Leg swelling, also called oedema, can appear after a long working day, hours of sitting, a long journey or in hot weather. Sometimes it is short-lived and goes away after rest, but legs that swell regularly can also be a sign of vein problems or other health conditions.
It is important to notice whether both legs swell or only one, when the swelling appears and whether it comes with pain, redness, shortness of breath or other symptoms.
What is leg swelling?
Leg swelling happens when fluid builds up in the tissues. It is most often noticed in the feet, ankles or lower legs. Shoes may feel tighter, socks leave deep marks and the legs feel heavy and tired in the evening.
Sometimes pressing a finger on the swollen area leaves a dent in the skin for a short time. However, not all swelling looks the same, and its cause cannot be determined from appearance alone.
Leg swelling is not a diagnosis in itself. It is a symptom, and its causes can range from fairly simple to medically serious.
Why do my legs swell?
Many factors can cause leg swelling. Vein disease is not always the cause, but problems with how the veins work are one of the most common reasons, especially when the swelling keeps coming back in the evening.
Common causes of leg swelling include:
- sitting or standing for long periods;
- an inactive lifestyle;
- hot weather;
- long car journeys or flights;
- pregnancy;
- being overweight;
- venous insufficiency;
- varicose veins;
- certain medicines;
- injuries or joint inflammation;
- problems with lymphatic drainage;
- heart, kidney, liver or thyroid disease;
- deep vein thrombosis.
If your legs started to swell after you began a new medicine, do not stop taking it on your own. Talk to your doctor, who can assess whether the two are linked and whether your treatment needs to change.
Why do my legs swell in the evening?
If the swelling mainly appears at the end of the day and goes down after a night’s sleep, one possible cause is impaired return of blood through the veins.
The valves inside the leg veins help blood flow towards the heart. If they do not close properly, gravity causes some blood to pool in the legs. Pressure in the veins rises, and fluid can build up in the tissues.
Possible signs of chronic vein disease include:
- swollen legs and ankles in the evening;
- a feeling of heaviness or fullness in the legs;
- pain or tiredness after standing for a long time;
- night cramps in the calves;
- itching or burning;
- visible enlarged veins;
- changes in skin colour or texture around the ankles.
Symptoms caused by the veins often get worse after long periods of standing and ease when you rest with your legs raised. Varicose veins can also cause heaviness, pain and swollen ankles. NHS information on varicose veins
Does leg swelling always mean a vein problem?
No. Swelling in both legs can also be linked to heart, kidney, liver or hormonal conditions. Certain medicines, pregnancy, lack of movement and too much salt in the diet can also contribute.
If both legs are swollen, the swelling is already there in the morning, gets worse quickly or comes with shortness of breath, unusual tiredness or other general symptoms, you may need to see your GP or another specialist.
A phlebologist can check whether the swelling is related to how your leg veins are working. If the vein examination shows no significant changes, the doctor may recommend further tests with the appropriate specialist.
What does it mean if only one leg is swollen?
Swelling in one leg needs particularly careful assessment. It can be caused by an injury, inflammation, or problems with venous or lymphatic drainage, but sudden swelling of one leg can also be a sign of deep vein thrombosis (DVT).
Possible signs of deep vein thrombosis include:
- sudden swelling of one leg;
- pain or a pulling sensation in the calf or thigh;
- red or darker skin;
- warmer skin over the swollen area;
- painful or more prominent surface veins.
Deep vein thrombosis is a blood clot in a deep vein. It can be dangerous because part of the clot can travel to the lungs and cause a pulmonary embolism. Swelling and pain in one leg are typical signs that need urgent medical assessment. NHS information on deep vein thrombosis
When should I seek help immediately?
Seek urgent medical help if:
- one leg has swollen suddenly for no clear reason;
- the swelling comes with pain, redness or noticeable warmth;
- you suddenly become short of breath;
- you have chest pain, especially when breathing in;
- you feel dizzy, faint or very weak;
- you are coughing up blood.
