Limb Edema: Causes, Treatments, and When to Seek Help

Peripheral edema

I have been experiencing erysipelas in my left foot, which sometimes causes pain, prompting me to take anti-inflammatory medication prescribed by the hospital.
When the pain is more severe, I also receive anti-inflammatory injections, which provide some relief.
This condition has persisted for many years; initially, it only affected my left foot, but in the past six months, I have been experiencing frequent swelling.
It started with my face and hands, but after taking diuretics, I was able to eliminate a large amount of urine, which reduced the swelling in my hands and face, allowing me to work normally.
However, in the last two to three months, I have been experiencing persistent swelling, especially in my palms.
Even after taking diuretics, the swelling does not seem to subside within a day, making it very inconvenient to handle objects.

Additionally, I had a physical examination that indicated elevated uric acid levels, and I have noticed a small red spot on my left foot that is quite painful.
I would like to know how to address my swelling issue so that I can work normally.
I suspect that the swelling may be related to high uric acid levels or poor kidney function.
Could you advise me on which specialty I should consult? Can you recommend a general hospital where I can seek treatment? (I prefer a regular hospital since large hospitals often have long wait times.
I have been advised to be hospitalized multiple times due to the erysipelas in my left foot, but previous admissions have not resolved the issue; they only advised me to avoid injuries to my foot.)
I would also like to know if the pain relief and anti-inflammatory medications I frequently take could negatively affect my kidney function.
Here are the medications I commonly use:
1.
Lysozyme 90mg (active ingredient: LYSOZYME CHLORIDE)
2.
Ibuprofen 400mg (active ingredient: IBUPROFEN)
3.
Doxycycline 100mg (active ingredient: DOXYCYCLINE HCL)
4.
Amoxicillin 500mg (active ingredient: AMOXICILLIN TRIHYDRATE)
5.
Ulstop F.C.
20mg (active ingredient: FAMOTIDINE)
6.
Rasitol 40mg (active ingredient: FUROSEMIDE)
I kindly request your advice and look forward to your suggestions.

Zhuang Xiansheng, 40~49 year old female. Ask Date: 2012/04/13

Dr. Chen Zonglin reply Family Medicine

In assessing edema, in addition to the commonly known evaluation of kidney function, it may also be necessary to assess liver function.
Furthermore, some cases may involve issues related to blood vessels or lymphatic vessels.
As mentioned in your text, it is difficult to assist you with the evaluation.
You may first seek assistance at a general clinic or hospital for evaluation, and if necessary, the physician can refer you to a larger hospital for further management.

Reply Date: 2012/04/13

More Info

Limb edema, or swelling in the limbs, can be a complex condition with various underlying causes. In your case, it seems to be associated with a history of erysipelas (丹毒), which is a bacterial skin infection that can lead to inflammation and swelling. Additionally, you mentioned experiencing high uric acid levels, which can contribute to gout and potentially lead to swelling in the joints and surrounding tissues.

Causes of Limb Edema
1. Infection: Conditions like erysipelas can cause localized swelling due to inflammation and fluid accumulation. This is often accompanied by pain, redness, and warmth in the affected area.

2. Kidney Function: Impaired kidney function can lead to fluid retention, resulting in edema. If your kidneys are not filtering waste effectively, it can cause fluid to build up in the body.

3. High Uric Acid Levels: Elevated uric acid can lead to gout, which is characterized by sudden and severe pain, redness, and swelling in the joints. This can also contribute to overall limb swelling.

4. Medications: Certain medications, including non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can have side effects that may affect kidney function, especially with long-term use. Diuretics (like furosemide) can help reduce swelling but may also lead to electrolyte imbalances if not monitored properly.

5. Heart Issues: Conditions affecting heart function can lead to fluid retention and swelling in the limbs.

Treatments for Limb Edema
1. Diuretics: As you mentioned, you are taking furosemide, which is a diuretic that helps the body eliminate excess fluid. However, it’s essential to use this medication under medical supervision to avoid dehydration and electrolyte imbalances.

2. Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain and inflammation but should be used cautiously, especially if you have concerns about kidney function.

3. Compression Therapy: Wearing compression stockings can help reduce swelling by promoting better circulation in the legs.

4. Elevation: Elevating the affected limb can help reduce swelling by allowing fluids to drain away from the area.

5. Dietary Changes: Reducing salt intake can help minimize fluid retention. Staying hydrated is also crucial, as it helps the kidneys function properly.

When to Seek Help
You should seek medical attention if:
- The swelling worsens or does not improve with home treatments.

- You experience severe pain, redness, or warmth in the swollen area, which could indicate an infection.

- You have difficulty breathing, chest pain, or other systemic symptoms, which could suggest a more serious condition.

- You notice changes in urination, such as decreased output or changes in urine color.

Recommended Specialists and Hospitals
Given your symptoms and history, it would be advisable to consult a nephrologist (kidney specialist) to evaluate your kidney function and manage your uric acid levels. Additionally, a rheumatologist may be helpful if gout is suspected.
For general care, you can consider visiting a general practitioner or an internal medicine specialist who can provide a comprehensive evaluation and refer you to the appropriate specialists.
In terms of hospitals, you might want to look for community hospitals or clinics that have shorter wait times compared to larger hospitals. Many community hospitals have outpatient services that can address your needs without requiring long waits.

Conclusion
Managing limb edema effectively requires a comprehensive approach that addresses the underlying causes. It’s essential to work closely with your healthcare providers to monitor your symptoms, adjust medications as needed, and explore other treatment options. Always communicate any new or worsening symptoms to your doctor promptly to ensure appropriate care.

Similar Q&A

Understanding Edema: Causes, Treatments, and Specialist Consultations

I am 22 years old, 158 cm tall, and weigh 47 kg. I often experience body swelling, which is very concerning for me. Are there any medications or prescriptions that can help? Which department should I consult for this issue?

Dr. Tang Jieru reply Cardiology
Hello Ms. Cat: Edema refers to the accumulation of excess fluid in the body, most commonly seen in the eyelids and lower extremities. You can press the skin on the front of your calf with your hand; if the skin remains indented for several seconds after you release your hand befo...

Understanding Causes of Lower Limb Edema: When to Seek Further Medical Advice

Hello Doctor: My father has been experiencing lower limb edema (with pitting), abdominal bloating, loss of appetite, subjective fatigue (increased sleep duration), along with pain in the skin of both legs and ankle joint pain. Additionally, his lower limb skin has darkened. He ha...

Dr. Xie Rongyuan reply Internal Medicine
Hello: If the albumin level in the blood is too low, it may also cause lower extremity edema. It is recommended to check the albumin level data, as low levels can lead to lower limb swelling. Thank you for your message!

Effective Treatments for Leg Edema Caused by Prolonged Standing

If your mother is experiencing calf edema due to prolonged standing at work, it is important to address the issue appropriately. She should consider consulting a specialist in vascular medicine or a phlebologist, as they focus on conditions related to veins, including varicose ve...

Dr. Xiao Yongxun reply Internal Medicine
Hello: In response to your question, edema is the swelling of soft tissues due to an abnormal increase in interstitial fluid. Common diagnoses include localized venous obstruction, lymphedema, as well as systemic conditions such as heart failure, nephrotic syndrome, hypoalbuminem...

Understanding Unexplained Foot Edema: Causes and Treatment Options

I have undergone a full-body health check at Chang Gung Memorial Hospital and have consulted with specialists in cardiology, nephrology, and metabolism, but no underlying cause has been identified. Some doctors have mentioned that it is idiopathic edema, which cannot be treated. ...

Dr. Hong Hongchang reply Internal Medicine
1. Edema of unknown origin; consume low-sodium foods. 2. Elevate your legs while sleeping. 3. If symptoms persist, please follow up at the internal medicine outpatient clinic. For obesity, increase metabolic function: exercise more and reduce intake of high-calorie foods. If ...