Edema (Swelling): Causes, Treatment, and More
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Medically reviewed by Jane Kim, MD
Swelling occurs due to excess fluid under your skin. The swollen area may feel puffy or firm to the touch, or you may see your skin stretch over the extra fluid. Edema is the most commonly used medical term to describe this condition.
Localized edema occurs in a small area of your body, like a finger joint. You can also have full-body edema, known as anasarca.
Slight swelling, especially in your lower legs, is common in certain situations. For example, you might experience edema in very hot weather, after sitting for long periods of time, or during pregnancy. However, it can also be a symptom of a more serious condition. Knowing the cause of the swelling helps determine the most effective treatment.
Types
Swelling is generally categorized based on symptoms, location, and cause.
One common symptom is "pitting." Your healthcare provider might push on the area of suspected edema with a fingertip and look for a depression or "pit." They will estimate how deep the hole is and see how long it takes for the hole to refill:
Pitting edema: After about five seconds of pressure, a dimple or pit in the swollen area appears and slowly fills back up.
Non-pitting edema: The skin does not move (no pits form) after five seconds of pressure.
Swelling is also described based on location. Medical terms to describe location-based swelling include:
Peripheral edema: Swelling of your limbs, anywhere along your arms or legs. It's more common in your lower legs due to gravity. If swelling occurs in your feet and ankles, your socks and shoes might feel tight.
Ascites: Swelling in your abdomen (belly).
Pulmonary edema: Swelling in the soft tissue of your lung or lungs, which can make breathing more difficult.
Pleural effusion: Swelling between your lungs and chest wall (in your chest cavity but outside your lungs).
Anasarca: Generalized full-body swelling.
Causes
Normally, a small amount of fluid regularly leaks out of your blood vessels (intravascular space) into the surrounding tissue (interstitial space). The fluid remains for a while before being collected by the lymphatic system and returned to circulation in the blood vessels. The lymphatic system is a part of the immune system that produces, stores, and transports white blood cells throughout the body to fight infection. Edema occurs when there's an imbalance of fluid: either more fluid exits the intravascular space or less fluid exits the interstitial space.
There are many potential causes of generalized and localized swelling.
Diet
Several factors related to diet to can cause swelling, including having an eating disorder or consuming large amounts of sodium (salt).
A diet high in sodium can lead to water retention and swelling. Electrolyte imbalances play a role in this. Electrolytes are essential minerals, including calcium, potassium, and sodium, that help your body use fluids and function efficiently. Consuming excess sodium increases the amount of fluid in your body.
Edema is also a possible symptom of malnourishment. If you do not consume enough calories, your body is unable to make the protein necessary to keep fluids in your blood vessels. When the fluid leaks out into the tissues, you can develop swelling.
Edema can occur with eating disorders like anorexia nervosa and bulimia. Anorexia nervosa is characterized by abnormally low body weight, a fear of gaining weight, and a distorted view of your body. Bulimia is characterized by repeated cycles of bingeing (overeating) and purging (for example, by vomiting or using laxatives), as well as extreme dieting and exercise. Causes of swelling with eating disorders might be due to various factors, including electrolyte imbalances.
Related: Signs of an Eating Disorder You Shouldn't Ignore
Pregnancy
Edema is a common symptom of pregnancy. Nearly 80% of pregnant people develop swelling sometime during their pregnancy. It is normal for a pregnant person to gain over two gallons (eight liters) of fluid as the fetus grows. You may also experience swelling in your hands and feet, which may increase later in the day or after long periods of standing or walking.
During pregnancy, the body produces about 50% more body fluid and blood. About 25% of weight gain during pregnancy is due to extra fluid retention, which helps prepare the body for labor and delivery. Edema generally increases later in pregnancy, often starting around month five.
Injury
When you have an injury, immune cells are sent to the site of your injury to defend your body from harmful substances. This is called an immune response. The immune response triggers your blood vessels to leak more fluid and stimulate inflammation in the area, both of which often create localized swelling.
Injuries that can cause swelling at the area of an injury include:
Sprained joints (for example, ankle or finger joints)
Hitting an object (for example, hitting your head on a cabinet door or hitting your hand on a doorway)
A cut, scrape, or abrasion to your skin
Lymph Node Removal
Surgeries to diagnose or remove cancer often include the removal of lymph nodes. Lymph nodes are bean-like structures that contain white blood cells and filter foreign substances, like infections. They're located throughout your body, including your lungs, neck, armpits, and groin.
Without lymph nodes, interstitial fluid may not effectively return to the body's circulation. This causes a build-up of lymphatic fluid—a fluid in your lymphatic system composed of white blood cells, proteins, and fats—and can lead to a condition called lymphedema.
Lymphedema often requires specialized care, so reach out to a healthcare provider if you think you have new or worsening lymphedema after surgery.