Shortness of breath or chest pain together with a swollen leg can be a sign of a pulmonary embolism. In this situation, call 113 or 112 — do not wait for a routine phlebologist appointment. NICE guidance on diagnosing venous thromboembolism
When should I see a phlebologist?
A phlebologist specialises in diagnosing and treating vein disease. A consultation is recommended if:
- your legs regularly swell in the evening;
- the swelling keeps coming back for no clear reason;
- your legs feel heavy, painful or cramp;
- you can see enlarged or knotted veins;
- one leg has been more swollen than the other for some time;
- the skin colour around your ankles has changed;
- the skin has become hard, dry or itchy;
- you have a wound that is slow to heal;
- you have had deep vein thrombosis before;
- you want to find out whether vein disease is causing the swelling.
There is no need to wait until the veins become clearly visible. Problems with venous return can cause symptoms even when no large enlarged veins can be seen.
Dr. med. Roberts Rumba
Vascular surgeon, phlebologist
How does a phlebologist check the leg veins?
During the visit, the phlebologist asks when the swelling appears, whether it affects one or both legs and what other symptoms come with it. The doctor also asks about past operations, injuries, pregnancies, blood clots, current medicines and other conditions.
To assess the veins accurately, a leg vein duplex ultrasound may be done. This ultrasound scan helps to:
- assess blood flow in the veins;
- check how the vein valves are working;
- detect backflow of venous blood;
- examine the deep and superficial veins;
- find a thrombosis or the changes it has caused;
- choose the most suitable treatment.
The scan is painless and uses no ionising radiation. Duplex ultrasound is also used to diagnose varicose veins and plan their treatment.
What can I do if my legs tend to swell?
If there are no sudden or worrying symptoms, simple everyday measures can help your legs feel better:
- walk regularly and move your feet;
- avoid sitting or standing in one position for a long time;
- get up regularly if you work sitting down;
- raise your legs when resting;
- keep to a healthy body weight;
- avoid too much salt;
- wear comfortable shoes and clothing that does not press on your legs.
These measures can ease the symptoms, but they do not replace finding out the cause.
Compression stockings are not a universal solution for every patient. Before buying them, it is best to find out the cause of the swelling and ask a doctor about the right compression class and size. This is especially important for people who may have problems with the arteries.
Diuretics (water tablets) should not be taken on your own initiative either. They do not treat every cause of leg swelling and can upset the balance of fluids and electrolytes.
Swollen legs? Get your leg veins checked
If your legs regularly swell, feel heavy, ache or you can see enlarged veins, a phlebologist consultation in Riga is recommended.
At Republikas laukuma klīnika, a phlebologist consultation and a leg vein duplex ultrasound can be done in a single visit. This makes it possible to assess your veins straight away and find out whether problems with the veins are causing the swelling.
To book an appointment with a phlebologist in Riga city centre, call:
Frequently asked questions
Why do my legs swell in the evening but less in the morning?
This pattern can be linked to long periods of sitting or standing, or to impaired return of blood through the veins. If the swelling keeps coming back, it is a good idea to have your leg veins checked.
Which doctor should I see for swollen legs?
If your legs feel heavy, you have enlarged veins or the swelling gets worse in the evening, a phlebologist is the right specialist. If both legs are swollen and you also have shortness of breath or other general symptoms, start with your GP. Sudden swelling of one leg must be assessed urgently.
Can a phlebologist do a vein ultrasound straight away?
Yes. At Republikas laukuma klīnika, a phlebologist consultation and a leg vein duplex ultrasound can be done in a single visit.
Can legs swell without visible varicose veins?
Yes. Problems with how the veins work can cause heaviness, tiredness and swelling even when no large knotted veins are visible under the skin.
Are swollen legs always dangerous?
No. Swelling can appear after long periods of sitting or standing, or in hot weather. However, swelling that keeps coming back, gets steadily worse or appears suddenly should be assessed by a doctor.
Questions about your health?
Specialist doctors see patients at Republikas laukuma klīnika in central Riga. Our reception will help you choose the right specialist and time.
