Leg Swelling in Adults: Causes and Treatment

 Author: Numtas Thomas RN,RCCN, BNSc, Reviewed by Dr Azuka Chinweokwu Ezeike, MBBS, FWACS, FMCOG, MSc (PH)

Highlights

• Leg swelling (oedema) is common in older persons and may result from fluid retention, often seen in the legs, feet, and ankles. 
• Symptoms include heaviness, tightness, swelling, and skin changes.
• Causes include inactivity, obesity, salt, pregnancy, and health issues.
• Seek medical help if swelling worsens or comes with pain or breathing issues.
• Diagnosis involves history, physical exam, and tests like blood work or scans.
• Treatment depends on the cause. 

Introduction

A long day may leave your legs feeling heavy or puffy. You might notice your shoes fitting tighter or see that your ankles look swollen. It's easy to dismiss these changes as just part of a busy day, standing for too long, or even getting older. Leg swelling also known as oedema happens when there is excess fluid (fluid retention) in your legs. It is quite common in older persons especially as they advance in age. 

Leg swelling can happen without pain and gravity's impact on the body makes it more obvious in your legs, feet and ankles. While leg swelling can sometimes resolve on its own, other times it lingers. When this happens, it could be a sign of an underlying health problem. This article will help you understand why leg swelling happens, what you can do about it, and most importantly, when to see your doctor.

Signs and symptoms of leg swelling

You might notice some changes in how your legs feel or look. It is important to pay attention to early signs, as this can help you catch a problem before it gets worse. Here are some common signs and symptoms to watch for:

• Obvious swelling in the legs
• Your legs feel heavy to lift
• Temporary dimpling on the legs when you press on them
• Colour changes on the skin of your legs
• Your shoes and socks become difficult to fit
• Appearance of varicose (prominent, enlarged) veins
• Your legs feel warm and tight [1]

Common causes of leg swelling

Leg swelling can be a way your body responds to everyday activity, such as standing or sitting for extended hours. It can also be connected to health problems. The good news is that many causes of swelling can be treated by your doctor, especially when you report early. Here are some of the common causes of leg swelling:Causes related to illness:

• Infection in the leg
• Injury to the leg or due to a surgical procedure
• Low haemoglobin, as in the case of anaemia 
• Health problems affecting your body organs, such as the 
  • Heart
  • Liver 
  • Kidney
• Obstruction of the lymph channels, as in filariasis
• Presence of a blood clot in the leg(Deep Vein Thrombosis) [2]

Causes not related to illness:

• Obesity
• Sitting or standing for long hours
• Pregnancy
• Taking too much salt in your food
• Advanced age
• Varicose veins

Causes related to medicines:

• Medicines for high blood pressure, such as amlodipine
• Medicines for hormone treatment, such as oestrogen
• Medicines for treating depression, such as Trazodone
• Steroids [4]

When to see a doctor

Understanding when to arrange a visit to your doctor's office is important, as this can prevent complications. See your doctor if any of the following happens:

• If you find it difficult to breathe
• If you cough up blood
• If you have a tight feeling in your chest or heaviness, and pain
• If your leg swelling becomes worse
• If your leg swelling is not connected to any injury or health problems
• If you have heart, kidney or liver problems and your legs are swollen
• If your body temperature becomes high
• If the swollen leg becomes painful to touch
• If your swollen leg becomes red [3]

Do not delay if any of the above occurs. Your body may be signalling a bigger health issue. 

How the cause of leg swelling is diagnosed

Your doctor will usually begin by asking you some questions (history taking) and checking you, followed by some tests. History taking: This involves your doctor asking questions such as:

• When did you first notice the swelling? 
• Is the swelling located in your whole leg or feet only? 
• What worsens the swelling or relieves it? 
• Have you had treatment for a swollen leg before? 
• Are you currently taking any medications? 
• Have you been experiencing unexplained tiredness? 
• Do You have any underlying health, kidney or liver problems? 
• Your doctor will check for dimpling after gently pressing the legs 
•  Check for change of skin colour [2]

Physical assessment: 

Your doctor will perform a physical examination to check every part of your body [4]

• General assessment
  • Check for the presence of anaemia
  • Check for the presence of jaundice
  • If one or both legs are swollen
  • Increased body weight
• Circulation and heart
  • Blood pressure check (could be elevated) 
  • Heart rate (could be high) 
  • Distended neck veins
  • Difficulty breathing
  • Abnormal rattling sounds in your lungs called crackles
• Liver
  • Presence of yellowish eyes
  • Swelling of the abdomen
• Kidney
  • Elevated blood pressure
  • Swelling of the face and abdomen
• Your swollen leg 
  • Pain on touch 
  • If your leg feels hot or warmer than usual

