Pitting Edema

Table of Contents

What is a Pitting Edema?

Pitting edema is a condition where excess fluid builds up in the tissues, typically in the lower limbs, causing swelling. The term “pitting” refers to the way the skin retains an indentation when pressed with a finger. When you press on the swollen area, the indent stays for a few seconds before slowly returning to its original shape. This is because the fluid in the tissues temporarily displaces when pressure is applied.

Body swelling caused by an overabundance of fluid is called edema. Although it can happen anywhere, it usually affects the lower body, including the legs, feet, and ankles. Most edema will decrease if there is adequate fluid and the swelling is due to fluid and nothing else.

Pitting edema is typically caused by a systemic issue with your heart, kidneys, or liver, or by a localized issue with the veins in the affected area. Your thyroid or lymphatic system problems are more likely to be the cause of nonpitting edema.

In any case, having edema indicates that too much fluid is retained in certain bodily tissues and is not being adequately expelled. It’s critical to consult a physician to identify the source of pitting edema.

Causes of pitting edema?

Pitting edema occurs in a wider range of instances with differing degrees of severity than non-pitting edema, which usually arises from diseases of the thyroid (myxedema) or lymph nodes (lymphedema).

For instance, in certain situations, standing for extended periods of time causes gravity, which stops when you shift positions. Dietary changes can be made to address lifestyle variables that contribute to fluid retention, such as excessive salt consumption. However, severe conditions like chronic obstructive pulmonary disease (COPD) are among the other causes.

Medication:

Pitting edema may indicate an allergic reaction or be a side effect of a number of different drugs. Among these drugs are:

Prednisone, prednisolone, triamcinolone, and other corticosteroids
Nonsteroidal anti-inflammatory medications, such as naproxen, ibuprofen, and aspirin
Medicines for heart illness (acebutolol, betaxolol, and bisoprolol)
Drugs for high blood pressure (ACE inhibitors, beta-blockers, and diuretics)
Some diabetic drugs.

Deep Vein Thrombosis:

Although it usually affects elderly folks, young people, including children, can also have deep vein thrombosis (DVT), which is a clotting of veins deep within the body. The clotting, which is typically found in the lower thigh calf, needs to be treated right away with anticoagulants or another drug since it can cause pain and edema.

Although DVTs can be managed, problems including post-thrombotic syndrome (PTS) may result. Additionally, PTS patients may develop edema at the site of injury, necessitating the adoption of longer-term therapies such as elastic compression stockings.

Swelling in the lower limbs or elsewhere is another symptom of venous insufficiency, which is a weakening of the vein walls in the legs. Consequently, varicose veins develop.

Congestive Heart Failure:

When the heart muscle can no longer adequately pump blood to meet the body’s oxygen needs, congestive heart failure (CHF) results. Depending on which of the heart’s four chambers is affected, it may be the result of either left-sided or right-sided failure. In CHF, both sides could fail.

A buildup of fluid in the lower back (sacral edema) or lower legs (peripheral edema) is typically the result of right-sided failure. The lungs may also be impacted by the edema. The goal of treatment for CHF is to address the underlying cause, which is typically a heart problem but can also be connected to an infection, cancer treatment, or another factor.

Kidney Disease:

Edema can result from kidney illnesses such as acute glomerulonephritis and nephrotic syndrome because they impair the body’s capacity to eliminate fluids through urination. In addition to the face, the hands, feet, and ankles may be affected by the swelling.

As kidney disease progresses, it also impacts other bodily systems and results in consequences like elevated electrolyte levels, which are important minerals that include calcium and potassium. Pulmonary edema can impact the lungs in cases of renal hypertension.

Cirrhosis:

The extensive scarring of liver tissue that results in fibrosis and usually leads to a progressive loss of liver function is known as liver cirrhosis. Edema in the legs, ankles, and feet as a result of fluid accumulation is one of the symptoms in the final stages of the illness. Fluid will frequently accumulate in the abdomen as well.

Edema may result from hepatic hepatitis. Because portal hypertension prevents blood from returning to the liver from the digestive tract, alcohol-related hepatitis can also cause edema in the body.

Pregnancy:

Fluid retention during pregnancy and associated hormonal changes can result in edema. Additionally, pregnant women’s blood volumes are larger. Although it’s rather common, get checked out if you suddenly start to swell. It might indicate preeclampsia, a dangerous illness that requires immediate medical intervention.

The feet, ankles, and other lower limbs may enlarge as a result of hormonal changes caused by menstruation.

