Swelling – Causes, Types and Treatment (2)

What is swelling?

Swelling (oedema) is the accumulation of fluid in the intercellular space, from which the fluid can subsequently reach other parts of the body – e.g. into body cavities or the air sacs of the lungs. If swelling occurs in only one part of the body (e.g. a limb), it is local swelling. If it occurs throughout the body, it is generalised swelling.

Swelling is actually a local circulatory disorder, but it can also have a cause outside of the cardiovascular system. Due to swelling, the exchange of water and nutrients between the blood and cells is inhibited, which causes a change in the metabolic conditions.

Swelling can occur anywhere (in the limbs, around the eyes, in the lips, tongue, face), including in the internal organs. Such swelling can be life-threatening. If, for example, the upper or lower limbs (e.g. calves) swell after greater exertion, this is usually a short-term condition and the swelling soon subsides. In some cases, however, there may be a more serious cause, so it is always necessary to address such problems and consult with a doctor, explains Mudr. Eva Znojemská, occupational physician at EUC PLS.

Causes of swelling

In the context of particular locations and manifestations, the causes of swelling can range from physical exertion to certain serious illnesses. The possible causes of swelling include the following:

• injury
• infection, inflammation (e.g. insect and tick bites)
• sitting or standing for a long time (swelling of the legs)
• water retention in the body (during menstruation or pregnancy)
• allergic reaction
• fatigue (e.g. swelling of the eyelids and surrounding area)
• chronic venous insufficiency
• lymphatic drainage disorder
• heart failure
• kidney disease
• liver disease
• deep vein thrombosis

Types of swelling

Swelling is a common manifestation of many illness. Ordinary swelling of a part of the body visible to the eye is caused by the accumulation of fluid outside of the blood vessels in the surrounding tissues. As previously mentioned, swelling can also occur in body cavities (e.g. the abdominal cavity) and in certain tissues and organs. The most dangerous forms of swelling include pulmonary oedema and cerebral oedema.

Brain swelling

Brain swelling, or cerebral oedema, is a serious, life-threatening condition. It can cause compression of the brainstem by brain structures, which are pressed through the tentorium cerebelli (the dura mater covering the cerebellum) or the foramen magnum (large occipital opening).

Thus, it is a general pathological response of the brain to various types of damage, leading to the accumulation of water and sodium ions. Cerebral oedema can be caused by many factors, including:

• traumatic brain injuries of varying severity
• brain tumours
• massive heart attack
• bleeding and inflammation
• extended cerebral hypoxia
• severe alcohol and drug intoxication
• stasis of cerebrospinal fluid due to obstruction of the cerebrospinal fluid ducts

A minor oedema may not manifest immediately; the standard symptoms of excessive intracranial pressure gradually appear – headache, nausea, vomiting, dizziness and various neurological disorders. The greatest risk is that, under the resulting pressure, the brain and the medulla oblongata will be pushed into the opening at the base of the skull through which the spinal cord enters the skull. The pressure of the bony edges of this opening damages important brain centres, resulting in loss of consciousness and death.

Swelling of the legs

In this case, it is necessary to first determine the cause of swelling. If the cause is unknown and the problem is long-term or recurrent, it is appropriate to visit a doctor, who will then recommend an examination and choose the appropriate treatment. If anything is unclear, the patient will be referred to a specialised cardio-angiology facility or, as the case may be, to a dermatology or orthopaedics department. Swelling of the legs is most commonly caused by:

• extended periods of sitting or standing
• water retention in the body, e.g. during pregnancy or menstruation
• vascular problems (e.g. venous thrombosis)
• problems with the lymphatic system
• traumatic and post-traumatic conditions
• cardiological problems
• kidney and liver disease
• thyroid disorder

If swelling of the legs is accompanied by other symptoms such as swollen eyelids, fatigue and lack of appetite, visit a doctor without delay.

What helps with swelling of the legs?  In the case of a more serious cause, always follow the prescribed treatment plan. For leg-swelling problems in general, following a few simple principles can help:

• Ensure that you have a sufficient and balanced intake of vitamins and minerals.
• Maintain a proper hydration regimen and do regular physical activity; walking is the most effective.
• When sitting for a long time, keep your legs in a slightly elevated position to prevent pressure in the lower legs.
• Support blood circulation – regularly stretch and reposition your legs.
• Wear compression socks or leggings.

Treatment can also be supported by certain over-the-counter products and medications that are available in our online pharmacy.

TIP:  In addition to cold compresses, common home remedies for swelling include, for example, couch grass, ground elder, coltsfoot, dill and catnip. Carrots, corn, fennel, cauliflower, pumpkin and strawberries can also generally improve the condition.

