“Good News” About Pitting Edema?

When you wear tight socks or shoes and see lines on your feet and ankles at the end of the day, you probably have a swelling problem. And I can relate!

I took off my compression socks after working in them, on my feet all day, and after an hour or so (puttering around the kitchen, making some dinner, and now sitting at my computer with my legs down (not elevated), I press my finger into a “cuff” around my ankle. What do I see? A small indentation that stays put for a second. This is why I try to get in several hours of exercise each week, and wear compression socks every day… because swelling in my lower legs is an ongoing problem.

While pitting edema and non-pitting edema both indicate underlying health issues, pitting edema can sometimes be seen as having certain “advantages" in terms of diagnosis, treatment and prognosis compared to non-pitting edema. Here are the top five “good news” aspects of having pitting edema versus non pitting edema.

First, pitting edema is swelling that keeps an indentation when pressed with a fingertip. Other edemas bounce back or are simply firmer to the touch and don’t  indent much at all. So what’s the positive side of having the type of edema that pits?

1. With pitting edema, it's easier to diagnose the underlying cause. Often, pitting edema is linked to systemic conditions like heart failure, kidney disease, liver disfunction, or simply an inflammatory diet; which are well-understood and have tests that can quickly identify the cause. Non-pitting edema, on the other hand (lymphedema) may require specialized testing and can be harder to pinpoint.

2. Pitting edema is more likely to be reversible. Unlike non-pitting edema, which tends to be chronic due to permanent tissue changes, pitting edema generally responds to treatments that target the underlying cause. If you manage the condition causing the edema, the edema can significantly improve or resolve.

3. With pitting edema, there are clear treatment options. Pitting edema is frequently managed with straightforward interventions like diuretics, dietary sodium restrictions, massage, and compression therapy. Non-pitting edema, such as lymphedema, often requires more complex, long-term management, like manual lymphatic drainage, specialized compression garments, exercise, etc.

4. Pitting edema is less likely to indicate long-term tissue damage. Fluid overload can cause swelling, which over time, decreases the ability of the lymphatic system to work efficiently. But if you can address the pitting edema early on, the underlying tissues are less likely to be permanently altered. This is why you want to address pitting edema at the first sign. Long term non-pitting edema often causes fibrosis and thickening of the skin and underlying tissues.

5. Finally, in pitting edema, treatment is easily monitored because it’s a visible marker of fluid overload. When non-pitting edema is present, the structure of the tissues can make fluid retention more difficult to detect and may not reflect the status of fluid in the tissues as well.