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Swelling

Topic Overview

Swelling is an increase in the size or a change in the shape of an area of the body. Swelling can be caused by collection of body fluid, tissue growth, or abnormal movement or position of tissue.

Most people will have swelling at some time. When it is hot and you have stood or sat in the same position for a long time, you might notice swelling in your feet and ankles. Staying in one position for any length of time increases the risk that the lower legs, feet, or hands will swell because body fluid will normally move down a limb from the effects of gravity. Swelling can also be caused by heat-related problems, such as heat edema from working or being active in a hot environment.

Body fluid can collect in different tissue spaces of the body (localized) or can affect the whole body (generalized). Causes of localized swelling include:

  • Injury to a specific body area. Bruising (hematoma) from an injury is caused by tears in the small blood vessels under the skin. Bleeding can also affect the joint (hemarthrosis) or the area that cushions and lubricates the joint (traumatic bursitis). Swelling can affect just one area or may involve large sections of the body, such as swelling that occurs following a motor vehicle accident.
  • Infection, which can occur in a joint or under the skin. An abscess is a pocket of pus that forms at the site of infected tissue. Cellulitis is a skin infection that can cause mild or severe swelling.
  • Burns, which can cause swelling at the site of the burn or in a larger area around the burn.
  • Inflammation that occurs when tissue is irritated by overuse or repeated motion.
    • Swelling of the tendon and swelling caused by a series of small tears around a tendon (tendinosis) can occur together or separately.
    • Swelling of the sac that cushions and lubricates the joint (bursitis) can be caused by prolonged or repeated pressure or by activities that require repeated twisting or rapid joint movements.
  • Insect bites or stings. Most insect bites or stings cause a small amount of redness or swelling. Some people have an allergic reaction to a bite or sting and develop a lot of swelling, redness, and itching.
  • Other causes, such as swelling related to a sac-shaped structure with clear fluid, blood, or pus (cyst) or a swollen gland, such as a salivary gland. For more information, see the topic Swollen Glands, Hernias, and Other Lumps Under the Skin.

Causes of generalized swelling include:

  • Allergic reaction. Sudden swelling of the hands and face may be a severe allergic reaction (anaphylaxis) and needs immediate medical evaluation.
  • Autoimmune diseases, such as lupus, rheumatoid arthritis, and scleroderma. These diseases can cause swelling when the body produces antibodies and other cells that attack and destroy tissues in the body.
  • Medicines. Some medicines change how body fluids circulate, causing swelling. Swelling may also occur as an allergic reaction to a medicine.
  • Circulation problems related to certain medical conditions, such as peripheral arterial disease, heart failure, diabetes, or kidney disease. Thrombophlebitis causes swelling of an extremity when a blood clot interrupts blood flow in a vein in the arm or leg.
  • Fluid that accumulates in the abdomen (ascites) because of other problems, such as malnutrition, cirrhosis, or liver disease.

Some people may experience swelling as a reaction to a medical treatment, procedure, or surgery. Swelling from a medical treatment may be related to the procedure or to a substance, such as dye, used during the procedure. Swelling may occur at an intravenous (IV) site used during a procedure or at an IV site used for medicines given at home. Some swelling at the site of surgery is normal, such as swelling of the arm after a mastectomy. Lymphedema is swelling that occurs in an area around lymph nodes that have been removed (such as following surgery) or injured (such as following radiation treatments).

Swelling can also be caused by the fluctuation of hormone levels within the body. Some women may notice swelling from retaining fluid during their menstrual cycles. This may be called cyclical edema because it is related to the menstrual cycle. Some women experience mild swelling in their hands or feet during pregnancy. Swelling in the feet may be more noticeable in the third trimester of the pregnancy. Generalized swelling can be a sign of a pregnancy-related problem called preeclampsia. For more information, see the topic Pregnancy-Related Problems.

Swelling can occur when tissues move out of their normal position, such as hernias in the abdomen. For more information, see the topic Inguinal Hernia.

Most of the time swelling is mild and goes away on its own. You may not even know what caused the swelling. Home treatment is usually all that is needed to relieve mild symptoms.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Is swelling your main concern?
You may have concerns about swelling around the face, in the arms or legs, or in the belly or groin.
Yes
Swelling is main concern
No
Swelling is main concern
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Could you be having a severe allergic reaction?
This is more likely if you have had a bad reaction to something in the past.
Yes
Possible severe allergic reaction (anaphylaxis)
No
Possible severe allergic reaction (anaphylaxis)
Are you having trouble breathing (more than a stuffy nose)?
Yes
Difficulty breathing more than a stuffy nose
No
Difficulty breathing more than a stuffy nose
Would you describe the problem as severe, moderate, or mild?
Severe
Severe difficulty breathing
Moderate
Moderate difficulty breathing
Mild
Mild difficulty breathing
Do you have pain in the area with the swelling?
Yes
Pain with swelling
No
Pain with swelling
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
Do you think you may have a fever related to the swelling problem?
Swelling and fever can be symptoms of infection or other problems.
Yes
Possible fever
No
Possible fever
Do you have swelling all over?
Yes
Swelling is all over
No
Swelling is all over
Do you have swelling in your legs?
Yes
Leg swelling
No
Leg swelling
Have you been urinating a lot less than usual lately?
Yes
Decreased urination
No
Decreased urination
Is the swelling:
Quickly getting worse?
Swelling is quickly getting worse
Slowly getting worse?
Swelling is slowly getting worse
Staying about the same?
Swelling is not getting worse
Do you have heart failure?
Yes
Heart failure
No
Heart failure
Do you think that a medicine may be causing the swelling?
Think about whether the swelling started soon after you began using a new medicine or a higher dose of a medicine.
Yes
Medicine may be causing swelling
No
Medicine may be causing swelling
Has any swelling that does not have a clear cause lasted for more than a week?
Yes
Unexplained swelling for more than 1 week
No
Unexplained swelling for more than 1 week

