Leg oedema
EBM Guidelines
Dec 28, 2022 • Latest change Jan 4, 2024
Table of contents
Extract
- Causes of leg oedema that require prompt treatment must be identified, e.g. deep vein thrombosis and heart failure.
- The most common cause of leg oedema in patients over 50 years of age is insufficiency
of the superficial or deep leg veins.
- Mildly symptomatic oedema caused by insufficiency of the veins can be treated with compression therapy (graduated compression stockings); in more severe symptoms also invasive therapies are applicable, see Venous insufficiency of the lower limbs1.
- In women under the age of 50 years, the most likely cause is idiopathic oedema and non-drug therapy is the first-line treatment approach.
- Oedema caused by medication (particularly calcium-channel blockers) must be recognised.
- Excessive use of diuretics must be avoided when oedema results from immobilisation, venous stasis or an obstruction to the lymph flow.
- In many cases, oedema is caused by a multitude of factors.
Linked evidence summaries
- Use of intermittent pneumatic compression device may be effective in treating post-thrombotic syndrome compared to a placebo device.C
- Evidence is too limited for any conclusions about the best physical therapy in the treatment of lymphoedema.D
Search terms
Aged, Cardiology, Edema, Heart Failure, Congestive, I87.2, I89*, Immobilization, Internal medicine, Lower Extremity, Popliteal Cyst, Postphlebitic Syndrome, R60*, Stockings, Compression, Venous Insufficiency, Venous Thrombosis, bilateral edema, calf edema, compression therapy, deep venous insufficiency, deep venous thrombosis, edema, orthostatic, fibrin fibrinogen degradation products, leg edema, lymphstasis, pitting edema, unilateral edema, varicose eczema, venous stasis