Why won’t my swelling go away?

Steven Zeiss, DPT, CLT

AUGUST 14, 2017

If you walked around the city of Louisville or any other city in the United States and asked people if they have ever had some form of swelling, you would be hard pressed to find someone that said no. It is a very common symptom of a large number of injuries and diseases. The majority of the time, swelling occurs during an injury and goes away on its own with time or simple treatment such as elevation or rest. But what happens when the swelling does not go away? That’s the same question millions of Americans have struggled with and still struggle to find the answer to. If you are one of those people, you are not alone.

Swelling is an element of the body’s inflammatory process. Its function is to cushion the area of injury and bring cells to the area to allow for healing, repair, and fighting infection. While swelling is a good thing and a perfectly normal response of the human body, too much swelling can cause compression on surrounding areas, limit range of motion, and increase pain. Common causes of swelling can be an ankle sprain, post-operative recovery from a surgery, heart conditions, kidney dysfunction, and lymphedema. Surely the health professionals you see regularly can give you advice on how to manage the swelling, right? More than likely, they will tell you that rest, ice, elevation, losing weight, anti inflammatories, compression stockings, and elastic bandages are the magic cure to get rid of all swelling. Although that may be the case for some, treating swelling is never a one size fits all process.

So, let’s just assume that you have had a surgery or injury, you’ve tried all the treatments above, and nothing is helping. There is even a possibility that the swelling is getting worse. "If you keep icing and elevating your legs, it will eventually go away" is not an appropriate answer under these circumstances. In fact, something more serious such as Lymphedema may be present. Lymphedema is a relatively popular/significantly understudied disease. In fact, according to Norton and Zuther, it is estimated there are 140 million cases of lymphedema worldwide and 3-5 million in the United States[1]. If you are like most Americans you probably have no knowledge about what lymphedema is. I would even challenge you to take it a step further and ask your medical doctor about it. You will probably get a lot of blank stares.

Lymphedema is a collection of high protein swelling just beneath the skin. While I won’t go into extensive detail about all the ins and outs of lymphedema during this blog, it is important to understand it could be a possibility for your chronic swelling. It can affect all areas of the body and generally will start in the foot or hand and progress up the affected limb. There are a multitude of causes for lymphedema including but not limited to: cancer treatment, surgery, genetics, infection, trauma, untreated medical conditions that have swelling involved, and malignant tumors.

The use of compression, massage, exercise, and skin care is a standard used to treat lymphedema. However, this treatment is not limited to just that condition. General orthopedic swelling conditions may respond to the same treatment. As one of the few certified lymphedema therapists in the area, I can tell you that there are people out there that may be able to assist you in reducing your swelling.

By decreasing your swelling you could reduce your pain, increase your range of motion, allow for faster healing during an injury, and return to some of the activities that you have had to stop. So stop waiting until your clothes no longer fit and get out there and get help!

[1]Zuther, Joachim E., Norton, Steve. Lymphedema Management: The Comprehensive Guide for Practitioners. New York: Thieme Medical Publishers, 2013. 3rd edition.

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