Long sitting office workers are suffering from lower leg swelling, which is caused by the retention of fluid in leg tissues known as pedal edema. It can make it harder to move around in part because the patient may not have as much feeling in the feet. It can be caused by a problem with the circulatory system, the lymphatic system or the kidneys. However, the new study published in the European Journal of Molecular & Clinical Medicine suggests that it is related to autonomic nervous system as well. Is it possible to find a solution without drug and surgeries? Keep reading to know more.
What is the cause of pedal edema?
The physiopathology of pedal edema is multifactorial, sometimes not caused by any disease. Lack of mobility due to unbearable pain plays an essential role by initiating the hemodynamic alternation. Side effects of drugs might also play a role. Treatment of lower limbs edema depends on control of the underlying cause and it’s usually beyond the scope of chiropractic practice. Severe swelling can result in peripheral neuropathy and cause permanent damage to nerves. Following spinal adjustment, pain relief in turn promoting ease of mobility and possible sympathetic response accelerating lymphatic return might have help in alleviating leg edema.
A 40-year-old office worker suffered from unbearable sciatic pain which had limited her daily activities. Her initial solution was taking acetaminophen (Tyleno®) and celecoxib (Celebrex®) which provided only temporary relief for her disc herniation in the first two months. Her feet had turned pinkish and swollen up to the calves. Cutaneous telangiectasias, reticular veins and bluish (cyanotic) tinge to the skin were also noted in both legs. Her medication was discontinued for suspicion of causing edema, replaced with pregabalin (Lyrica®), tramadol (Ultram®) and vitamin B1. She later has been treated by an oral bisphosphonate (Fosamax®) for osteoporosis and also with acupuncture for low back pain for 8 months. Her laboratory abnormalities were an elevated AST of 44 U/L (reference <35), elevated potassium of 5.5 mmol/L (reference 3.5–5.1), and low urea of 1.7 mmol/L (reference 2.5–6.4). A cardiac consultation excluded deep venous thrombosis, structural heart and other systemic diseases by Professor John Wong, from the Department of Medicine and Therapeutics, Faculty of Medicine, the Chinese University of Hong Kong.
Figures and legends
Fig. 1. MRI revealed pronounced disc bulges at left L4/5 and right L5/S1 levels, with significant impingement onto the left trasversing L5 nerve root.
Fig. 2. Asymmetric pitting oedema was observed in both feet, more on the right. Cutaneous telangiectasias, reticular veins and bluish (cyanotic) tinge to the skin were also noted in bilateral gaiter areas. Oedematous features alleviated over 5 days following spinal adjustment.
Dr. Eric Chun-Pu Chu, BSc, DC, PhD(Hon), ICCSP, Chairman of the Chiropractic Doctors Association of Hong Kong, performed the research and explained, “the office workers subsequently sought chiropractic care to relieve their sciatic pain. She unexpectedly experienced beneficial results from the chiropractic treatment in which both sciatic pain and pedal edema were simultaneously resolved; Her blood test also returned to normal after the treatments. Just like most wellness chiropractic patients, the office lady continued with her maintenance care on a monthly basis to achieve the stable therapeutic effect in the past 8 months.”
Conclusion: “the pathophysiology of leg edema might be attributable to complex factors and remains inconclusive in this case without solid evidence. Despite spinal adjustments do not actually alter peripheral blood circulation, the adjustments reflexly mediate autonomic responses might have helped alleviating edema via lymphatic return.”, listed as the second most popular research by the European Society for Translational Medicine.
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About The C.D.A.H.K.
The Chiropractic Doctors’ Association of Hong Kong (CDAHK) was found in January 2000 to actively promote and establish Chiropractic profession in Hong Kong, China. CDAHK is the largest Chiropractic Professional body in Hong Kong.
Dr. Eric Chun-Pu Chu, BSc, DC, PhD(Hon), ICCSP
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