Edema Control
Edema (or dropsy) is swelling due to excessive buildup of fluid in the body’s tissue or interstitium. Regulation processes, such as thermal and metabolic, form part of homeostasis that is responsible for regulating tissue fluid (interstitial fluid) and when there is dysfunction in the fluid removal process, edema may result.
General causes of edema may include:
- Diet – too much salt intake
- Lifestyle – being under or overactive in hot weather
- Environment – sunburn, bacteria
- Disease – such as heart, kidney and liver (cirrhosis); diabetes
- Surgery – such as mastectomy where irregularities with lymph nodes may occur
- Medicine – certain drugs
Process specific causes of edema are:
- pressure either over or under exerted by proteins in blood plasma (oncotic) and blood vessels
- pressure from increasing inflammation
- pressure exerted by static fluid in the tissues (hydrostatic), such as water retention or kidney sodium retention
- changes in tissue water retaining capacity
- blocked lymphatic fluid flow
Types of Edema
While edema most commonly affects the legs, ankles and feet, physical therapists need to identify the cause of edema to understand which organs are affected for appropriate treatment. Edema is often classified according to the swelling in or from particular organ, such as:
- Pulmonary edema (pulmonary veins of the lungs are obstructed)
- Ocular edema (glauccoma, conjunctivitis, keratitis or ocular surgery)
- Periorbital edema (periorbital tissue swelling around the eye)
- Cerebral edema (fluid buildup in brain cells such as from systemic lupus)
- Cutaneous edema (swelling of the skin such as in contact dermatitis)
- Myxedema (increased hydrophilic carbohydrate in connective tissue cells of the skin such as from lymphatic or estrogen abnormalities)
- Lymphedema (Lymphatic system failure or lymph node irregularities such as from cancer)
People with edema may also suffer from shortness of breath, restricted breathing and chest pain. Controlling edema is vital because it decreases blood circulation and vein, joint and muscle elasticity. This may further cause skin conditions, ulceration, and limited mobility when walking is affected.
Controlling Edema
Edema control is therefore aimed at treating the type of edema cause and the swelling symptoms. A number of methods are suggested by medical practitioners to reduce edema swelling and there are taking diuretics (Thiazide, Furosemide/Lasix or Spironolactone /Aldactone) to relieve water retention, reducing salt intake, keeping the legs raised as much as possible and/or wearing compression or support stockings. Physical therapy treatments for edema control include:
- Electrotherapy (using electrical stimulation remove obstruction)
- Manual lymph drainage (MLD) (to drain the lymph nodes such as with a pump)
- Manual Edema Mobilization (MEM) (using massage to stimulate the lymphatic system to release excess fluids and proteins)
- Complete Decongestive Therapy (CDT) (MLD, bandaging, and exercise)
- Compression bandages (such as ACE or the FarrowWrap); Air splints
- Orthotic footwear and clothing, such as therapy gloves or ankle sprain edema control boots