation or compression.
  • Pedal edema. Swelling specifically affecting the feet and lower legs, more common in older individuals and pregnant women. Pedal edema can be caused by a variety of factors, including heart or kidney conditions that impact fluid retention and blood pressure.

Not all swelling is the same. Each subtype of peripheral edema poses unique risks and complications. Identifying the specific subtype of peripheral edema is crucial for determining the underlying cause and developing an appropriate treatment plan.

Peripheral Edema Symptoms

In many cases, peripheral edema is related to blood pressure and the effects of gravity, causing fluid to pool in the extremities. Some of the most common symptoms of peripheral edema include:

  • Swelling or puffiness. This is typically most noticeable in the feet, ankles, and lower legs, but can also affect the hands and arms. The swelling may appear as a visible enlargement of the affected area.
  • Aching or heavy feeling. The excess fluid accumulation can cause a sensation of heaviness, aching, or discomfort in the affected limbs. This may be accompanied by a feeling of tightness or fullness.
  • Stretched or shiny-looking skin. As fluid builds up in the tissues, the skin may appear stretched, smooth, or shiny due to the increased tension.
  • Skin that retains a dimple after being pressed (pitting edema). When you press on the swollen area, the skin may retain a dimple or indentation for a few seconds to a few minutes, depending on the severity of the edema. This is known as pitting edema and can help healthcare providers assess the extent of fluid accumulation.
  • Decreased flexibility or range of motion. In some cases, peripheral edema may cause stiffness or decreased mobility in the affected joints, such as the ankles or wrists, due to the increased fluid pressure in the surrounding tissues.
  • Changes in skin temperature. Depending on the underlying cause of peripheral edema, the affected area may feel warm or cool to the touch compared to the surrounding skin.

If you experience any of these symptoms, particularly if they are persistent, severe, or accompanied by other concerning signs such as shortness of breath or chest pain, it is essential to consult your healthcare provider for proper evaluation and management.

Peripheral Edema Causes and Risk Factors

Peripheral edema can be caused by a variety of risk factors. Some of the most common include:

  • Age. Peripheral edema is more common in people over the age of 65 due to changes in the circulatory system and decreased mobility
  • Obesity. Excess body weight can put additional pressure on the veins and lymphatic system, leading to fluid retention in the extremities
  • Pregnancy. Pregnant women often develop peripheral edema due to increased pressure on the blood vessels and hormonal changes that promote fluid retention
  • Prolonged sitting or standing: Remaining in the same position for extended periods, especially in hot environments, can cause fluid to pool in the legs and feet
  • High salt intake: Consuming too much salt can lead to fluid retention and increase the risk of peripheral edema
  • Certain medications: Some blood pressure drugs, NSAIDs, and steroids can cause peripheral edema as a side effect
  • Venous insufficiency: Weakened or damaged valves in the leg veins can allow blood to pool, leading to venous edema
  • Lymphatic system damage: Conditions that damage or block the lymphatic system, such as cancer treatment or surgery, can cause lymphedema
  • Underlying health conditions. Conditions such as the following can contribute to the development of peripheral edema by affecting fluid balance and circulation:

pregnant woman in a doctor's appointment

Edema Diagnosis

Diagnosing peripheral edema involves a focused physical exam of the affected extremities, such as the arms, legs, feet, and hands. Your doctor will assess the extent and severity of the swelling, as well as any skin changes or signs of infection. They will also review your other symptoms and consider your overall health history.

During the physical exam, your doctor will determine the severity of peripheral edema by measuring pitting, or how quickly your skin bounces back after being pressed. The pitting edema grades are specifically relevant to peripheral edema and may not apply to other forms of edema.

The four grades of pitting edema are:

  • Grade 1. Skin returns to normal almost immediately with a 1-2 millimeter pit (sometimes called a depression or dimple).
  • Grade 2. Skin returns to normal in less than 15 seconds with a 3-4 millimeter pit.
  • Grade 3. Skin returns to normal after 15 to 60 seconds with a 5-6 millimeter pit.
  • Grade 4. Skin returns to normal after 2 to 3 minutes with an 8 millimeter pit.

Your doctor may also assess your pulse, blood pressure, and heart sounds to help determine the underlying cause of your edema, such as venous insufficiency or heart failure. They may inquire about your medical history, medications, and lifestyle factors that could contribute to peripheral edema, such as prolonged sitting or standing, salt intake, and any recent injuries or surgeries.

If your doctor recommends further examination, peripheral edema testing can include:

  • Blood tests. These may include kidney function tests, liver function tests, and thyroid hormone levels to help identify underlying conditions that could be causing the swelling.
  • Urine tests. To assess kidney function and check for signs of protein or blood in the urine.
  • Imaging tests. These may include ultrasound, X-ray, CT scan, MRI, or venous ultrasound/Doppler studies to assess blood flow in the legs and detect any blockages or valve problems that could be contributing to the edema.

