Podiatrist (Foot and Ankle Specialist) Questions Swelling

What to do for swollen feet?

My mother is 70 years old and is heavily diabetic. She is unable to walk much because her feet swell up to a large extent. Most of the day she keeps her foot elevated but the minute she walks they swell up. Is there a way to manage this condition better?

16 Answers

Yes! She needs a vascular consultation to check circulation in lower extremities. She could be a good candidate for compression pump therapy for one hour 2 times per day when she is resting at home. Also, when she is standing or walking, she should have compression socks on at all times. Continue elevating the foot when she is resting on the bed. I hope this will help to reduce down your mother's foot swelling.
Her problem is circulatory; not only the feet, she needs to see a specialist in circulation.
Yes. First, must check her circulation, because if that is not working well, then her blood can stay in the legs and the veins are unable to fully take the blood back to the heart for recirculation and that can lead to swelling. Certain medications for heart conditions can also lead to edema (swelling) and lower kidney function. Swelling is very common in diabetics and we must find the reason for it to treat it properly. There are lots of ways to control swelling. Swelling should be treated since it’s a sign that something in the body (plumbing) isn’t working how it should.
Compression stockings are the mainstay of treatment for patients with venous insufficiency. It is a common issue I see in my diabetic patients. I routinely perform weekly compression castings on my patients who have severe swelling to manage it with the plan to go back into compression hose once the swelling has improved. It sounds like she needs more aggressive compression. Give the office a call if you would like to schedule her an appointment. I wish you both the best of luck and thank you for the question.
Leg swelling or peripheral edema is produced by expansion of fluid within the surrounding tissues. Generalized swelling results from increased fluid pressures across the capillary beds, reduced capillary oncotic pressure or increased capillary permeability. Sodium or salt retention by the kidneys can also produce swelling. It is not uncommon for diabetics to have some level of kidney disease. It may also be compensatory in response to reduced arterial blood volume resulting from heart failure and liver disease. Peripheral swelling can also result from poor blood circulation particularly related to venous blood flow. There are drugs that can influence organ systems specifically heart, liver and kidney that can also be associated with swelling. When looking at swelling of the legs, we often characterize the presentation as nonpitting or pitting. By their own name presentation, pitting swelling produces a dimpling effect when the tissues are pressed on with gradual expansion back to their swollen state. Pitting swelling is frequently related to the previously mentioned organ disease. Non-pitting edema does not produce a dimpling effect and may be associated with vein insufficiency or chronic lymphedema. Any type of acute single leg swelling should always raise the possibility of blood clot such as deep vein thrombosis that needs to be acutely evaluated. Given the history as presented, I do believe this swelling more than likely is related to her diabetes and potential impact on other organ systems by the disease itself or medications that are required. Elevation of the extremities can be extremely beneficial when sedentary to help manage the expansion of fluid out of the vascular system. It is imperative that the cause of the swelling be established in order to provide an effective treatment. This would be best handled by your primary care physician who can assess current medications, obtain appropriate laboratory studies, and assess organ systems.
Support hose might be beneficial to help reducing her swelling. Swelling could also be coming from other issues such as circulation, hard-core kidney. I would speak with primary care physician prior to trying support hose.
Thus could be the sign of congestive heart failure. She needs to see an internist asap. This can be the precursor to a heart attack.
Most of the time swelling could be due to a poorly functioning cardiovascular system. Other factors would be congestive heart failure, kidney failure or liver pathology. Too much salt intake or drugs taken for hypertension could be also a factor. The first thing to treat chronic swelling would be to wear compressive stockings which could be purchased from a local pharmacy.
I will prescribe you Diuretics - water tablets to release the fluid retention on your ankle. Also, I will do circulation test.
She can have leg wrapping, physical therapy, compression stockings, or inflatable tubes that the patient wears on her legs and by controlled inflation milks the fluid up the legs (back into the general circulation). Usually, we give the patient a combination of some of the above.
Compression stockings or a lymphedema pump can be helpful, but the patient should also see her physician to determine if medication is needed as well.
Hi there, sounds like your mother might need a full lower extremity vascular exam to rule out any vascular disease leading to edema in her extremities. She should have a podiatric physician evaluation and posible vascular specialist evaluation as well.
The swelling usually comes from excess fluid in the lower extremities. This is usually systemic; coming from poor circulation secondary to diabetes or other health issues including kidney failure and cardiovascular problems. Some people are placed on a water pill to help remove the fluid. A primary care physician would prescribe that medication if deemed necessary. Compression stockings can also help decrease the swelling.
The swelling can be for many reasons, can be from congestive heart failure; Can be from lymph node problems; Can be from chemical imbalance; Can be from diabetes vascular compromise.
You should elevate both feet; Walk a few steps a day; Check your chemistry in the blood; Do vascular studies to the lowest extremity; Check for any infection or ulcers or inflammation that causes this edema.
Consult a cardiologist.
Would use 20-30 mmhg compression stockings
The best way to manage is to have her schedule an appointment with the PODIATRIST. Also have an evaluation by primary physician. She will need compression socks and diabetic shoes. AAFOOTCARE.COM