GENERAL MEDICAL

CONDITION

EDEMA
 CONTENTS :

A
-
1. Introduction

2. Body fluid movements

3. Normal fluid circulation

4. Edema definition

5. Risk factors of edema

6. Causes of edema

7. Classification of edema

8. Management
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 Introduction
• 60% of body’s weight is water.
• 2/3rd of it is intracellular and
1/3rd is extracellular.
• Extracellular is further divided
into interstitial fluid and plasma.

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 osmosis

Body
diffusio
Active Fluid n
transpo
rt movement

filtratio
n

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 NORMAL FLUID CIRCULATION
• The movement of fluid between vasculature is controlled by
opposing effects of “Vascular Hydrostatic Pressure” and “Plasma
Colloid Osmotic Pressure”.
• Hydrostatic pressure is more at the arteriolar end whereas oncotic
pressure is more at the venous end.
• Exit of fluid from arteriolar end is balanced by inflow at venular
end of microcirculation.
• Small residual amount of excess interstitial fluid is drained by
lymphatics.

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 EDEMA
• DEFINITION : Edema is an abnormal accumulation of fluid in the
interstitium, located beneath the skin and in the cavities of the
body.
• Edema is a normal response of the body to inflammation or
injury. For example, a twisted ankle , a bee sting , or a skin
infection will all result in the involved area.
• In some cases , such as in an infection, this may be beneficial.
Increased fluid from the blood vessels allows more infection-
fighting white blood cells to enter affected area.

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 Risk factor of oedema :
Mild cases of oedema may result from :
 Sitting or staying in one position for too long
 Eating too much salty food
 Having premenstrual signs and symptoms
 Being pregnant

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 Edema can also be a side effect of some medications,
including :
1. High blood pressure medications
2. Non-steroidal anti-inflammatory drugs
3. Steroid drugs
4. Estrogens
5. Certain diabetes medications

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 Amlodipine, a potent CCB Antihypertensive drug often causes
pedal edema secondary to arteriolar dilatation leading to
intracapillary hypertension and fluid extravasation. Edema
usually do not resolve with diuretics and frequently needed to
withdraw amlodipine.
NSAIDS long term use of NSAIDS can damage the kidneys and
cause edema by blocking the production of prostaglandins ,
which are essential for proper kidney function.

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 Several diseases and
condition may cause edema,
including
Inadequate
: Weakness or
Congestive damage to
lymphatic
heart failure veins in your
system
legs

Severe, long
Kidney
term protein
damage
deficiency

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 Causes of edema

5 factors can contribute to the formation of edema:

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 1. Increased capillary hydrostatic
pressure

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 2. Reduced plasma oncotic pressure

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 3. Inflammation

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 4. Lymphatic system

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 5. Sodium and water retention

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 Classification of oedema :

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 Management of oedema :
(a)Conservative management
(b)Medical management
(c)Physiotherapy management

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 Principals of therapy :
1. Reversal of the underlying
disorder (if possible)
2. Dietary sodium restriction
3. Diuretic therapy

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 (a) Conservative management (RICE
protocol)
1. Elevate limb using pillow above heart level (30
minutes/3-4 times/ day)
2. Soak your legs in salt bath
3. Avoid salt intake
4. Wear support stockings
5. Do not sit or stand for long periods of time
without moving
6. If oedema is caused by lung disease, such as
emphysema or chronic bronchitis, quit smoking
7. Cut down on excess alcohol
8. Stop the medications which causes edema , will
resolve the edema

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 (b) Medical management
DIURETICS
action = causes the kidney to excrete more water and
sodium, which can reduce the oedema
side effects = diuretics must be used with care because
removing too much fluid too quickly can :
-Lower the blood pressure
-Cause light-headedness or fainting
-Impair kidney function

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 (c) Physiotherapy management
Two great ways to reduce excess fluid in a body part is via muscle
contraction and movement.
1. Ankle muscle pumping and motion (in peripheral oedema) : acts
as a pump that accelerates the entry and exit of fluids entering
and leaving the injured area and also maintain rom of unaffected
joints.
2. Manual lymphatic drainage : retrograde massage and regular
deep tissue release therapy , may help to improve fluid
movement and return as well, to prevent pocketing of fluids.
3. Compression bandaging therapy
4. Kinesio taping
5. Icing / cold therapy : to reduce heat due to oedema and halt the
process of oedema and reduce pain
6. Ultrasound therapy : may help to reduce soft tissue healing
which decreases oedema and swelling as well.
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Thank
you