From acute lower extremity injuries to serious systematic health conditions, there are many reasons that your lower legs, ankles, and feet might become swollen. One of the most common causes of persistent leg swelling is progressive vein damage caused by a painless disorder known as chronic venous insufficiency (CVI).   

Our skilled team of board-certified vascular experts here at Somerset Surgical Associates, LLC, discuss various possible causes of leg swelling, explore the connection between vein damage and persistent swelling, and explain why prompt expert evaluation is so important.  

Signs and symptoms of leg swelling 

Lower extremity swelling is a frequent complaint among older adults and pregnant women, but it’s a problem that can affect anyone. 

Moderate to severe leg swelling is hard to miss: Your well-defined ankles may transform into “cankles” (calf-ankles), your favorite pair of shoes may feel uncomfortably tight, or you may notice abnormal skin changes that make parts of your lower extremities look puffy, shiny, or stretched. 

 Mild lower extremity swelling — which usually precipitates moderate to severe swelling — isn’t always easy to spot. Signs of mild swelling include indentations on your ankles after you remove your socks or fingermarks on your skin for several seconds after you gently press it.

Is it inflammation or fluid retention?

Virtually every condition that causes leg swelling is driven by one of two underlying problems: inflammation or fluid buildup. In most cases, it’s possible to determine which basic mechanism is behind lower extremity swelling based on whether it’s painless or painful.

Inflammation-related leg swelling

Leg swelling can be a symptom of inflammation in your lower extremity joints or tissues caused by:

  • Normal healing response to an acute injury (joint sprain; bone fracture)
  • Ongoing immune system response to chronic disease (osteoarthritis; osteoporosis
  • Long-term inflammatory disorder (rheumatoid arthritis; lupus; vasculitis)

Inflammation-related lower extremity swelling is typically accompanied by some degree of leg pain or discomfort. Treating the specific problem, whether it’s a sprained ankle or rheumatoid arthritis, is usually all it takes to reduce inflammation, ease swelling, and alleviate pain. 

Leg swelling from fluid retention 

Lower extremity swelling caused by the accumulation of fluids in your tissues is a painless condition known as peripheral edema. It can be a temporary symptom caused by:

  • Sitting for hours (air or car travel)
  • Standing still for long stretches
  • Wearing tight stockings or pants 

Persistent peripheral edema — which is usually painless — may be an ongoing side effect of pregnancy, obesity, chemotherapy, certain medications, or even a high-sodium diet. It may also be a symptom of a serious, hidden health problem, such as:

  • Heart disease (i.e., cardiomyopathy, heart failure)
  • Pulmonary hypertension or thrombophlebitis
  • Chronic kidney disease or acute kidney failure 
  • Blockage in the lymphatic system (lymphedema) 

In many cases, persistent peripheral edema is a symptom of chronic venous insufficiency (CVI) or progressive leg vein damage that leads to a fluid buildup through poor circulation.  

How vein damage causes leg swelling 

As one of the most common forms of vascular disease, venous insufficiency happens when your leg veins sustain some type of damage that leads to inadequate blood flow or drainage. Often, that damage comes in the form of weak or dysfunctional vein valves. 

 Your blood is supposed to flow through leg vein valves efficiently as it makes its way back to your heart and lungs for fresh oxygen. When vein valves are damaged, however, blood pools behind them, exerting considerable pressure on the surrounding vessel wall and slowing the entire circulatory process.  

Over time, these areas of high intravascular pressure may cause the affected vessel wall to bulge and distort — or become “varicose.” Chronically sluggish lower extremity blood flow can also damage nearby capillaries, prompting them to leak fluid, blood cells, and proteins into adjacent tissues, including your skin. 

The longer CVI goes untreated, the more problems it can cause. Without care, what starts as persistent leg swelling can lead to the formation of:

CVI vein damage and its complications can often be linked to underlying peripheral vascular disease (PVD), or the vessel-narrowing buildup of plaque in leg veins that impairs circulation even more.  

Never ignore persistent leg swelling 

Chronic lower extremity swelling isn’t a problem you can ignore — it should be investigated by one of our experts as soon as possible. By conducting a thorough health evaluation complete with diagnostic ultrasound imaging, our team can pinpoint the underlying cause of your leg swelling and provide the care you need to ease your symptoms and protect your health. 

If you’re experiencing persistent leg swelling, we can help. Call or click online to schedule an appointment at Somerset Surgical Associates, LLC, in Somerville, New Jersey, today. 


We accept most insurance providers. If you have specific questions regarding your coverage, please contact us for additional information.

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