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Question about my knee/leg. By the end of the day my knee,

question about my knee/leg. By...

question about my knee/leg. By the end of the day my knee, calf, ankle and foot swells up and is a little painful-not bad but it is all so swollen and stiff. I ice it down with my leg elevated above my heart and take one dose of Norco if needed. What can I do to help slow this swelling? The PT gave me a sleeve for my leg today. Guess I need some reassurance I am doing everything I can to keep my knee and leg healthy.

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Answered in 1 hour by:
1/3/2013
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 36,198
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Verified
Greetings.

I am sorry that your question was unanswered for long. I saw your previous interaction on this question with other experts here on JustAnswer.

Swelling of feet, ankles and calves on both the sides can be associated because of the following reasons;

It is always important to discuss this with your primary care physician for the evaluation.

1) Venous valvular incompetence
2) Obstruction of the lymphatic outflow
3) Dependent edema which can occur because of the prolonged standing or sitting.
4) Congestive heart failure
5) Kidney diseases
6) Protein deficiency
7) Hypothyroidism
8) Anemia
9) Medications.

Following measures can be helpful:

1) Avoid prolonged standing or walking for long distances in a single stretch.
2) Whenever you sit; keep your legs elevated on a chair or a sofa or stool. Do not hang the legs, otherwise gravity will increase the swelling.
3) Exercises / physical therapy
a) Lie down straight and raise your leg and feet for 10-20 seconds. Repeat this for ten times (twice a day whole set).
b) When you sit; pull the feet towards you for 10-20 seconds. Repeat it for ten times twice a day.
4) Raise leg end of your bed by 6 inches.

Throbbing pain can be helped by;

1) Analgesics
2) Acupuncture
3) A very mild massage; keeping the massage direction towards heart.
4) Electrical stimulation; this is a small device which physical therapy centers would give your for the home use.

The knee surgery may the contributory reason for the swelling. Any surgery impeded the lymphatic flow of the limbs and the sluggish flow may be contributory to the swelling.

Idiopathic edema is another entity which may be the cause of swelling. Unfortunately, the cause is not clearly known. Idiopathic edema may be a multifactorial disorder that has not been completely delineated. The postulated causes are;

1) secondary hyperaldosteronism,
2) primary abnormalities of the hypothalamus,
3) Abnormalities of thyroid,
4) dopaminergic release

The underlying cause seems to be due to fluid leaking out of the small blood vessels called capillaries into the tissues. Why this occurs in some people is not clear. It is usually worse after standing for long periods, as there is increased pressure in veins when standing compared to lying down. Long periods sitting can also worsen the swelling. One other possible explanation is the retention of salt. When the body retains salt it also holds on to fluid and thereby may cause some edema. Idiopathic edema is characterized by impaired water excretion also, particularly in the upright posture. Indirect evidence has shown that antidiuretic hormone is involved in this disease.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

We have recently implemented a new rating and feedback system. Please be aware that you are rating my courtesy and service as a professional. If you have any questions whatsoever, or there is anything I can clarify for you, please temporarily bypass the rating system by clicking “Continue the Conversation” or "Reply."

Clicking either of the lowest two options reflects poorly on me so please reply to me if there is anything else I can do to help before choosing those options. I appreciate your patience while we work out the kinks. It's important to me that you are 100% satisfied with the service I have provided you. Thank you.
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 36,198
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Verified
Dr. Arun Phophalia and 87 other Health Specialists are ready to help you
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Customer reply replied 4 years ago

Wow!!!!! Thank you so much for such a kind and extremely detailed response. I feel much better now. I was very anxious about this because I have a long medical history. Again, thanks!

You are very welcome.

Please let me know, if you have any further questions.

It is privilege assisting you.

Wishing you a very happy, healthy and prosperous new year 2013.
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Dr. Arun Phophalia
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 36,198
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Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine

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