Is It Lymphedema, Pitting Edema, or Chronic Venous Insufficiency?

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Sudden and unexplained swelling is always a cause of concern, especially given the variety of different causes that can trigger them. These causes can range from the easily treated to the ones that need immediate medical attention: and the difference between a good outcome and a bad one can be in how quickly the cause is identified.

So how do you know if it's lymphedema, chronic venous insufficiency, or pitting edema? While getting a medical expert to look you over should always be your first option, there are a few ways you can tell these conditions apart. While these signs should never be a substitute for a professional opinion, they can give you some idea of what to prepare for to manage your condition, especially after primary treatment.

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What is Lymphedema?

Lymphedema is a condition that's caused when your lymphatic system is unable to drain properly. Lymphatic drainage is crucial for getting rid of toxins, waste, and other fluids that your tissue doesn't need. These lymph vessels help keep your body's fluids balanced since they also help white blood cells get to the site of tissue that needs to fight off infection.

Causes

When your lymphatic drainage is working properly, the fluid flows without issue throughout your body. However, with a damaged lymphatic system, rapid accumulation of fluid occurs - and it's this excess lymphatic fluid that causes lymphedema.

Some of the possible causes of lymphatic obstruction include:

  • Cancer treatments: radiation or tumor removal can affect the lymphatic system in the treated area, which can cause lymphatic obstruction if the tumor is big enough or if the radiation strains the body too much. Typically referred to as secondary lymphedema or cancer-related lymphedema.
  • Family history: Genetic mutations or a history of meige disease/Milroy diseases in your family can increase your risk for lymphedema, though this type of lymphedema is not as common. Typically referred to as primary lymphedema or non-cancer-related lymphedema.
  • Surgery: any surgical procedures that affect or remove the lymph nodes can also cause lymphedema as the obstruction leaves the fluid with nowhere to go. However, removing lymph nodes or lymph vessels doesn't always affect the functions of your lymphatic system.

Obesity, age, and pre-existing conditions like arthritis can increase your risk of developing lymphedema but don’t directly cause it. 

Symptoms

Symptoms for lymphedema can differ depending on how severe the patient's condition is. Some patients with lymphedema can experience mild to moderate symptoms immediately, while others (usually patients who've had cancer treatment) may not experience any symptoms until months or years after their cancer treatments.

Some signs to watch out for include:

  • Swelling in the arms, legs, or feet
  • Infections that occur often and heal slowly
  • Skin discoloration or leathery skin texture
  • Weakened joints and muscles
  • Localized tingling or other sensations

Symptoms of lymphedema can often get worse over time, so it's important to get the right diagnosis of lymphedema as soon as you notice anything amiss - especially right after getting cancer treatment.

Treatments

Unfortunately, there is no permanent cure for lymphedema. Most treatment options for this condition aim to reduce the symptoms as much as possible and prevent them from getting worse.

  • Lymphatic massage: using physical therapy, a therapist can use light pressure to move the fluid to work lymphatic channels. While this can't correct lymphatic flow, it can help with cases of chronic lymphedema, especially in relieving any symptoms.
  • Compression garments: using compression for treatment can correct lymphatic flow by preventing the chronic accumulation of fluid in your system. By using a leg compression stocking or similar garments, the additional pressure can move the fluid to lymphatic channels that are working properly.
  • Pneumatic compression device treatment: for cases of severe or chronic lymphedema, using a pump to apply pressure on the leg or limb can change the lymphatic flow to working lymphatic channels. However, this is less effective for patients with lymphedema who caught it early.

For early treatments for lymphedema, surgical options like lymph node transplantation or drainage connection can work - though these require some downtime for the patient to recover.

What is Pitting Edema?

Pitting edema occurs when there's excess fluid build-up. Any fluid that's trapped in the tissue and isn't being drained properly can cause edema, and there are different types of edema that you can experience with a variety of causes. It can often be a sign of an issue with a certain area of your body, or it can be a systemic symptom with a specific organ group.

Causes

Pitting edema has many different causes - which can make its overall diagnosis and treatment difficult without a professional opinion. Since the majority of your body is made up of fluid, any condition that causes excess fluid production or improper fluid drainage has the possibility of triggering pitting edema.

Here are some of the more common causes of this condition:

  • Medication: intravenous fluids, medicines for blood pressure, and hormonal pills can all cause extra fluid to pool up underneath subcutaneous tissues. Some serious cases of these can often be attributed to incorrect dosing, though these are rare complications.
  • Venous insufficiency: issues like deep vein thrombosis affect your vein walls, preventing them from pumping blood efficiently back to the heart. A blood clot along the leg or other limbs can lead to a drastic pooling of blood, which can cause pitting edema.
  • Kidney problems: if your kidneys have malfunctioned, it means there's an excess of salt and water in your body. This can lead to complications like high blood pressure, kidney failure, and pitting edema. This type of edema often needs immediate medical attention to avoid any more complications.

Pregnancy, poor diet, and a sedentary lifestyle are also possible risks for you getting pitting edema, though these are not usually the cause.