 

Swelling of the knees

Swelling of the knees is generally indicative of a more serious problem. If your knees swell without any obvious cause or previous injury, this may involve arthritis, gout or other inflammation.

If your knee swells within an hour after an injury, this probably involves a problem with a ligament or a fracture. If the knee swells after several hours or even days, it is probably due to an intra-articular injury.

Swelling of one leg

Swelling of one leg is usually due to an injury or inflammation. The skin is red and warm to the touch. There may be a minor wound in the area of the limb, which is a gateway for infection. If swelling occurs without obvious trauma, it may be due to a blockage in the lymphatic system of the limb or vascular obstruction (venous thrombosis). In this case, it is essential to seek medical attention and initiate appropriate treatment.

Swelling of the ankles

Swelling of the feet below the ankles may be due to heart-function problems and resulting salt retention. If the feet feel heavy, this may be  due to venous thrombosis. If the ankle swells immediately after an injury, the swelling is probably due to a sprain.

Swelling of the hands

Swelling of the hands often occurs suddenly and without an obvious cause. Swelling may appear in the forearms, palms or only in the fingers – on both hands or only on one side. Because such a condition indicates that something is wrong in the body, the symptoms should not be neglected. Rather, it is necessary to seek out the cause of the swelling.

• Physical stress– swelling of various parts of the upper limbs may be caused by, for example, excessive physical exercise or work, in which case the swelling usually subsides when the body is at rest.
• Allergic reaction– in this case, swelling is a reaction to contact between an allergen and the skin, e.g. after an insect bite. In order to avoid generalisation of the swelling and development of an overall reaction, allergies should not be underestimated.
• Inflammation– inflammation causes the area of the hand to become red and swollen, with itching and a burning sensation. Swelling occurs because the blood vessels suddenly become more permeable and fluid, usually lymph, seeps from them into the surrounding tissue. This is why lymphoedema, which occurs when lymph drainage is impaired, is also a cause of swelling.
• Superior vena cava syndrome– swelling of both upper limbs is a characteristic of this syndrome. If the superior vena cava is compressed (e.g. by a tumour), swelling may be accompanied by a so-called “collar of Stokes” due to the permeation of the subcutaneous tissue of the entire neck.

Swollen areas may be painful, are more sensitive to touch and are usually soft, as they are filled with lymph. What can you do about swollen hands? Cooling with cold compresses can help as a form of first aid. It is good to keep your hands still and give them a rest. If the swelling does not subside within a few days, you should seek medical attention.

Swelling of the eyes

• Swelling under the eyes – this type of swelling is usually harmless and does not require medical care. If it is severe, persistent, painful, itchy or red, it is necessary to visit a doctor without delay. Swelling around the eyes is often caused by the accumulation of fluid in the dermis and subcutaneous tissue, a common cause of which is impaired lymphatic drainage from this area. Swollen eyes are also caused by, for example, thyroid dysfunction and inflammation of the eye called periorbital cellulitis, and may be a manifestation of mononucleosis or allergies. Swollen eyelids are also the first sign of insufficient kidney function.
• Swelling of one eye– this is most commonly caused by a viral or bacterial infection or allergies. Redness, tearing and pain are also often associated with this condition. A classic example of a purulent bacterial infection is a hordeolum, or stye.

How to relieve swelling of the eyes? Minor swelling can be relieved with a cold compress or over-the-counter products in the form of eye ointments. In more severe cases, always see a doctor.

Swelling after an insect bite

The toxic substances contained in insect venom can induce a toxic reaction and cell and tissue damage in the area of the bite and throughout the body. However, more severe reactions usually involve an allergic reaction, which is usually stronger when a large number of bites occur in quick succession – the most severe reaction, anaphylactic shock, may occur.

If swelling occurs only in the area of the bite (without other symptoms), treatment is usually simple. The swollen area should be cooled; ointments and tablets containing antihistamines are appropriate to relieve itching. If a severe local reaction occurs in the face or other symptoms appear (e.g. hives), it is necessary to seek medical attention.

It does not pay to underestimate treatment

Swelling is a common reaction to many illnesses, injuries and other conditions. We most commonly encounter swelling of the limbs – symmetrical and unilateral, swelling due to allergies or hypersensitivity to various noxious substances, whether of plant or animal origin, chemical agents, cosmetics, food, metals or drugs.

Swelling may occur due to countless minor factors that do not require the intervention of a specialist. However, swelling also occurs in body cavities and in certain tissues and organs, in which case it can be life-threatening. In this case, it is necessary to be able to recognise a more serious problem (massive, suspicious, persistent or recurrent swelling), which requires medical attention.

If you develop swelling, consult your general practitioner.

EUC General practitioners