Tests: 

Possible tests your doctor might recommend include:

• Urine testing: This is important to rule out the possibility of an underlying health problem, such as a kidney problem. An indicator of a kidney problem is the presence of protein in your urine
• Blood testing: Your doctor will recommend this test to check for a shortage of blood or any underlying heart problems. How well your kidney or liver functions can also be detected through a blood  test [2]

Imaging: 

These include:

• X-ray of the chest: Health problems affecting your heart or lungs can be checked and detected using a chest X-ray
• X-ray of the leg: This is usually recommended when injury to the leg such as a bone infection or fracture are possible causes of your leg swelling. 
• Leg scan: An ultrasound scan might be recommended for your swollen leg. Problems with the blood vessels supplying blood to your leg can easily be detected with a scan. The origin of the swelling or presence of a blood clot can also be seen with a scan
• Electrocardiogram (ECG): This type of test is performed to check for heart-related problems. Your doctor will recommend this if you have a heart issue or you complain of chest pain. Your heart function is represented in wave form when you have an ECG done
• Heart ultrasound called echocardiogram: This test indicates the movement of blood within your heart. If you experience chest pain, breathing problems, or have a heart issue, your doctor will recommend this test. The doctor will have the test results in picture form
• Doppler ultrasound: This is a special type of ultrasound used in checking blood vessels. This is especially useful when a blood clot is suspected [4]

How leg swelling is treated

Treatment is usually directed at the cause of the swelling and should be prescribed by your doctor. Treatment includes:

• Use of medications such as diuretics, to help your kidneys get rid of body fluid fast. This, in turn, helps reduce your leg swelling. This treatment is useful if health problems affecting the heart, kidney or liver are present [4]
• Medications, heart surgery and the use of medical devices may also be recommended by your doctor in the presence of a heart problem, like heart failure
• If your kidneys are the cause of your leg swelling, vitamin supplements, surgery to replace the kidney, or dialysis will be recommended by your doctor
• Treatment directed at the liver includes surgery and the use of medications. Your doctor will also require you to avoid alcohol consumption
• If your leg swelling is caused by a blood clot, your doctor will prescribe blood thinners. 
• Antibiotics will be required if your leg swelling is caused by bone infections
• Your doctor may recommend a blood transfusion or iron and folic acid supplements(haematinic). if your leg swelling is caused by anaemia
• Your doctor may stop you from continuing any medications if it is suspected to be the cause of your swelling. Or your doctor may simply lower the dose [5]

Other supportive treatments useful in reducing your leg swelling include:

• Make sure to elevate your legs when you sit or lie down. Using pillows can help with that
• Move your legs regularly, and engage in some minor leg exercises to improve circulation
• Avoid taking too much salt in your food, and maintain a diet that is low in salt
• Maintain a healthy weight
• Plan to take breaks during your journey to just stand or take a simple walk
• Use compression stockings if you have a blood clot in the leg. Avoid tight ones [2]

Conclusion

Leg swelling is common in adults and is connected to a number of causes. Treatment is simple, especially when caught on time. While some cases of swelling are mild and normal, some are pointers to more serious health issues. Do not ignore symptoms that suggest you should see your doctor. Early treatment prevents you from long-term health problems. 

References

1. What To Do About Swollen Legs. Cleveland Clinic [Internet]. [cited 2025 May 4]. Available from: https://health.clevelandclinic.org/when-is-leg-swelling-a-sign-of-something-serious.
2. Waheed SM, Kudaravalli P, Hotwagner DT. Deep vein thrombosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 May 12]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK507708/.
3. Swollen ankles, feet and legs (oedema). NHS UK. [Internet]. 2017 [cited 2025 Apr 30]. Available from: https://www.nhs.uk/conditions/oedema/.
4. Goyal A, Cusick AS, Bhutta BS. Peripheral Edema. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 [cited 2025 May 4]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK554452/.
5. Largeau B, Cracowski JL, Lengellé C, Sautenet B, Jonville-Béra AP. Drug-induced peripheral oedema: An aetiology-based review. Br J Clin Pharmacol. 2021 Aug;87(8):3043–55. Available from: https://pubmed.ncbi.nlm.nih.gov/33506982/

Disclaimer:
The information provided on this website is for general educational and informational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Published May 13, 2025