From the Guidelines
Leg swelling at the end of the day is likely due to venous insufficiency, and patients should elevate their legs above heart level for 30 minutes, 3-4 times daily, and especially in the evening to alleviate symptoms. This condition is characterized by a range of symptoms and signs, including pain, swelling, heaviness, fatigue, itching, and cramping in the affected limb, which may worsen by the end of the day or with prolonged standing or walking, and improve with rest or limb elevation 1. To manage leg swelling, consider the following:
- Reduce salt intake to less than 2,300 mg daily
- Stay well-hydrated with water
- Engage in regular exercise like walking for 30 minutes daily to improve circulation
- Wear compression stockings (15-20 mmHg pressure) during the day to prevent fluid buildup
- Avoid prolonged sitting or standing; take breaks every hour to move around
- Be aware that medications like calcium channel blockers, NSAIDs, or steroids may contribute to swelling It is essential to note that if swelling is accompanied by shortness of breath, chest pain, or is only in one leg with redness or warmth, seek immediate medical attention as these could indicate serious conditions like heart failure, kidney problems, or blood clots, such as postthrombotic syndrome (PTS) 1. Persistent swelling despite these measures warrants a medical evaluation to rule out underlying conditions.
From the Research
Leg Swelling After the End of the Day
- Leg swelling, also known as edema, can be caused by various factors, including heart failure, which is discussed in the provided studies 2, 3.
- According to the study published in 2021 3, diuretics, such as furosemide, are commonly used to treat heart failure and can help reduce edema.
- However, the use of diuretics can also lead to side effects, including fluid and electrolyte abnormalities, which can predispose patients to serious cardiac arrhythmias and may increase the risk of arrhythmic mortality 3.
- The study published in 2016 2 reports a case of acute kidney injury (AKI) in an infant with heart failure who was treated with enalapril and furosemide, highlighting the importance of caution when using combination therapy in pediatric patients.
- While the provided studies do not directly address leg swelling after the end of the day, they suggest that diuretics can be effective in reducing edema in patients with heart failure, but should be used with caution and under medical supervision 2, 3.
Possible Causes of Leg Swelling
- Heart failure, as discussed in the provided studies 2, 3, can cause leg swelling due to fluid buildup in the body.
- Other possible causes of leg swelling, not directly addressed in the provided studies, may include kidney disease, liver disease, and certain medications.
- The choice of diuretic and treatment plan should be guided by the patient's clinical situation and the presence of other co-morbidities 3.