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Pedal Edema Causes in Indians: Diagnosis & Treatments

With inputs from Dr.Nikhileshwari Vanukuru, General Physician

Updated on: November 2023

With inputs from Dr.Nikhileshwari Vanukuru, General Physician

Updated on: November 2023

Reviewed by Dr Raja Indana

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Table of contents

Key Takeaway:
– Pedal edema is the swelling of the feet, ankles or legs. It occurs when there is a retention of body fluids due to inactivity or due to an underlying medical condition.
– Pedal edema causes swelling that is either pitting pedal edema or non pitting pedal edema. Pitting edema dimples or creates a “pit” upon pressing the affected areas. Non pitting pedal edema causes swelling, but no dimpling or pits.
– Pedal edema could be an early indicator of liver, kidney or heart failure.
– In most cases, the swelling reduces by reducing salt intake or by keeping the affected foot in an elevated position.
– It is more common in older people or in women who are pregnant.

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Chapter 1: About Pedal Edema in Indians:

What is Edema?
Edema is a medical term commonly used for swelling. This swelling may be caused by injury, inflammation, infections or drugs causing pedal edema. In some cases, the swelling is a result of an underlying disease like cirrhosis of the liver or congestive heart failure, due to which small blood vessels leak fluids to nearby tissues. People with edema may notice tight, shiny, and stretched out skin that dimples for a few seconds when pressed with a finger.

Edema can happen anywhere in the body but foot edema happens in the case of the following:

Peripheral edema – This type of edema commonly causes swelling in feet, ankles, and legs and is sometimes observed even in arms. It could occur due to underlying kidney disorder or circulatory diseases.
Pedal edema – This usually causes excessive fluid retention in feet resulting in swollen feet and legs. It could occur during pregnancy or in the elderly.
Lymphedema – This type of foot edema could be caused by damage to the lymph nodes. The damage to the lymph nodes may be due to cancer treatments like radiation or surgery.

What is pedal edema?
Pedal edema causes abnormal accumulation of fluid in ankles, feet, and lower legs that results in swollen feet and ankles. There are two mechanisms that can bring about pedal edema. Venous edema occurs due to enhanced capillary filtration causing leakage of fluid into interstitial space from the venous system. Lymphatic edema is brought about by the dysfunction or the obstruction of the outflow of lymph from the legs. This results in the accumulation of fluid in ankles. These mechanisms of fluid accumulation can occur together or independently. Venous edema can also lead to lymphatic edema.

Most often, mild cases of pedal oedema are usually caused by a fluid build up called oedema. Pedal oedema causes swollen feet and legs that is often caused by standing (or sitting) in the same position for a long period of time. Reducing salt in food intake or doing basic exercises or keeping feet raised may reduce swelling. If pedal edema is due to an underlying medical condition, it is important to treat that condition to relieve edema.

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Chapter 2: What are the Pedal Edema Symptoms in Indians?

Pedal edema causes damage to health adversely. It may not be a very serious condition but it can be an indicator of an underlying serious condition. The condition is generally more common if you are pregnant or older in age. Pedal edema causes the following symptoms:

Puffiness and swelling in feet, legs, and ankles.
Constant Discomfort
Disturbance in gait
Reduced mobility (difficulty in walking)
Enhanced risk of falling
Impairment of sensation in the foot
Cutaneous ulcers

One of the top reasons for pedal edema is inactivity or sitting for long periods of time. In cases of long drives, long flights, or inactivity due to other reasons, you may develop pain and swelling on top of foot. This pain and swelling should typically reduce with movement and basic warm-up exercises. If pain, swelling and discomfort persist, kindly seek immediate medical assistance as this could imply a blood clot in your vein (Deep vein thrombosis)

When to see a doctor?
It is absolutely vital to see a doctor if the following pedal edema symptoms occur:

Swelling on top of foot occurring immediately after any injury
Swollen ankles and legs with red blotches
Unexplained foot edema or ankle edema
Swollen feet and ankles along with swollen abdomen (especially if there is a history of liver disease
Pain in ankle edema especially if it is in one foot
Increasing swelling, especially if there is a history of kidney or heart disease)
Fever with pedal edema

It is important to visit a general physician immediately if you notice any of these pedal edema symptoms to get yourself diagnosed and treated appropriately. At mfine we have a wide variety of specialized doctors who are well-experienced and help provide a treatment plan for pedal edema causes speedily.

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Chapter 3: What are the Pedal Edema Causes in Indians?

Pedal edema is further characterized into two types:

Bilateral pedal edema (occurring in both feet)
Unilateral pedal edema (occuring in one foot, either right or left)

Acute bilateral pedal edema causes swelling of the feet due to medication or bilateral DVT (Deep vein thrombosis). Bilateral Chronic pedal edema in older people may be due to venous insufficiency. It could also be due to heart failure or in some rare cases, systemic reasons like renal or liver disease. Some women also experience short term pedal edema in pregnancy, which normally resolves after birth.
Unilateral pedal edema causes swelling in only one foot or leg. This could also be due to DVT or due to cellulitis, ruptured popliteal cyst, gastrocnemius musculotendinous rupture or any other trauma.

Both bilateral and unilateral pedal edema are further classified as pitting and non pitting pedal edema. Pitting pedal edema causes a dimple or a “pit” if pressed by a finger for a few seconds. Non pitting pedal edema causes swelling but does not dimple or cause any such pits up on external force.