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Swelling can be a sign that you are having an allergic reaction to a medicine. This can happen with almost any medicine.

Many prescription and nonprescription medicines also may cause swelling as a side effect. A few examples are:

  • Corticosteroids.
  • Hormones, such as birth control pills and hormone therapy used to treat menopause symptoms.
  • Some blood pressure medicines.

Symptoms of a severe allergic reaction (anaphylaxis) may include:

  • The sudden appearance of raised, red areas (hives) all over the body.
  • Rapid swelling of the throat, mouth, or tongue.
  • Trouble breathing.

A severe reaction can be life-threatening. If you have had a bad allergic reaction to a substance before and are exposed to it again, treat any symptoms as an emergency. Even if the symptoms are mild at first, they may quickly become very severe.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Severe trouble breathing means:

  • You cannot talk at all.
  • You have to work very hard to breathe.
  • You feel like you can't get enough air.
  • You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

  • It's hard to talk in full sentences.
  • It's hard to breathe with activity.

Mild trouble breathing means:

  • You feel a little out of breath but can still talk.
  • It's becoming hard to breathe with activity.

Symptoms of difficulty breathing can range from mild to severe. For example:

  • You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
  • It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Home Treatment

Mild swelling will usually go away on its own. Home treatment may help relieve symptoms.

Swelling and pain are very common with injuries. When you have swelling, you should look for other symptoms of injury that may need to be evaluated by your doctor.

If you have a medical condition that may cause swelling, follow your doctor's instructions on how to treat your swelling.

Mild swelling

  • Rest and protect a sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
  • Elevate the injured or sore area on pillows while applying ice and any time you are sitting or lying down. Try to keep the area at or above the level of your heart to help minimize swelling.
  • Avoid sitting or standing without moving for prolonged periods of time. Exercising the legs decreases the effect of gravity, so swelling goes down.
  • A low-sodium diet may help reduce swelling.
  • Drink plenty of fluids to help prevent swelling caused by dehydration.
  • Keep your skin cool in hot environments.
Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:

Talk to your child's doctor before switching back and forth between doses of acetaminophen and ibuprofen. When you switch between two medicines, there is a chance your child will get too much medicine.

Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Swelling increases or spreads.
  • Other symptoms develop, such as pain, fever, trouble breathing, or decrease in urination.
  • Symptoms become more severe or frequent.

Prevention

The following tips may help prevent swelling.

  • Do not sit with your feet hanging down for long periods of time. Elevate your feet whenever possible. If you take a car trip, stop and walk around every 1 to 2 hours. If you are traveling in an airplane, be sure to get up and walk around every 1 to 2 hours.
  • Limit the amount of salt in your diet.
  • Exercise regularly. Warm up and stretch before exercising.
  • Drink plenty of fluids, and keep your skin cool in hot environments.
  • Avoid repetitive motions, or take frequent breaks often to rest a body area.
  • Take medicines as instructed. If swelling occurs often, discuss with your doctor whether taking your medicine at another time of day would decrease the swelling.
  • Do not smoke cigarettes or use other tobacco products. They increase circulation problems.

If you have a chronic medical condition or are pregnant, follow your doctor's instructions on how to prevent swelling and when to call to report your symptoms.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • What are your main symptoms?
  • How long have you had your symptoms?
  • What do you think is causing the swelling?
  • What specific body area is swollen?
  • Did the swelling begin suddenly, or did it develop gradually?
  • Is the swelling always present? Is it worse in the morning or the evening?
  • Have you had this problem before? If so, do you know what caused the problem at that time? How was it treated?
  • What activities make your symptoms better or worse?
    • Do you think that activities related to your job or hobbies caused your symptoms?
    • Do you do sports activities?
  • Have you recently moved from a different climate, such as from a colder climate to one with more heat or humidity?
  • What home treatment measures have you tried? Did they help?
  • What prescription and nonprescription medicines do you take?
  • Do you have any health risks?

Credits

By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer David Messenger, MD
Last Revised July 24, 2013

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