What is Lymphedema?
Lymph is a clear fluid drained from tissues throughout the body into tiny tubes called lymphatic vessels. The functions of the lymphatics include regulating body fluid levels, allowing immune cells to travel where they are needed, and absorbing fat and other nutrients from the digestive systems. The lymphatic network runs alongside the blood vessels throughout the entire body and disposes of several waste products. Lymphedema is swelling of a body part due to a blockage of the lymph vessels, as lymphatic fluid is normally moved back into the bloodstream.
Causes of lymphatic blockage
Conditions that affect the lymphatic system may be present at birth or manifest early in childhood (Primary Lymphedema) or develop after a trauma or disease (Secondary or Acquired Lymphedema). These include:
- Injury
- Radiation therapy
- Skin infections such as cellulitis (more common in obese patients)
- Surgery with removal or damage to lymph vessels
- Tumors
- Advanced Venous Insufficiency (Phlebolymphedema)
- Infection by a parasite (Filariasis)
One of the most common causes of lymphedema is removal of the breast (mastectomy) and underarm lymph tissue for breast cancer. This causes lymphedema of the arm in 10 – 15% of patients, because the lymphatic drainage of the arm passes through the armpit (axilla).
Signs and Symptoms
The main symptom is persistent swelling, usually of an arm or a leg. Pain, heaviness, skin thickening, and cracking characterize the more advanced stages. In the most severe cases the affected limb becomes quite large, fluid leaks through the skin and severe infections may occur. There are 3 stages of lymphedema.
How is lymphedema diagnosed?
The physician will perform a physical exam and ask questions about your past medical history to assess the cause(s) of your limb swelling. The following tests may be done:
- Ultrasound
- CT or MRI scan
- Lymphoscintigraphy
If the physician identifies symmetrical accumulation of leg fat and if your feet are not swollen, you might be diagnosed with another condition, called Lipedema.
Treatment for lymphedema includes:
- Lifestyle changes
- Compression (usually with multilayered bandages)
- Manual lymph drainage (MLD)
- Range of motion exercises
- Compression pumps
- Skin care
- Complete decongestive therapy
- Surgery
Applying compression bandages on the affected area or using a compression pump under medical supervision may be helpful.
Lymphedema pump applied at home.
Treatment also includes skin care to prevent injuries, infection, and skin breakdown, as well as light exercise and movement programs.
Surgery may be an option in in some cases. Talk to your doctor about all treatment options.
For further information please consult following chapter of Layman’s Handbook of Venous Disorders:
Other Lymphatic Resource Websites
Lymphatic Education and Research Network, Lymphedema
Fighting lymphedema and lymphatic disease through education, research, and advocacy.
