Why do my feet swell after sitting for long?

Doctor, why do my feet swell when I sit for a long period?

Maureen

Dear Maureen,

The swelling, also called oedema, is caused by accumulation of excess fluid under the skin or in between the tissues. It can happen in the feet, around the ankles, the legs, hands and arms, and even in other spaces within the body like around the brain, the heart, the lungs and in the abdomen.

It may be acute, developing quickly, and also resolving over a short period of time. This can be caused by spraining an ankle, infection, blood clot, bee or wasp sting, allergic reactions, and worsening of kidney or heart failure.

It can also be chronic, developing over time and lasting for a long time. This can be caused by problems with blood flow or draining of lymphatic fluid, heart failure, kidney disease, liver disease, thyroid disease, low blood level or a tumour in the pelvis.

In your case, it may be due to poor circulation, either blood flow or drainage, when you are seated. This is because the leg muscles act like a “heart”, pumping fluid back to the upper body, so when there is no leg movement, there is no pumping activity. There may also be a problem with the valves in the blood vessels that prevent blood that is on its way to the upper body from flowing backwards to the lower limbs. The swelling may also develop if you have a swelling within the pelvis such as pregnancy or fibroids. It is advisable to visit a doctor for examination. A doppler ultrasound scan may be requested – a scan that checks the blood flow within the veins. If this is normal, you may consider a pelvic ultrasound scan to check for swellings/tumours in the pelvis.

Treatment involves increased leg exercise, elevating the feet, avoiding prolonged sitting or standing at one place. You may be advised to wear compression stockings to improve blood (or lymphatic) flow.

In some women, especially between 20 and 30 years of age, the cause may not be any of the above. If that’s the case for you, then management involves elevating and exercising the legs, reducing your weight if you are overweight, reducing salt intake and avoiding taking too many fluids.

Dear Dr Flo,

My feet itch and are sometimes painful when I wear open shoes or when exposed to air. What could be the problem?

Martin

Dear Martin,

The itching of the feet and pain could be due to a nerve problem. Other causes may include having a fungal infection on the feet, sweating of the feet, impaired blood flow and inflammatory skin conditions like skin allergy, eczema and psoriasis. Rarely, other conditions can also cause itching of the feet like liver and kidney diseases.

To manage it, do not stand for long; move around every few minutes to help with blood flow and relieve pressure from your nerves and muscles. You can also sit down after standing for a while and raise the legs with a pillow or foot rest.

You can use cold packs to cool your feet or soak them in warm water and then massage them to improve blood supply. Wear clean socks and well aerated shoes with good insoles, preferably not wearing the same shoes on consecutive days. Avoid walking on wet surfaces to avoid getting a fungal infection.

It would be good to be reviewed by a doctor. Some tests that can be done are a blood sugar test, vitamin deficiency test, nerve conduction study and if a particular illness is suspected, then there will be tests targeting that specific illness.

If an underlying cause can be identified, treating the cause will stop any further nerve damage. For example, if the problem is diabetes, the best way to control the symptoms is by controlling the blood sugar levels. Unfortunately, nerves do not heal easily and any damage they may have already suffered may not be reversible. Medication can be given for the pain including painkillers, pregabalin, amitriptyline, gabapentin and other medications that help relieve nerve pain. Vitamin B supplements may also be given. If you have a fungal infection, it can be easily treated with antifungal medication. Inflammatory skin conditions can be managed with creams and oral medications.

What causes arthritis?

Alnashir

Dear Alnashir,

Arthritis refers to inflammation within a joint. It can affect one or more joints in the body, including the upper or lower limbs and even the bones of the spine. Arthritis can result in pain, swelling, stiffness and/or warmth at the joint. It may be caused by wear and tear of a joint; overuse; infection; injury; gout or an auto immune illness (where the body’s own immune system attacks some parts of the body, in this case, the joint). You are more likely to suffer from arthritis if one of your close family members also has arthritis, or if you are older in age, or if you have had injury to that joint before, or if you are overweight.

Arthritis symptoms are recurrent and never fully go away. Treatment is aimed at reducing the symptoms and further damage to the joint. There is medication to relieve pain and inflammation, and physiotherapy also helps with the symptoms. Treatment also depends on the cause of the arthritis, for instance,if there is gout, medicine to reduce uric acid levels is used.

Other measures are maintaining a healthy weight, proper diet, reducing alcohol consumption (especially beer), reducing consumption of meat and seafood, taking a lot of water, exercise, and use of hot or cold packs.

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