Hot Weather:

Heat edema, a moderate type of heat-related sickness, is not unusual.
These conditions also include heat exhaustion, cramping in the muscles, and heat stroke, which can be fatal.
Once a person is taken out of the heat and kept with their legs propped up to help reduce the swelling, the edema of the extremities occasionally accompanied by facial flushing usually goes away.

Symptoms of Pitting edema

Depending on the reason, further symptoms may include:

Pain and aching in the swollen areas,
As well as tingling or burning sensations surrounding the swollen,
Puffy, or stiff skin
Warm or hot skin that feels numb to the touch
Water retention cramps and bloating
Unexpected coughing,
Fatigue, or a drop in everyday strength
Breathing difficulties,
Shortness of breath,
Chest pain.
Individuals should get medical help right once if they have chest pain, dyspnea, or swelling in just one limb.

Risk factors for pitting edema?

Anyone can get pitting edema, although some people are more susceptible than others.

These consist of:

a sedentary lifestyle
a diet overly rich in sodium
obesity
multiple pregnancies
a history of lymph node surgery
thyroid conditions
lung diseases, such as emphysema
heart disease

Pitting edema during pregnancy:

Pitting edema can occur during pregnancy and normally goes away at the conclusion of the pregnancy.

Talking to a doctor about any new symptoms is a good idea, though, since they can perform tests to rule out serious illnesses like preeclampsia or extremely high blood pressure that are associated to edema.

Diagnosis and Grading of Pitting Edema:

A physical examination is usually used by medical practitioners to diagnose pitting edema. on check for a long-lasting indentation, they could apply pressure on the puffy skin for a brief period of time.

Determining the underlying cause of the edema is crucial since some related disorders are more deadly than others. Extensive testing could be necessary for this. After the source has been addressed, the edema will typically go away.

A healthcare provider may ask about drugs and take a thorough medical history in order to accurately determine the underlying problem. The patient may then be sent to a physician who focuses on problems related to the circulatory system or veins.

The following tests can help diagnose pitting edema:

imaging tests, including chest X-rays, to reveal lung fluid or an enlarged heart
ultrasound of the leg, if a blood clot is detected, echocardiogram, if cardiac involvement is suspected, and blood tests
echocardiograms, which are heart ultrasound scans.

Grading:

The depth and length of the indentation determine the classification of pitting edema. Healthcare practitioners can rate the severity using the following scale:

Grade 1: A 0–2 mm indentation is left by the doctor’s pressure, and it instantly bounces back.
Grade 2: Within 15 seconds, the 3–4 mm indentation left by the pressure returns.
Grade 3: It takes up to 60 seconds for the pressure to return after leaving a 5–6 mm indentation.
Grade 4: An indentation of at least 8 mm is left by the pressure. Rebounding takes two to three minutes.

A medical expert can choose the best course of treatment by having a thorough understanding of the degree of edema.

Treatment for pitting edema:

In order to treat pitting edema, the underlying cause of the condition must be addressed.

The variety of reasons is reflected in the variety of therapies available, but some of these include:

Raising the limb that is enlarged
lowering your salt consumption and using compression stockings if a doctor advises them and the cause is persistent
In severe cases of venous insufficiency, diuretics, often known as water pills, if the reason is heart failure, liver illness, or renal disease; blood thinners, if the cause is DVT; and vascular surgery.

Prevention of pitting edema:

Edema is unlikely to return if the underlying cause has been effectively treated.
Certain dietary and lifestyle changes can lower the incidence of edema, especially in high-risk individuals.
Keeping active, avoiding prolonged sitting or standing, and performing mild workouts to lessen edema are a few examples of these adjustments.
Edema risk can be decreased by maintaining an active lifestyle. keep away of prolonged sitting. Set a timer to remind you to get up and move around for a few minutes each hour if you work at a desk.
Because exercise promotes blood flow, it may help lower swelling. However, before beginning a new fitness regimen, consult a physician.

Complications

Your skin may alter and start to seem “woody” over time as a result of scarring surrounding the edema. These could get worse if the edema is caused by varicose veins.
Your chance of getting an infection in the swollen tissues is increased by prolonged edema, particularly if there is skin breaking.

Summary:

Pitting edema is a common symptom. Edema should not cause any long-term complications. Pitting edema is reversible, common, and curable. Although it shouldn’t result in long-term issues, it’s crucial to consult a physician for an accurate diagnosis and treatment strategy. It may occasionally indicate a more serious illness, such as renal or cardiac failure. A person may be more susceptible to pitting edema if they have certain medical issues, such as obesity or heart disease. Additionally, it’s more prevalent if you spend a lot of time sitting down or consume a lot of salt. Pitting edema may also be more common among pregnant women, so they should consult their doctor to make sure it isn’t an indication of something more serious.

