Sign up
Log in
EspañolWhat causes swollen legs from the knee down? Related conditions and treatments
Overview: What do swollen legs from the knee down look like?
Edema is swelling caused by excess fluid in the body’s tissues. It can be due to high blood pressure in the veins, too much water in the blood, or capillaries that leak too much fluid. Edema and fluid buildup frequently happen in the lower legs and feet due to gravity and distance from the heart. Swollen legs from the knee down are usually very obvious. The calves, ankles, and feet get larger and thicker. The skin around the swollen area gets tight and shiny. Sometimes, pressing on the swollen site with a finger will leave a pit or depression that can take a while to go away. There’s usually no pain, but sometimes there is. There are many causes of swollen legs below the knee. Some may be minor, like medication side effects. However, swelling below the knees can be a sign of a serious condition, such as kidney failure, heart failure, or a blood clot, so a healthcare professional should look at it and diagnose the cause.
Key takeaways:
Having swollen legs from the knee down is a common symptom that may be caused by venous insufficiency, blood clots in the leg, bacterial infections, lymph buildup, heart failure, kidney disease, liver disease, pregnancy, hypothyroidism, allergies, obstructive sleep apnea, and prescription drugs.
Typically, swollen legs from the knee down do not require immediate medical attention.
Swollen legs from the knee down generally require treatment. They may improve or resolve with treatment, depending on the cause.
Treatment of swollen legs from the knee down may include treating the underlying cause, diuretics, compression stockings, pneumatic compression devices, decongestive physiotherapy, and surgery.
Swollen legs from the knee down can be managed by reducing salt intake, standing and walking regularly, elevating the legs, or wearing support stockings or similar compression clothing.
Use coupons for swollen legs from the knee down treatments, like Lasix (furosemide), Bumex (bumetanide), and Aldactone (spironolactone), to save up to 80%.
What causes swollen legs from the knee down?
Swollen legs below the knee can be a localized problem with one or both legs. Local causes of swollen legs from the knees down include:
Chronic venous insufficiency, a condition in which leg veins are damaged, and blood flows back into the leg veins rather than up to the heart
Deep vein thrombosis (DVT), a blood clot in the leg’s veins that blocks blood flow to the upper body
Lymphedema, an accumulation of fluid that is normally drained away by the lymph system
Cellulitis, a bacterial infection of the skin
Compartment syndrome, increased pressure within a leg muscle
A blockage of the iliac vein, the large vein in the pelvis through which blood flows back to the heart
Lipedema, a fluid buildup in fat cells
Complex regional pain syndrome, a medical condition with uncertain causes that produces pain in the legs or arms
Other causes of swollen legs from the knees down often cause swelling in other parts of the body. These generalized causes of swelling include:
Heart failure
Liver disease
Kidney disease and kidney failure
Underactive thyroid
Malnutrition
Allergic reactions
Pulmonary hypertension
Side effects of prescription drugs
Though not a cause of lower leg edema, obesity can lead to conditions that cause swollen legs from the knee down.
Should I be worried about swollen legs from the knee down?
Swollen legs below the knees are common, particularly among older adults. The swelling is rarely a serious health threat, but it raises the risk of complications, such as infections and sores. It’s the underlying cause that’s the issue, but the cause is not always worrisome. For instance, it may be a medication side effect or a problem with diet. However, swollen lower legs may indicate a serious medical condition, like heart failure, kidney disease, liver disease, or a blood clot.
See a healthcare professional if one or both of your legs are swelling. Get emergency medical treatment if one or both legs swell up quickly or if there are other symptoms, such as chest pain, shortness of breath, fatigue, coughing up blood, cramping, or throbbing leg pain.
How is the cause of swollen legs from the knee down diagnosed?
When faced with a patient with swollen legs below the knee, the clinician has to discover why the leg is swelling. Because there are several different causes and there could be more than one cause, the clinician will take a thorough medical history. Expect questions like:
How quickly did the swelling happen? Did it happen gradually over time or all at once?
Are there any other symptoms in the leg, like pain or heaviness?
Are there other general symptoms, like coughing or fatigue?
How long has the leg been swollen?
Is it worse during the day?
Does it improve or not improve when the leg is elevated?
What medications, over-the-counter drugs, and supplements do you take?
Have you had blood vessel problems in the past?
Have you been injured? Have you had surgery?
Have you had cancer? Have you had radiation treatment?
A thorough physical examination will involve the lower extremities, heart, lungs, liver, kidneys, and other body parts. Even if only one leg is swollen, both legs will be carefully examined. On the swollen leg, the clinician will look at the color of the swollen area, feel the texture of the skin, and check for ulcers, skin infections, swollen feet, pitting, warmth, tenderness, or damaged veins like varicose veins.
