13 doctors weighed in:

Edema in legs I am experiencing severe edma in my legs from the knees down. I have had the standard tests that do not show any reason. The only reason two doctors have told me is that at 60 my veins must be deteriorting early. I take methadone for chronic

13 doctors weighed in
Dr. Bret Boyle
Wound care
5 doctors agree

In brief: Many possibilities

Sedentary lifestyle, medications, heart and kidney disease, "bad" veins, obesity and a few others can all cause and/or contribute to chronic edema in legs.
Proper compression in the form of stockings or wraps (circaid garments) along with adequate elevation of legs above the heart, must be used daily in order to control this problem. See a lymphedema clinic for help.

In brief: Many possibilities

Sedentary lifestyle, medications, heart and kidney disease, "bad" veins, obesity and a few others can all cause and/or contribute to chronic edema in legs.
Proper compression in the form of stockings or wraps (circaid garments) along with adequate elevation of legs above the heart, must be used daily in order to control this problem. See a lymphedema clinic for help.
Dr. Bret Boyle
Dr. Bret Boyle
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Dr. Mark Lacambra
Family Medicine
3 doctors agree

In brief: Edema

Edema can be the result of lots of different causes and that sometimes makes the source of it hard to diagnose.
As a physician, i usually start with the most ominous possibilities first, rule them out, and proceed with less worrisome causes. Top of the list is to rule out blood clots. Given the fact that your swelling is in both legs and that the ultrasound was negative (normal), it is safe to say that is not the source. Sometimes those studies will describe valvular insufficiency, a problem with the valves in your veins not working so well. This could benefit from compression stocking that your doctor could perscribe. There are other ominous causes that your history does not elaborate on. Your doctor probably has evaluated you for congestive heart failure and kidney problems. Sometimes thyroid problems can contribute to this as well. If those issues are not the source, a review of your medications may be revealing. Certain meds are notorious for causing this, like Norvasc or amlodipine. Finally, yes, the narcotics may be contributing, but getting of them at present may be hard. You may be sedentary from your pain and that could contribute as well. Sitting for prolonged periods makes it hard to mobilize the fluid that accumulates in the lower parts of your body. If able, regular activity may help. Ultimately, you may benefit from diuretics, a class of meds that help your kidneys get rid of excess fluid in conjunction with the compression stockings. Good luck! mark lacambra sand point internal medicine.

In brief: Edema

Edema can be the result of lots of different causes and that sometimes makes the source of it hard to diagnose.
As a physician, i usually start with the most ominous possibilities first, rule them out, and proceed with less worrisome causes. Top of the list is to rule out blood clots. Given the fact that your swelling is in both legs and that the ultrasound was negative (normal), it is safe to say that is not the source. Sometimes those studies will describe valvular insufficiency, a problem with the valves in your veins not working so well. This could benefit from compression stocking that your doctor could perscribe. There are other ominous causes that your history does not elaborate on. Your doctor probably has evaluated you for congestive heart failure and kidney problems. Sometimes thyroid problems can contribute to this as well. If those issues are not the source, a review of your medications may be revealing. Certain meds are notorious for causing this, like Norvasc or amlodipine. Finally, yes, the narcotics may be contributing, but getting of them at present may be hard. You may be sedentary from your pain and that could contribute as well. Sitting for prolonged periods makes it hard to mobilize the fluid that accumulates in the lower parts of your body. If able, regular activity may help. Ultimately, you may benefit from diuretics, a class of meds that help your kidneys get rid of excess fluid in conjunction with the compression stockings. Good luck! mark lacambra sand point internal medicine.
Dr. Mark Lacambra
Dr. Mark Lacambra
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1 comment
Dr. Gabriel Goren
As someone dealing with veins for 30 years I permit myself a few comments. To have simultaneous bilateral DVT is very unlikely therefore only extension of the clot into the vena cava could theoretically explain bilaterality. THIS HOWEVER IS A VERY ACUTE AND SERIOUS PROBLEM with a presentation not mentioned by the patient. Valvular incompetence/reflux disease if it is localized in the superficial veins one should clinically observe (in most cases) varicose veins also not mentioned. If located in the deep veins ( again bilaterality is rare) it is either congenital or secondary to a previous DVT. No history of a previous DVT was mentioned either. A Doppler/duplex examination of the venous system in a STANDING postion should however clear any suspicion. Thus to explain a bilateral edema one must usually look for a systemic origin. l In absence of heart liver and kidney problems, low levels of blood protein especially albumin ( for various reasons) could guide the diagnosis in different direction. Drugs can be a source of bilateral leg edema. As to Lymphedema - also rare bilaterally -clinically it can be separated from venous edema by a simple fact: in lymphedema the toes and feet are swollen and one can't pinch/elevate the skin on them. This will NEVER be the case in edema of venous origin unless the venous disease is chronic and triggered lymphedema as well. Symptomatic treatment of leg edema: gravitational drainage (lift ankle above the heart) whenever possible, compression stocking to knee during the day, and walking to activate the muscle pump. Of course in case the etiology has been determined one should treat the cause and not just the symptom.
Dr. Ted King
Phlebology
2 doctors agree

In brief: Leg swelling

The answers from drs.
Lacambra and wright are very good. As dr. Lacambra said, getting to the bottom of leg swelling can be very difficult. If your veins are the cause, as you doctors have apparently suggested, then you should see a vein specialist. Vein treatment, in that case, should help.

In brief: Leg swelling

The answers from drs.
Lacambra and wright are very good. As dr. Lacambra said, getting to the bottom of leg swelling can be very difficult. If your veins are the cause, as you doctors have apparently suggested, then you should see a vein specialist. Vein treatment, in that case, should help.
Dr. Ted King
Dr. Ted King
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Dr. Thomas Wright
Phlebology
2 doctors agree

In brief: Lymphedema

One of the most common cause of leg swelling is lymphedema.
This is caused by poor lymphatic circulation. Venous insufficiency primarily from superficial or deep vein failure can also cause leg swelling. There is effective treatment for both of these conditions[ that include compression stockings]. Good luck.

In brief: Lymphedema

One of the most common cause of leg swelling is lymphedema.
This is caused by poor lymphatic circulation. Venous insufficiency primarily from superficial or deep vein failure can also cause leg swelling. There is effective treatment for both of these conditions[ that include compression stockings]. Good luck.
Dr. Thomas Wright
Dr. Thomas Wright
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