An abnormal buildup of fluid in tissues called edema is what causes swelling in the legs. Sometimes, painfully swollen legs can be caused by lymphatic dysfunction. In other cases, edema can result from long-standing venous reflux. A venous disease that causes spider veins and varicose veins. It can lead to more serious conditions, such as ulcers or skin discoloration.
Bulging and swollen veins may appear in cases of edema caused by venous reflux. These veins typically resemble varicose veins, which are twisted veins that bulge near the surface. In other cases, edema caused by venous reflux can occur without the appearance of bulging veins.
Where Does Swelling Appear?
Edema typically causes swelling first in the area around the ankle bones and then spreads to the lower legs, calves and feet.
Those that suffer painful swollen legs and ankles from edema, the swelling may be constant or it could vary throughout the day. In cases of constant edema, lymphedema may also be a contributing factor. Since swelling often decreases with leg elevation, it may be less visible in the morning. It then will become more visible in the evening, after a day of sitting, standing, and walking.
What Causes Leg Swelling Related to Edema?
While edema in legs can be caused by lymphatic dysfunction or even a blood clot, painful swollen legs and ankles can also be caused by the progressive stages of venous disease. In these cases, venous reflux forces fluids to collect and pool in the tissues around the ankle and lower legs, causing the tissues to swell.
Several factors can contribute to the venous reflux that causes edema:
- Genetics — Determines more than anything else whether a patient will develop vein disease
- Obesity or weight gain — Excessive weight causes vein disease to progress more quickly
- Prolonged sitting or standing — Lack of physical activity from sedentary lifestyles and certain occupations prevents muscles from helping pump blood
- Gender — Vein disease is more common among women
- Pregnancy — Elevated blood volume, hormone levels and pressure on the leg veins due to an enlarging uterus
- Surgery or injury (especially near the pelvis) — Veins that are damaged can restrict blood flow from the legs back to the heart
- Blood clot — Clots that form inside veins can cut off blood flow entirely
Symptoms Related to Edema and Painful Swollen Legs and Ankles
Edema that causes swelling in the legs from venous reflux can lead to several symptoms:
- Leg Swelling in the areas around the ankle and lower leg
- Puffiness of the skin, which may cause it to appear stretched and shiny
- Thinning of the skin
- Pain in and around the affected areas, most notably the ankle and calf