Blood tests will be administered to measure several parameters, including blood count, thyroid hormones, liver enzymes, protein levels, and any chemical markers of a blood clot. A urinalysis may also be needed.
An ultrasound scan of the leg may be used to evaluate the veins in the leg, but this is most commonly used if a cause can’t be determined. CT or MRI scans may be used if the clinician suspects certain causes, such as a compressed iliac vein. Chest X-rays, electrocardiograms, and other heart tests will be used for suspected heart failure. In rare cases, a clinician may use an invasive procedure, called an intravascular ultrasound, to look directly at the insides of blood vessels in the legs.
How long do swollen legs from the knee down last?
Swollen lower legs and feet may be a temporary or chronic problem, depending on the cause. Some of these causes can be fixed, like medication side effects. Other causes, like heart failure and venous insufficiency, may not be curable.
How to stop swollen legs from the knee down
Swollen legs are not curable. Instead, treatments for them focus on either treating the cause or improving the swelling and other symptoms. The swelling is not life-threatening, so healthcare professionals will focus their attention on the cause:
People with a blood clot in the leg will be treated with blood thinners or clot-busting drugs
Bacterial infections are treated with antibiotics
Edema caused by medications is treated by switching medication regimens
People with swelling due to diet can change their diets
Obstructive sleep apnea is treated with positive pressure devices
Surgery may be used in some cases of venous insufficiency, blood clots, or iliac vein obstruction.
If the causes of leg swelling can’t be resolved, then the swelling and other symptoms can be partly reduced or managed through a variety of interventions:
Depending on the cause, diuretics (water pills) can be taken to reduce swelling
Compression garments can control and reduce swelling in people with a blood clot, venous insufficiency, or lymphedema
Pneumatic compression devices—inflatable leg sleeves or boots—prevent swelling and blood clots in people with blood clots, lymphedema, or venous insufficiency
Physical therapy reduces swelling and increases the range of motion in the swollen leg
Complete decongestive therapy—massages to drain fluids from tissues, compression bandages, exercise, and skincare—is used to reduce swelling caused by lymphedema, as well as prevent infections and sores
Living with swollen legs from the knee down
Some people have persistent swelling in their legs, ankles, and feet that does not go away. A few tips can help reduce the swelling and increase general wellness:
Follow all instructions given by healthcare providers
Lose weight or maintain a healthy weight
Eat a healthy diet with adequate protein and vitamins
Reduce salt intake
Use compression garments on the legs and feet
Elevate the leg above the level of the heart when possible
Avoid sitting still for long periods of time because not moving can cause fluid to build up in the legs
Walk and move around periodically to help drain excess fluid in the lungs
Gently but firmly massage the swollen area to release excess fluid retention from the tissues and move it to lymph nodes
Keep the skin in the swollen area clean, and use moisturizers
Most importantly, see a healthcare professional
Leg swelling alone is not a serious health threat, but it may be a sign of a serious condition. It also can cause discomfort and interfere with range of motion, walking, and performing daily functions. More seriously, chronic leg swelling can result in complications, like sores and infections, even if the cause of the swelling is minor. See a healthcare professional about swollen legs.They can determine if the cause is minor or serious, then start the appropriate treatment.
FAQs about the causes of swollen legs from the knee down
Do swollen legs mean heart failure?
Many different types of medical conditions can cause swollen legs. Heart failure is just one of the possible common causes of leg swelling. If leg swelling is due to heart failure, other symptoms are likely to be experienced, including fatigue, shortness of breath, dizziness, lightheadedness, sweating, and a persistent cough. As far as leg swelling is concerned, people with heart failure typically develop swollen legs gradually, rather than within a few days.
What medications cause leg swelling?
The most commonly-used medications that cause edema include certain high blood pressure medications, such as beta blockers and calcium-channel blockers, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), male or female hormones, a family of diabetes drugs called thiazolidinediones, some anticancer drugs, and vasodilators.
What organ failure causes swollen legs?
Swollen legs can be caused by heart, kidney, or liver failure. These organ failures all cause swelling in different ways, but the result is fluid building up in the body’s tissues, especially the legs. These diseases will have other symptoms besides swelling. Additionally, people who develop organ failure often know well in advance that they have problems with these organs. Still, heart, kidney, or liver failure can develop very rapidly in some cases.
What’s next? Additional resources for people with swollen legs from the knee down
Test and diagnostics
Diagnostic approach to lower limb edema, Phlebology
Edema: diagnosis and management, American Family Physician
Intravascular ultrasound, Cleveland Clinic
Peripheral edema, StatPearls
Treatments
Complete decongestive therapy, Physiopedia
Treatment of edema, American Family Physician
Scientific studies and clinical trials
Peripheral edema, PloS ONE