As you may recall, my daughter, QOTPE, isn’t truly content unless she has something to worry about. Yes, it seems ironic to me, too. Anyway, she got that from her dad. Aaron often mentions something that’s bothering him—pre-cancerous skin lesions, fatigue, a cough, the list goes on. I offer suggestions, usually herbal, and then he goes looking for a pharmaceutical solution. Such is my lot in life. Anyway, for the past couple of years his feet and ankles have occasionally swollen a bit. And most of the time he attributed it to too much salt at dinner, and the issue resolved by the next morning. However, a little earlier this year, his ankles started swelling more, and more frequently. And one was worse than the other. And he was more than a little concerned. Truth be told, I was as well.
And so he made an appointment with his cardiologist. Aaron was primarily concerned that the swelling in his ankles suggested progression of congestive heart failure. In this case, it did not. The good doctor indicated that it was just another sign of advancing age, in his case chronic venous insufficiency. The valves in the veins that help return blood to the heart were starting to fail. And Aaron’s solution to this situation, lots of resting with his feet up, was not the best idea. In fact, the doctor stated that Aaron needed to be more active. Hallelujah.
There are several potential reasons for edema. Today we’ll cover the most common.
Edema, swelling, is the result of excess fluid trapped in the tissues of the body. It can happen anywhere, but most commonly affects the legs and feet.[1] And that’s because most edema is gravity-dependent. Fluid starts accumulating in the feet and ankles and moves up the legs as fluid accumulates. This edema is commonly called pitting edema, and this is how you test for it:
- Press thumb into skin firmly for 1-2 seconds.
- Remove thumb.
- If normal, the skin springs back into shape immediately.
- If abnormal, the thumb leaves a dent or pit in the skin.
Other signs and symptoms
The following comes from The Ship’s Medicine Chest:
Edema
Edema means the accumulation of excess body fluid. This fluid usually accumulates in the legs, abdominal cavity, or chest. Edema may be secondary to a variety of causes, the most common being congestive heart failure. Swelling of the patient’s ankles and occasionally an increase in the size of his abdomen may be noted. There may be shortness of breath either after exertion or when lying down. A history of high blood pressure, angina pectoris, heart murmur, or a variety of other symptoms related to heart disease may be present. Other common causes of edema include chronic liver disease, kidney disease, varicose veins, or previous vein inflammations (phlebitis). Also, frostbite may cause localized leg swelling.
Treatment
The amount of salt in the patient’s diet should be limited. [5] When the edema is caused by a leg problem, swelling will diminish if the legs are elevated. However, if heart failure is suspected, the legs should not be raised as this may aggravate shortness of breath. Medical advice by radio should be obtained before administering any medications. (See Angina Pectoris, p 136.) (p 138.)
Causes and risk factors
Mild edema
- Pregnancy[6] [7]
- Being premenstrual[8]
- Diet[9]
- Too much salty food[10]
- Sitting or staying in one position for too long[11] [12]
- Medications[13] [14] [15]
- High blood pressure drugs like Amlodipine (and other calcium channel blockers) [16] [17]
- NSAIDs[18], like Aleve, Advil, etc. [19]
- Diabetic medications like Avandia and Actos[20]
- Steroids[21]
- Estrogens[22]
- Thiazolidinediones[23]
- Age, 50+ years[24]
- Obesity[25]
- In women, prior pregnancies[26]
- Standing excessively[27]
- Sleeping in a chair with the legs down[28]
- Being at high altitude[29]
More serious causes
- Congestive heart failure[30] [31][32]
- Kidney disease[33] [34] [35]
- Liver damage[36] [37]
- Chronic venous insufficiency[38] [39]
- Deep vein thrombosis[40]
- Lack of protein in the diet[41]
Treatment
- Mild edema usually resolves on its own.
- Raise the affected arm or leg above the heart.
- Massage towards the heart to move the fluid along.
- Limit salt intake[42]
- Diuretics, like Lasix (furosemide) or hydrochlorothiazide
- Wear compression socks—boot socks[43]
About those compression socks. Aaron and I asked the good doctor about them. By way of reminder, he’s nearly 70 years old, and prior to coming to our little town he was the head of the cardiology department at one of the best medical schools in the country. In all his years of practice, he said, he never recommended compression socks. And then he told us why. Because they’re so dang hard to get on and they are so uncomfortable that people won’t wear them. So they do no good. What he wears (he pulled up his pant leg and showed us) and what he recommends to his patients, are boot socks. They’re basically knee-high socks for cowboys. Buy a couple different brands to determine which are most comfortable for you. That’s what Aaron did, and he is quite happy.
[1] Edema, Mayo Clinic, 21 May 2026, https://www.mayoclinic.org/diseases-conditions/edema/symptoms-causes/syc-20366493 (accessed 4 August 2026).
[2] Edema, Mayo Clinic.
[3] Edema, Cleveland Clinic, 4 February 2026, https://my.clevelandclinic.org/health/diseases/12564-edema (accessed 4 August 2026).
[4] Edema, Mayo Clinic.
[5] Edema, Cleveland Clinic.
[6] Edema, Mayo Clinic.
[7] Edema, Cleveland Clinic.
[8] Edema, Mayo Clinic.
[9] Cynthia Koelker, Armageddon Medicine, 2012, 386.
[10] Edema, Mayo Clinic.
[11] Edema, Mayo Clinic.
[12] Edema, Cleveland Clinic.
[13] Edema, Mayo Clinic.
[14] Edema, Cleveland Clinic.
[15] Koelker.
[16] Koelker.
[17] Edema, Mayo Clinic.
[18] Edema, Mayo Clinic.
[19] Koelker.
[20] Koelker.
[21] Edema, Mayo Clinic.
[22] Edema, Mayo Clinic.
[23] Edema, Mayo Clinic.
[24] Koelker.
[25] Koelker.
[26] Koelker.
[27] Koelker.
[28] Koelker.
[29] Koelker.
[30] Edema, Mayo Clinic.
[31] Edema, Cleveland Clinic.
[32] Koelker.
[33] Edema, Mayo Clinic.
[34] Edema, Cleveland Clinic.
[35] Koelker.
[36] Edema, Mayo Clinic.
[37] Edema, Cleveland Clinic.
[38] Edema, Mayo Clinic.
[39] Edema, Cleveland Clinic.
[40] Edema, Mayo Clinic.
[41] Edema, Mayo Clinic.
[42] Edema, Mayo Clinic.
[43] Edema, Mayo Clinic.