Pitting edema is a form of swelling that often affects the lower limbs and results in enough fluid retention to create an indentation or pit when pressure is applied to the affected area. The depth of the pitting and the time it takes for it to go away on your skin after pressing will determine how severe the edema is. This condition is measured using the pitting edema scale.

Pitting edema can be caused by a wide range of diseases, some of which, such as congestive heart failure, can be quite dangerous. If you believe you are experiencing it, it is imperative that you see a healthcare professional.

Any swelling should be taken seriously, particularly if it is a sign of a more serious medical condition. The underlying cause of the edema will determine the course of treatment, thus it’s critical to obtain a precise diagnosis as soon as feasible. The prognosis, or potential outcomes, for your condition can then be discussed with your healthcare physician.

FAQs

Will edema from pitting go away?

After the source has been addressed, the edema will typically go away. A healthcare provider may ask about drugs and take a thorough medical history in order to accurately determine the underlying problem. The patient may then be sent to a physician who focuses on problems related to the circulatory system or veins.

Can pitting edema result from a vitamin D deficiency?

Electrolyte abnormalities and pitting edema were consistent with vitamin deficiencies, particularly severe VDD with hypocalcemia, and protein-calorie malnutrition.

What can be done at home to treat pitting edema?

Compression stockings, elevating the feet, and drinking plenty of water are examples of home remedies that could be helpful. To treat an underlying medical issue, a doctor may occasionally suggest diuretics or other therapies.

How can pitting edema be detected?

You can use your finger to feel for an indentation in swollen skin to check for pitting edema.

For pitting edema, which vitamins are beneficial?

Nutrient imbalances and deficiencies are the cause of edema; major vitamins and minerals that affect symptoms include zinc, magnesium, vitamin A, vitamin C, and vitamin B-6.

How may pitting edema be treated?

Reducing salt intake, treating the underlying cause, and utilizing compression stockings and diuretics are the methods used to treat pitting edema.

Can someone with pitting edema exercise?

Increasing blood flow in the legs is the goal of these exercises. Changing positions often and elevating the leg or legs as much as possible will assist shift fluid and minimize edema. Moving fluid will be facilitated by performing these movements from the foot to the knee to the buttocks.

Which malignancies result in pitting edema?

Some cancers may have peripheral edema as a symptom or indicator. For example, edema in your leg or foot is more likely to be caused by malignancies that are close to the pelvic veins, such as kidney, liver, ovarian, and uterine cancers.

How may pitting edema be tested for?

Pitting edema is classified into four “grades” or measures. For ten seconds, press your foot or lower thigh, then note what occurs: 0 (no pitting): when squeezed, your skin rapidly recovers. 1+: The dent is hardly noticeable.

How can pitting edema be prevented?

Reduce your intake of salt. Take a medication known as a diuretic to aid in the removal of excess fluid from your body. To maintain pressure on the swollen area and prevent fluid accumulation, put on gloves, sleeves, or compression stockings. Several times during the day or while you sleep, elevate the area of your body that has pitting edema over your heart.

Is it appropriate to massage pitting edema?

Advice for Getting a Massage for Edema:
Look for a massage therapist with lymphatic drainage experience. Do not put undue strain on the region where the fluid has accumulated. If you can get to the location, self-massage can be used to treat milder types of edema.

Does pitting edema improve with walking?

Jogging or Walking
It can activate the body’s muscles to assist the veins and lymphatic vessels, which keep blood and fluid flowing. For the majority of people, it is safe and easy on the joints, which makes it an excellent choice for reducing body edema and swelling in all conditions.

Can pitting edema be caused by salt?

In certain instances, eating too much salt may be the cause of edema. Your body retains water when you consume salt, which can induce swelling by seeping into your tissues. Your diagnosis of edema may improve if you alter your lifestyle to consume less salt.

Does heart failure always accompany pitting edema?

For a few minutes, the indentation where the finger was pressed can be apparent. Heart failure is not the only cause of pitting edema; liver and renal failure are also possible reasons.

References

Johnson, J. (2024, February 1). How to identify pitting edema. https://www.medicalnewstoday.com/articles/321773
Norris, T. (2024, October 15). Everything you should know about pitting edema. Healthline. https://www.healthline.com/health/pitting-edema
Pitting edema. (n.d.). WebMD. https://www.webmd.com/heart-disease/pitting-edema
Gurarie, M. (2024, April 3). What is pitting edema? Verywell Health. https://www.verywellhealth.com/pitting-edema-grading-5199435