Peripheral Edema Complications

When left untreated, peripheral edema can lead to:

  • Increasingly painful swelling. As fluid continues to accumulate in the affected extremities, the swelling can become more painful and uncomfortable.
  • Difficulty walking and performing daily activities. Severe swelling in the legs and feet can make it challenging to walk or carry out everyday tasks.
  • Stretched skin. As the skin stretches to accommodate the excess fluid, it can become itchy and uncomfortable.
  • Increased risk of skin infections and ulcers. The stretched, fragile skin is more susceptible to infections and the development of open sores (ulcers).
  • Permanent tissue damage. If left untreated, prolonged edema can lead to permanent damage to the skin, subcutaneous tissues, and muscles.
  • Reduced mobility. Swelling in the legs and feet can limit a person’s ability to move around, leading to a sedentary lifestyle and increasing the risk of other health problems.
  • Decreased quality of life. The discomfort, pain, and limited mobility associated with peripheral edema can significantly impact a person’s overall well-being and quality of life.

To prevent these complications, it is essential to identify and treat the underlying cause of peripheral edema, maintain a healthy lifestyle, and follow appropriate management strategies, such as compression therapy, exercise, and proper skin care.

Peripheral Edema Management and Prevention

Peripheral edema is often an indicator of an underlying health condition, so treating the root cause is key. Treatment and prevention measures for peripheral edema can include:

  • Diuretics (water pills). These medications help reduce fluid accumulation in the body, which can alleviate swelling in the extremities
  • Medication adjustments. If certain medications, such as calcium channel blockers, NSAIDs, or steroids, are causing peripheral edema, your doctor may recommend adjusting the dosage or switching to an alternative medication.
  • Managing underlying conditions. Treating underlying health conditions that contribute to peripheral edema, such as venous insufficiency, lymphatic disorders, or obesity, can help reduce swelling.
  • Compression therapy. Wearing compression socks, stockings, or sleeves can help improve circulation and reduce swelling in the affected limbs. However, consult with a healthcare provider before starting compression therapy. Inappropriate use can lead to complications, especially in individuals with peripheral arterial disease.
  • Exercise and physical therapy. Engaging in regular exercise and targeted stretches can help improve circulation, reduce fluid buildup, and maintain joint mobility in the affected extremities. Walking, swimming, or cycling can help improve circulation, reduce fluid buildup, and maintain a healthy weight. Aim for at least 30 minutes of moderate exercise most days of the week, or as tolerated.
  • Elevation. Elevating the affected limbs above the level of the heart, particularly when resting or sleeping, can help promote fluid drainage and reduce swelling. This is often more effective in cases where the edema is due to gravity and peripheral venous or lymphatic insufficiencies, rather than systemic issues like heart failure or kidney disease.
  • Lifestyle adjustments. Making changes to your diet, such as reducing salt intake and maintaining a balanced diet, can help minimize fluid retention.
  • Avoid prolonged sitting or standing. Changing positions frequently and taking regular breaks to move around can help prevent fluid from pooling in your lower extremities.
  • Protect your skin. Keep the skin in the affected areas clean, moisturized, and free from injury to reduce the risk of infection. If you have lymphedema, follow your healthcare provider’s instructions for proper skin care.

If your peripheral edema is related to pregnancy, symptoms will generally resolve after delivery. However, it is essential to monitor the swelling and report any concerns to your healthcare provider.

man experiencing swelling in his foot

When To Seek Medical Help for Peripheral Edema

In many cases, peripheral edema resolves on its own with healthy activity and elevation — especially if you’re experiencing occasional swelling due to hot weather or prolonged sitting.

However, if peripheral edema is causing pain, discomfort, or making it difficult to stay active, it’s important to consult your healthcare provider for proper evaluation and treatment.

Seek medical attention if you experience any of the following symptoms along with peripheral edema:

  • Persistent or worsening swelling: If the swelling in your extremities does not improve with home management strategies or continues to worsen over time.
  • Pain or tenderness. If you experience significant pain, tenderness, or warmth in the affected area, as this may indicate an underlying infection or inflammation. Pain or tenderness with edema can also indicate more severe conditions, like deep vein thrombosis (DVT).
  • Skin changes. If you notice any skin discoloration, such as redness or a bluish tint, or if you develop open sores or ulcers in the swollen area.
  • Asymmetric swelling. If you experience swelling or pain in only one leg, as this may be a sign of a more serious condition, such as DVT or a localized infection.
  • Difficulty with mobility. If the swelling makes it challenging to walk, move, or perform your daily activities.
  • Signs of infection. If you develop a fever, chills, or notice red streaks extending from the swollen area, these may indicate a serious infection, such as cellulitis.
  • Swelling that extends beyond the extremities. If you experience swelling in other parts of your body, such as your face, abdomen, or genitals, this may signify a more systemic condition.

In addition to these symptoms, if you have a history of heart, liver, or kidney disease, or if you are pregnant, it’s essential to promptly report any signs of peripheral edema to your healthcare provider for proper management and monitoring.

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This information is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. 

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