Medical Conditions
The internal organs work together to balance your body's fluid levels. Conditions that affect your heart, kidney, or liver can cause edema. Conditions that commonly cause generalized swelling include:
Heart disease: Can cause swelling in the legs or abdomen
Kidney disease: Can cause swelling in the lower legs and around the eyes
Liver disease, including cirrhosis (liver scarring): Can cause swelling in the lower legs or abdomen
Deep vein thrombosis (DVT) can cause sudden swelling. DVT is a condition in which a blood clot forms in at least one vein deep in your body. It often occurs in your thigh, lower leg, or pelvis.
Chronic venous insufficiency is a condition that causes veins in your legs to become less effective over time. This can be due to weak valves in veins that allow the blood to flow backward (toward your feet). It can also happen when there is a blockage, often a blood clot, as the blood tries to move upward. The veins become leakier and struggle to return blood from your lower legs to your heart.
Symptoms of chronic vein disease include swollen legs, often with pitting edema. Your legs may become heavy and hard to move due to the extra fluid.
Medications
Some medications can cause the body to retain water and swell. This swelling usually occurs due to leaky arteries, leaky capillaries, water and salt retention, or lymphedema.
Common drugs that can cause swelling include:
Cancer treatments like Taxol (paclitaxel) and Cytoxan (cyclophosphamide)
Blood pressure-reducing medications like Lopressor (metoprolol) and Apresoline (hydralazine)
Pain relievers like Advil (ibuprofen)
Neurontin (gabapentin), a medication used for seizures and nerve pain
Corticosteroids (a class of drugs that reduce inflammation), including prednisone and cortisone
Reactions to medications can also cause angioedema, a condition in which fluid leaks out of blood vessels into surrounding tissues. Symptoms include sudden swelling in areas like the face, throat, limbs, or genitals. If a medication causes swelling, you can talk to your healthcare provider about switching to a new medication.
Treatment
Treatment for swelling depends on your symptoms, as well as the cause. A healthcare provider can help you identify the cause and develop an effective treatment plan.
Medications
You might not need medication to reduce swelling. For example, edema caused by pregnancy, menstrual cycles, hot temperatures, or sitting for long periods of time does not usually require medical treatment.
Diuretics or water pills are commonly used to reduce swelling. These medications help your body get rid of excess fluid. They need to be prescribed by a healthcare provider and should only be taken while under their care. Diuretics and water pills can cause dangerous changes to levels of important blood substances like potassium and sodium and can cause dangerously low blood pressure.
A healthcare provider might also prescribe blood thinning medications, which can help break up a blood clot that's causing edema.
Home Remedies
Home remedies can help reduce swelling, including the following:
Wear loose-fitting clothing including shoes and socks to improve circulation.
Elevate swollen areas when possible. Putting your feet up on a stool or placing your arm on extra pillows in bed (above the level of your heart) for 30 minutes can help move fluid out of a congested area. Aim for three or four elevation sessions per day.
Compression garments, including socks, stockings, and sleeves, may be recommended by your healthcare provider to help manage edema in your limbs. These garments fit very tightly and apply pressure in order to improve circulation.
Try moderate amounts of gentle exercise to help move excess fluid. Follow instructions from your healthcare team regarding how much and which types of exercise to incorporate.
Reduce the amount of sodium (salt) you consume. Avoid adding salt when cooking and check food labels for sodium content.
Cold Therapy
Cold therapy, such as using ice packs, has been standard care for many years for acute injuries (injuries that occur suddenly, including sprains, strains, and fractures). It is generally believed that cold helps reduce swelling and relieve pain. However, there is little evidence that cold is helpful for treating acute injuries. Applying ice for longer periods of time may even delay healing and prolong the recovery process. More research is needed to better understand how cold therapy affects the healing process.
Prevention
You can prevent or minimize swelling not caused by an injury, depending on your health situation and the potential causes of swelling. Many prevention strategies are the same strategies used to reduce swelling.
They include:
Avoid sitting or standing for long periods of time
Elevate your arms or legs when resting
Wear compression socks, especially if you need to be on your feet for a long time
Limit the amount of salt in your diet
Always follow your healthcare provider's recommendations, and reach out if you think that a medication you're taking is making your swelling worse.
When To See a Healthcare Provider
Reach out to a healthcare provider if you experience any of the following symptoms:
Sudden or continually worsening swelling
Significant pain
A heartbeat that feels irregular or different
Significantly less urine (pee) when you use the bathroom
Swelling in your mouth, lips, tongue, or throat
New swelling in one or more limbs
Redness or heat in the swollen area
Daily Weight
If you have a medical condition that can cause edema, sudden overnight weight gain may be a signal that you are retaining fluid and may need to alter your treatment. Follow your healthcare provider's instructions for self-monitoring and reporting changes in weight.
A Quick Review
Swelling can be a normal bodily response to injury or irritation. It might resolve on its own relatively quickly. However, it can also be a side effect of medications or a symptom of a serious health condition.
In many cases, edema can be prevented with things like movement and dietary choices. Medications and managing chronic health conditions can also help prevent or treat swelling.
In some circumstances, swelling might require urgent medical care. Reach out to a healthcare provider if you notice any new swelling.
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