Fluid Retention
Nearly everyone has experienced some form of fluid retention at one point or another-whether as swelling from a bumped shin or ankle sprain or as a bloated feeling following a very salty meal or preceding the monthly menstrual period. Anyone who has had to stand or sit for hours on end knows that inactivity can cause a temporary swelling in the legs. Ironically, overexertion can also result in swelling. Typing nonstop or weeding a garden-any activity in which the same movements are performed over and over-can be the culprit. Fluid retention can also be an indicator of a deeper problem, such as a heart, blood vessel, or kidney disorder.
“Swelling is the body’s first obvious response to injury, and if it’s not treated, it can lead to joint stiffness, which compromises function and delays healing,” says Pamela Kirby, O.T.R./L., C.H.T., an occupational therapist and certified hand therapist at The Hand Center in Greensboro, North Carolina. That’s why it’s important to take steps to bring down swelling from an injury as soon as possible.
The following are some tips for bringing down minor swelling and for keeping excess fluid from accumulating in the first place. However, if you suspect that swelling is the result of a sprain or fracture, if swelling persists for more than a few days, if it is more pronounced in one extremity than another, or if it encompasses the whole body, see your doctor.
Bag some ice. Applying an ice pack can help bring down swelling caused by a sprain or strain. Ice cubes placed in a sandwich bag that has a zippertype seal make an effective ice pack, says Kirby. You can also use a bag of frozen peas or frozen unpopped popcorn. Specially made hot/cold packs can be effective, too. For rheumatoid arthritis, alternating hot and cold treatments on a swollen joint may help, says Kirby.
Keep it dry. “Wet compresses can be too harsh on the skin,” says Kirby. “So use a dry barrier between the ice pack and you.” She suggests a napkin, a cloth or paper towel, or a cotton T-shirt. Dry compresses also seem to allow the ice to affect deeper body tissues than damp barriers, she notes.
Go above your heart. By elevating your hand or foot, you’re allowing gravity to help drain the fluid and draw the swelling out. Raising the extremity above the level of your heart is even more beneficial. “When your hand swells, sit up and elevate it, so your thumb’s about even with your nose,” advises Kirby. Prop up your arm or leg on a couple of pillows or on the back of a couch.
Don’t get wrapped up in bandages. “Elastic wraps don’t apply a consistent pressure,” says Kirby. “Since the amount of pressure applied can’t be controlled, many people invariably make them too tight, which, ironically, can cause more swelling above or below the wrap.” If you think you need the support of an elastic bandage, consult your physician, who may recommend a variety with a more consistent pressure. If you suffer from arthritis, you can help minimize swelling with department-store stretch gloves. You can also ask your doctor about special gloves for this purpose.
Support your legs. For minor swelling that results from being on your feet all day, over-the-counter support hose may help. There are also stockings specially made to apply more pressure to the lower leg to help keep fluids from collecting. A doctor prescribes the stockings, which are available in various lengths and degrees of compression. Prescription stockings can help pregnant women who suffer swelling, says Claudia Holland, M.D., assistant clinical professor of obstetrics and gynecology at Columbia-Presbyterian Medical Center in New York.
Walk and walk some more. When it comes to swelling in the legs, “it’s very important to keep the legs moving,” says Robert C. Schlant, M.D., professor of medicine (cardiology) at Emory University School of Medicine in Atlanta. Whether you are at your desk or on a plane, get up periodically and stretch your legs. “Simply taking a walk around your desk can help,” he says. Better yet, put on a pair of sneakers, and take a walk during your lunch break or during a layover at the airport. Besides helping the leg muscles pump blood and other fluids back toward the heart, walking and other aerobic activities can help build the heart and leg muscles, making them more efficient. If you find that exercise itself causes swelling in your hands, wear a pair of stretch gloves while working out, suggests Kirby.
Flex your legs. For people who are limited in their activity, due to arthritis, for instance, flexing is the next best thing to walking. While sitting, flex your knee and ankle joints up and down, recommends Schlant. Doing a tighten and-release routine on the thigh and calf muscles can also help.
Take a break. Since repetitive motion is one cause of swelling in the hands and wrists, make sure you take breaks to give them a rest.
Don’t cross your legs. This can restrict blood flow through the veins in the thighs, which in turn can aggravate swelling in the lower legs.
Massage the swelling. Gentle massage will help increase circulation to the tender injury site, says Kirby. For hand injuries, gently bend the joints to prevent stiffness.
Don’t pull on the puffiness. “Some people think that if they jam their finger, they should pull on it to stop the swelling,” says Kirby. “What they don’t realize is that they can actually cause more injury to the area because their pulling can tear the ligaments and tendons, creating a bigger problem than they originally had.”
Get some over-the-counter help. Aspirin and ibuprofen can be an aid in controlling the inflammation that sometimes accompanies swelling, as is the case with rheumatoid arthritis and sprains and strains. (Acetaminophen, on the other hand, is not an anti-inflammatory medication, although it can help to relieve pain.)
Consider your medications. Some prescription drugs, including certain blood pressure medications (such as reserpine and nifedipine) and hormonal regulators (such as birth control pills), can cause fluid retention, says Allan D. Marks, M.D., associate professor of medicine and director of the Hypertension Clinic at Temple University Health Sciences Center in Philadelphia.
Avoid constricting clothing. Tight garments, such as belts, garters, and girdles, should be avoided because they can apply too much pressure on the upper thighs and waist, says Schlant. This pressure can restrict the removal of fluids and cause edema (swelling) in the lower legs.
Adjust your jewelry. Wristwatches, rings, and bracelets (for the wrist or ankle) that are worn too tight can aggravate, and in some cases even cause, swelling, says Missy Donnell, O.T.R., C.H.T., an occupational therapist at The Hand Clinic in Austin, Texas.
Don’t use your hands as tools. Instead of putting extra stress on your hands to carry out tasks, use tools made for the job, advises Kirby. For instance, don’t use the heel of your hand as a hammer. Arthritis sufferers should adapt the tools of their everyday tasks for ease of use. A toothbrush or hairbrush with a built-up handle, for example, can take the stress off the hands.
Take the pressure off your palms. When you lift something, don’t hold it from the bottom with your palms flat; instead, hold it at the sides, recommends Kirby. The reason, when the palms meet great resistance straight on, the wrists take the brunt of the load, which can lead to injury and swelling.
Maintain the proper weight. “Overweight people have more of a chance of developing edema,” says Schlant. They are also more likely to be affected by heat and humidity, which can aggravate swelling, says William F. Ruschhaupt, M.D., a staff physician in the Department of Vascular Medicine at the Cleveland Clinic Foundation in Ohio.
Shake the salt habit. Sodium causes the body to retain fluid. But keeping the shaker off the table isn’t the only way to cut back on salt. Avoid heavily salted snacks; opt for no-salt potato chips, pretzels, and popcorn instead. Processed foods can be high in sodium, so check labels. Virtually salt free, Fresh and frozen fruits and vegetables, whether eaten raw or steamed. If you cook them, do not add salt to the water.
Try to stay calm, cool, and collected. While stress doesn’t have a direct effect on edema, some doctors believe it can have an indirect one. “Stress can leave you lethargic and sedentary, leading to inactivity, which can aggravate swelling,” explains Ruschhaupt.
Tagged under: acetaminophen, arthritis, fluid retention, General Ailments swelling
Filed under: General Ailments