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The Doctors Book of Home Remedies II: Swelling

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Swelling

Eyes, nose, thumbs, toes-just about any body part can swell up. It happens for lots of different reasons, and the sensations that go along with swelling can be painful, itchy or annoying. And while there are many general remedies for swelling, some body parts require their own special treatments.

Swelling often accompanies injury, for instance, as fluid normally flowing through blood vessels seeps out into the surrounding tissue. That may happen when blood vessels are injured by a bump, by a muscle or ligament tear or by a fracture.

Swelling can also happen slowly, without an injury, as the result of pooled blood in an arm or leg. Through a process called effusion, fluid seeps from the blood vessels into tissue. It's this kind of swelling that occurs when you notice your hands puffing up while you walk or if your feet get a shoe size bigger when you've been standing around for a long time. (Because varicose veins impede the return of blood to the heart via the veins, they can cause this kind of swelling.)

Hives, welts and the itchy bumps caused by mosquitoes and other bloodsucking parasites are other examples of swelling. So are the stuffy, runny nose and scratchy, puffy eyes that accompany hay fever.

"The more a body part swells, the more blood circulation is slowed. And poor blood circulation slows healing," says Clayton Holmes, an athletic trainer and assistant professor of physical therapy at the University of Texas Health Science Center at San Antonio. For serious injuries, you'll want to see the doctor and follow his recommendations. But here are some all-purpose ways to keep swelling down.

When to See the Doctor

Many injuries that cause swelling deserve a doctor's prompt attention. That's because ligament or muscle tear, fractures or cartilage damage may be hiding under all that puffiness.

If you think you might have an ankle, foot or leg fracture, don't try to remove your shoe. Let the doctor do that. First-aid treatment is different for each kind of fracture, but generally you want to keep the limb from moving around until the doctor can treat it.

Also, if swelling is the result of an insect bite or sting and is accompanied by severe reactions such as chest tightness, dizziness or fainting, seek medical help at once. These are signs of potentially deadly anaphylactic shock.

Try an over-the-counter antihistamine. These drugs help counter-act the swelling caused by insect stings and many kinds of allergic reactions, says Thomas Platts-Mills, M.D., Ph.D., head of the Division of Allergy and Clinical Immunology at the University of Virginia Health Sciences Center in Charlottesville. Antihistamines are contained in some liquid medications, but Dr. Platts-Mills recommends the faster-acting chewable tablet. "Take the dosage suggested on the box as soon as you are stung," he says. (That way, the drug gets into your system quickly.) Take the antihistamine at recommended intervals as long as the swelling continues. Note: Antihistamines are useless for injury-related swelling.

Remember RICE. Not the long-grain variety but a proven first-aid method for injured ankles, knees and elbows: rest, ice, compression and elevation. "The sooner you do all four, the better," says Holmes.

If you want to reduce swelling in a leg, for instance, do RICE in this order. Wet a four- to six-inch-wide elastic bandage in ice water. Firmly wrap it a few times around the injured ankle or knee, providing compression, then apply two quart-size plastic bags of crushed ice, so they completely surround the joint. Continue wrapping, using the bandage to hold the ice in place. Leave the ice on for no longer than 20 minutes. Take off the ice and rewrap the injury. Wait an hour before you ice again.

While you're icing, elevate the injured part above the level of your heart.

Rest the injured part by immobilizing it. If it's an ankle or knee that's hurt, don't try to hobble around. Get some assistance when you walk, or else use crutches.

Step in place. Standing motionless for long periods of time may cause swelling. That's because up to a quart of blood pools in your legs and feet, and fluid may seep out of blood vessels into tissue. That not only makes your legs feel like lead, it makes your feet a size bigger. So walk in place, lifting your knees and pointing your toes downward. That helps your muscles pump blood upward. If you must stand still, keep your knees slightly flexed. Don't lock them, experts say.

Stay active after exercise. If you stop suddenly after hard exercise, blood can pool in your legs, resulting in swelling and sometimes low blood pressure as well. Instead of stopping abruptly after a run or swim, cool down with lighter activity for ten minutes or so. That keeps your circulation going but at a less intense pace, suggests John Duncan, Ph.D., associate director of the Exercise Physiology Department at the Cooper Institute for Aerobics Research in Dallas. This gradual slowdown is especially important for people taking heart medications such as beta blockers.

Bend and pump. Swinging your arms while you walk is a good way to loosen up, but the centrifugal force it creates can make blood pool in your hands, causing swelling. "Try bending your arms 90 degrees at the elbows, and use them as pistons," suggests Dr. Duncan. "Raise them up higher than you normally would and swing with the cadence of your walking gait." While you're doing that, keep your hands loosely open. Although you can occasionally clench your hands to squeeze out fluid, continual clenching interferes with the flow of fluid through the arm and will make your lower arm swell.

Keep a loose grip on your bike. Do your lower arms swell when you're bicycling? Unless you're barreling down some potholed road, you shouldn't have to grip the handlebars of your bike so tightly that you cut off circulation in your arms. But that's exactly what some people do, even while they're riding stationary bicycles indoors, Dr. Duncan says. "A healthy person might not notice it, but someone who already has circulation problems will see his lower arms swelling," he says. So keep a loose grip, he suggests, and shift from the upper to lower bars occasionally. Or simply move your hands. Padded gloves can help, too.

Stuck Ring? Dental Floss to the Rescue!

A ring may be a symbol of wedded bliss, but it can pose real danger when it's stuck on a swelling finger. Because it can cut off blood circulation just as surely as a tourniquet, that band of gold has got to come off--the sooner, the better.

If your knuckle has swollen and is already too big to slip the ring over, try this trick using dental floss. (Better yet, use waxed dental tape.) Used by emergency medical technicians, the technique is recommended by John C. Johnson, M.D., past president of the American College of Emergency Physicans and director of Emergency Medical Services at Porter Memorial Hospital in Valparaiso, Indiana.

Take a long piece of floss (two to three feet is not too long). Starting at the tip of the finger, closely wrap the floss around the finger, spiraling down toward the ring. Keep the encirclements 1/8 inch apart or less. When you get to the ring, slip the end of the floss under the ring and pull it toward your palm. Lift that end of the floss over the top of the ring and pull up toward the tip of your finger. As the floss unwinds, it will ease the ring up and off the finger.

To make this even easier, grease the floss-wrapped finger with petroleum jelly before you remove the ring.

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