LEG SWELLING AND LYMPHEDEMA

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Swelling in the legs is usually caused by fluid buildup under the skin, known as edema. Swelling of the legs can also be caused by trauma, blood clots, deep vein thrombosis, primary or acquired lymphatic disease, infection, or illness. Standing or sitting for a long time can cause leg swelling. 

Leg swelling can also be caused or contributed by venous and other lymphatic problems. When leg veins can't pump blood back into the heart as efficiently as they should, that's called venous insufficiency. Associated varicose veins are a sign of venous insufficiency, but they can also be just cosmetic. A blockage in the lymphatic system, known as lymphedema, or fat deposition underneath the skin, known as lipedema, can also cause leg swelling. Leg swelling can also be caused by kidney, liver, and heart problems. 

Medications can cause leg swelling, an often-underestimated cause. Discuss all your medications with your doctor. These are some examples:

1. Amlodipine (Norvasc) used to lower blood pressure,
2. Gabapentin (Neurontin) and Pregabalin (Lyrica) are used to treat nerve pain,
3. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin, Advil) and naproxen (Aleve),
4. Some oral contraceptive pills that contain estrogens (which also increase the risk of blood clots)
5. Steroid medications like prednisone may increase salt retention,
6. Pioglitazone (Actos) and rosiglitazone (Avandia) are used to treat diabetes.

Identifying the cause of recent onset or worsening leg swelling is important because some causes like organ failure and blood clots can be life-threatening. There aren't always associated symptoms like chest pain or shortness of breath, so patients shouldn't self-diagnose, but rather see a doctor.

There are certain things that can help people with uncomplicated mild to moderate chronic edema, such as lifting their legs above their hearts when they are lying down. While traveling or working, make sure you exercise regularly and move around frequently to assist your legs in pumping fluid back to your heart. One of the most important things to do is to lose weight if you have excess weight and to consume less salt. Wear graduated support hose to help your veins pump more efficiently, and avoid tight clothing. 

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