Symptoms

The most obvious symptom of pitting edema is swelling right underneath the surface of the skin, which leaves an indentation or "pit" when pressed with a finger or pressure. Pitting edema differs from normal edema, which is usually caused by a problem with your lymphatic or thyroid system.

Some other symptoms to watch out for include:

  • Decreased mobility and shortness of breath
  • A heavy or full sensation along the swollen limb
  • Skin discoloration or uneven skin texture
  • Chest pain or abnormal coughing
  • Chronic fatigue that doesn't go away with rest

Symptoms for pitting edema can often vary from mild to severe depending on what the underlying cause of your condition is, so always check in with a doctor.

Treatments

Treatments for pitting edema usually target the underlying cause - in many cases, simply getting rid of the fluid itself won't be enough if it just pools again. Other treatments can also help manage the severity of your symptoms, while also preventing them from becoming much worse.

  • Diuretics: if your pitting edema is caused by congestive heart failure, kidney disease, or liver problems, diuretics can drastically improve your condition and help the excess fluid drain properly again.
  • Vein treatment: issues with your blood circulation can be addressed with a wide variety of vein treatments, which can help your blood flow normally again.
  • Elevation: in some cases (especially for pitting edema in the legs) simply elevating the limb can help restore normal fluid flow again, to counteract the pull of gravity on normal flow.

For more information about the best type of treatments to get for your specific condition, consult your medical provider.

What is Chronic Venous Insufficiency?

Woman's legs with varicose veins

Chronic venous insufficiency is when your veins aren't working properly - usually because the vein valves have failed to control the blood flow in your body. This causes blood to pool behind the valves instead of going to the heart, which causes widespread swelling and other complications.

Causes

Any condition that affects normal blood flow can cause CVI - even acute venous insufficiency can progress to this state if the original condition isn't treated immediately. Because of the conditions that can usually trigger chronic venous insufficiency (and the risk of adverse complications), it's crucial to get a diagnosis immediately.

Some causes to watch out for include:

  • Varicose veins: veins that twist or swell unnaturally can cause venous obstructions that can disrupt the normal pressure required to move blood through your veins. If they affect enough superficial veins or progress over time, they can turn into chronic venous insufficiency.
  • Blood clotting: any blood clots can affect normal blood flow, as blood pools in the veins and eventually weakens both the vein walls and vein valves. Any condition that causes a blood clot can lead to CVI, though most cases usually progress from issues like deep vein thrombosis.
  • Inactive lifestyle: by far one of the most common causes of venous insufficiency is an unhealthy lifestyle. People who sit down or stand up for long periods can make the natural flow of blood back to the veins more difficult since the blood needs to fight against gravity. This can make pooling more likely.

Age, genetics, and smoking/drinking can also increase your risk of getting CVI, and may even worsen the symptoms.

Symptoms

CVI doesn't always manifest in symptoms - some patients can have it for years without any signs until it's already progressed into something serious. This makes catching it early extremely important since it's easier to treat.

Some symptoms to look out for include:

  • Skin discoloration, uneven skin tone, or rough skin texture
  • Varicose veins, often around the legs and feet
  • Chronic discomfort and/or pain in the legs
  • Ulcers or sores that heal slowly even with treatment
  • Limited mobility and chronic fatigue

Symptoms for CVI can vary between patients depending on how severe their condition is; aside from extensive swelling, your symptoms can be easily mistaken for other venous conditions. For an accurate and immediate diagnosis, you should always consult with a doctor or healthcare provider before starting treatment.

Treatments

Treatments for CVI will depend on how much the patient's condition has progressed. Usually, treatment aims to correct blood flow by either removing the venous obstruction, making the body more efficient at blood circulation, or helping the natural flow of blood by applying pressure to specific areas.

  • Compression therapy: by using compression garments like compression stockings or bandages, sufficient pressure is applied on the legs or limbs to give the vein valves the needed support to redirect blood flow back to the heart.
  • Sclerotherapy: by using a chemical to seal off damaged or weakened veins, blood is circulated back to veins with normal function, preventing any future blood pooling. The sealed veins turn into scar tissue and are eventually absorbed back by the body.
  • Surgery: veins are either twisted shut or removed in their entirety, preventing any future blood flow through the damaged vein system. For especially severe cases, healthier veins may be transplanted to the affected area to give the blood a bypass to flow properly.

With consistent and skilled treatment, chronic venous insufficiency can be managed to the point where the patient can still live a comfortable life. 

Safe and Reliable Treatments for Vascular Diseases and Vein Disorders at Vein Center Doctor

Swelling in the body can be explained by any number of conditions both serious and benign. No matter the reason, the first thing that patients should always do is to make sure what condition they have so they can get started on treatment as soon as possible. Patients risk developing adverse complications if they leave any of the conditions we've left above untreated - but they can also risk serious side effects if the wrong treatment is used for their condition.

Vein Center Doctor has years of experience in treating vascular diseases and vein disorders, with non-invasive yet effective treatments that offer long-term results. As trusted healthcare providers, we work with our patients to give them the results that they're looking for with the least risk and hassle to their bodies.

Reach out to us today and call 1-862-227-1054.

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