Swollen legs
Leg swelling has many causes, and they are not all the same. Some need a doctor today. Some are a sign of the heart, kidneys or liver. And some are lymphoedema — a drainage problem that has a name and a treatment. This page helps you work out which conversation you need to have.
Urgent
These can mean infection, a blood clot, or strain on the heart. They are not things to wait out, and they are not things to treat with massage or bandaging at home.
The first question
Before anything else, look at both legs together. It is the single most useful thing you can notice, and the first thing any clinician will ask.
More often a whole-body cause — the heart, kidneys, liver or thyroid, some blood pressure medicines, pregnancy, long periods of sitting or standing, or being overweight. This usually needs a doctor's assessment first, not a lymphoedema therapist.
More often a local cause in that limb — lymphoedema, a blood clot, venous disease, injury, or infection. Persistent one-sided swelling always deserves an explanation.
This is a guide, not a rule. Lymphoedema can affect both legs, particularly in podoconiosis, and heart problems can look uneven. It tells you where to start, not what you have.
Common causes
Across Kenya and the wider African continent, these account for most swollen legs.
Usually both legs, often worse by evening, and may come with breathlessness or swelling elsewhere. Needs medical assessment and treatment of the underlying condition.
Sudden swelling in one leg, often with calf pain, warmth or redness. A medical emergency. Do not massage the leg.
Red, hot, painful and tender, usually with fever. Needs antibiotics the same day.
Varicose veins and poor vein return. Swelling improves overnight at first, and the skin around the ankle may darken or harden over time.
Some blood pressure tablets, steroids and anti-inflammatories cause swelling. Never stop a prescribed medicine on your own — ask the prescriber.
Common and usually harmless, but sudden swelling of the face or hands, or a bad headache, needs same-day review.
A drainage failure in the lymphatic system. Builds slowly, stops settling overnight, and the skin thickens over time. The rest of this page is about recognising it.
When it is lymphoedema
Lymphoedema is the cause most often missed, and the one people most often wait years to have named.
Several of these sound familiar? It can be assessed, staged and treated — whatever anyone has told you before.
Book an assessmentWorth saying plainly
Across much of the continent a swollen leg is still read as witchcraft, punishment or bad luck, and people are told there is nothing to be done. Lymphoedema has no known definite cure, but it is effectively manageable, preventable and controllable — particularly when it is found early. Treatment reduces limb size, cuts infections, and restores the ability to work and walk.
It is also not contagious. You cannot catch it from someone who has it, by any route.
What to do now
If anything in the red box at the top of this page applies, go today. Everything else can wait a few days.
Heart, kidney, liver and thyroid causes need treating in their own right. A lymphoedema assessment comes after that, not instead of it.
When it started, whether it settles overnight, whether one leg or both, any episodes of redness and fever, any surgery or cancer treatment, and where you grew up. This shortens the first consultation considerably.
You do not need a referral letter to ask. Bring whatever records you have, and bring the history if you have none.