Chronic Swelling

Chronic Venous Insufficiency, Lymphedema. You may or may not know if you have it but you do know if you have pain, swelling, or fluid retention in your legs and feet. If you are ready to get your mobility back, call us at (415) 353-5715 or book online to the right. If not, read on to see how we can help! Hope to see you soon!

Dr. Magdalena Blasko, DPM offers treatment for chronic swelling in San Francisco, CA.

Chronic swelling which is scientifically known as edema, occurs when excess fluid is trapped within the body’s tissues. Edema is commonly seen in hands, ankle and feet as well as the abdomen. Chronic swelling of the legs and feet can occur due to many reasons. 

It may be a result of underlying medical disease such as chronic kidney disease or advanced chronic liver disease. Chronic swelling may also be a result of poor venous circulation. More specifically, long-standing swelling which creates changes in the soft tissue is called lymphedema.

If your feet are constantly swollen, then it is time to visit your podiatrist. Our specialized team at Magdalena Blasko, DPM, Inc. can help you determine why your feet are swollen and the best way to handle the issue. If the underlying condition is serious, we will take the necessary steps to treat you and direct you to the suitable specialist as needed.

What are the causes of chronic swelling of your feet?

  • Chronic kidney disease – when kidneys fail, excess fluid and sodium is retained in your blood because of the kidney’s inability to filter it out, leading to swelling in parts of your body such as your hands and feet, where the blood pressure is the lowest.

  • Cirrhosis – when the liver is damaged, it leads to liver failure and fluid will start to accumulate in your feet and abdomen.

  • Congestive heart failure – when your heart fails, it loses the ability to pump blood effectively. As a result, the blood at the furthest points from the heart slows down, allowing fluid to be retained in your feet.

  • Chronic venous insufficiency – when the one-way valves in your legs get damaged or weakened, blood will not return effectively back to your heart. The blood will pool in your leg veins leading to chronic swelling of your ankles and feet.

  • Lymphedema – the lymphatic system in your body helps to clear excess fluid from tissues. When the lymphatic system is damaged, fluid draining will not occur effectively, leading to chronic swelling. This is especially common after surgery on your lower extremities, removal of tumors (like cancer) or lymph nodes, or crush injuries with extended healing time.

  • Severe protein deficiency – an extreme lack of protein in your diet for a long time can lead to fluid accumulation and chronic swelling of your feet. This is potentially very dangerous because it is occurring without you noticeably realizing it.

  • High water intake with insufficient salt and protein intake

What are the symptoms and signs of chronic swelling?

If chronic swelling of your feet is left untreated you may develop the following symptoms:

  • Puffiness or swelling of your feet may be bilateral or unilateral.

  • Pain and difficulty in walking with a feeling of heaviness towards the end of the day.

  • Skin will look stretched and shiny or discolored.

  • Skin may develop minute cracks that initially feel itchy, but also may present themselves as small leaky areas almost invisible to the eye. If this is the case, you will notice your clothes getting wet.

  • Overlying skin as well as the veins inside the legs can get inflamed.

  • When pressed for several seconds your skin will retain a pit, or dimple, showing a lack of skin elasticity.

  • Cellulitis, skin ulceration and fungal infection or the webbing between your toes.

How is chronic swelling of the feet diagnosed?

By obtaining a thorough history, clinical observation and examination, we will be able to correctly diagnose the underlying condition. Once the cause is determined a treatment plan will be designed to help you.

Laboratory tests will be ordered to exclude the causes of chronic swelling that we don’t provide services for. For example, a renal profile and liver profile to exclude kidney or liver dysfunction. We will refer you to the appropriate specialist for any of these issues.

An MRI scan of your feet will reveal the extent of tissue damage and the extent of edema. A venous duplex scan will help to identify chronic venous insufficiency. An ultrasound scan of the lymphatic system will help to diagnose chronic lymphedema.

How can a podiatrist help in chronic swelling?

If there is skin infection or cellulitis is found in your swollen feet, a course of antibiotics will be prescribed. If there is chronic fungal infection, a topical antifungal or a course of oral antifungal medication will be prescribed.

Management of chronic venous insufficiency will be treated with leg elevation and compression stockings to improve venous return. If there are chronic ulcers, proper ulcer management and wound debridement (cleaning) will be necessary.

If the overlying skin is dry and inflamed, you will be advised on daily hydration and application of emollients to keep skin moisturized. Topical steroid creams will be used if the skin is too severely inflamed.

The mainstay of lymphedema management involves complex decongestive physiotherapy which includes manual lymphatic massage and use of multi- layer bandages. Compression stocking will also help. Pneumatic compression devices will be used in some patients.

If you are diabetic, we will advise you on how to keep your blood sugar values in check. In some instances, our specialists will prescribe a diuretic to alleviate excess fluid in your feet, while all patients will be crafted a proper foot care regime to practice at home. 

Chronic swelling of your feet can be unpleasant at the best of times and signal serious health conditions at the worst. If you are worried about your persistent swelling, you don’t have to live with it. Our team at Magdalena Blasko, DPM, Inc. will help you eliminate the swelling and keep your feet feeling their best.

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