Some of the most probable health abnormalities causing bilateral pedal edema are as follows:
– Obesity
– Pulmonary Hypertension
– Venous Insufficiency
– Gastrointestinal Disorders
– Liver Disease
– Anaemia
– Deep Vein Thrombosis
– Certain types of Cancer
– Myxoedema
– Heart failure
– Lymphoedema
– Hypothyroidism

Some of the unilateral pedal edema causes are as follows:
– Venous insufficiency
– Deep vein thrombosis
– Pelvic tumor
– Reflex sympathetic dystrophy
– Lymphoedema
– Ruptured Baker’s cyst

What are the Pedal Edema causes and treatment in Elderly Adults?
Bilateral pedal edema generally occurs in older adults and it suggests the presence of an underlying systemic disease that must be addressed. It is caused either by raised capillary filtration coupled with the retention of protein-poor fluid in the interstitial spaces or by obstructing the ‘lymphatic outflow’ from the legs. The presence of pedal edema in the older adults results in a decrease in mobility, disturbance in gait, impairment of sensation in the foot and the presence of cutaneous ulcers. Kindly seek medical assistance for treatment in these cases.

Causes of Pedal Edema in young adults:
While it is common in older people, the condition does occur in young adults as well. Pedal edema in pregnancy is quite common. This happens due to an increase in blood flow and pressure on your uterus, pelvic veins and your vena cava (large vein in the right side of the heart from where blood returned from the lower limbs). Furthermore, body fluids tend to increase in order to nurture the baby and the mother thus resulting in pedal edema in pregnancy.

Additional causes of pedal edema in young adults can be inactivity, being overweight, tight clothing or sitting or standing for too long.

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Chapter 4: How is the Diagnosis of Pedal Edema Done?

With the help of physical examination by a general physician and history, if the cause of an edema cannot be identified, then a pedal edema specialist, whom you can get in touch with at Mfine, would suggest further tests.
For ruling out a systemic disease, a full metabolic panel, complete blood count and urine analysis must be done by a cardiologist. The level of albumin below 2 gm/dl suggests edema caused due to malnutrition, liver or kidney disease. If pulmonary hypertension along with sleep apnea is suspected, an echocardiogram must be done.

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Chapter 5: Pedal Edema Treatment in India

Pedal edema treatment depends a lot on the cause that brings about the edema. In certain cases, the edema is curative and can be managed by discontinuing the drugs causing pedal edema. Pedal edema treatment is done for lowering the swelling by lowering capillary leakage and facilitating lymphatic drainage. A general practitioner is likely to prescribe non-pharmacological treatment comprising exercises, lymphatic massage and external graded compression for pedal edema.

Some swollen feet remedy to reduce lower limb edema include the following:

Exercise or movement:
Simple movement in the affected areas shall help the extra fluids to be pumped to the heart. It is important to note that vigorous exercise is to be avoided. Basic movement like ankle rotation or slow walks are sufficient.
Elevation:
Keeping the affected area in an elevated position may drain some of the extra fluids towards the heart due to gravity. Place your affected foot or feet over one or two pillows and rest till the swelling subsides.
Compression clothing:
Compression sleeves, or stocking may be suggested to control the swelling from occurring again. It is important to note that compression clothing is not safe to put while the limbs are still swollen. These garments are meant to stop the condition from reoccurring.
Healthy diet:
Consuming too much salt increases sodium content in the body which can lead to many ailments including high blood pressure, osteoporosis, kidney failure and stomach cancer. Some of these ailments may also be one of the pedal edema causes. For pedal edema treatment, reduce salt intake and processed food and include more fresh fruits and vegetables in your diet.

For chronic pedal edema, consult a physician immediately to determine the underlying cause of the condition and to get the appropriate treatment for it.
Patients can avail online consultation with a renowned cardiologist at mfine and have their treatment done by an esteemed doctor.

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References

1. What are the causes of facial puffiness and pedal edema?
Water or fluid retention can be due to injury or inflammation from inactivity or sitting (or standing) in the same position for a long period of time. Mild pedal oedema may be resolved by itself by keeping it in an elevated position or making slow movements to pump the excess fluid back to the heart. If swelling persists, it is better to consult a doctor immediately as this could be an indication of a serious medical condition. One of the common causes of this combination of symptoms is myxedema.

2. My feet are swollen. Do I need to go to the doctor?
IF you have been standing or sitting for a long period of time (long drives, long flights, etc), ankle edema or swollen feet and legs are common. Kindly try to move around slowly, and keep the swollen feet elevated to pump some of the extra fluid to the heart. If you’re experiencing sudden unexplained swelling, kindly consult a physician immediately.

3. How to reduce swelling in feet from kidney problems?
For serious underlying conditions, pedal edema or swelling in feet will not reduce until you treat it. Kindly consult your doctor for kidney ailment. In the meantime, you can try elevating your feet, reducing salt intake or soaking your feet in cold water.

4. Are anaemia and swollen feet connected?
Yes, anemic patients may show signs of pedal edema. It is observed that the low concentration of haemoglobin in your blood can stimulate salt and water retention in your body.

5. What is the link between pedal edema and heart disease?
In congestive heart failure, one or more chambers of the heart may fail to pump blood effectively. This leads to blood retention in some parts of the body which can lead to edema. Kindly consult your cardiologist to treat your heart ailment which will subsequently reduce pedal edema.

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