Published on: March 25, 2020
What is Lymphedema?
One can figure out what lymphedema is by breaking down the word into its two parts: lymph and edema.
Everyone has a lymphatic system which carries protein-rich lymph fluid throughout the body to assist the immune system. Consider it to be “the garbage disposal” of the body. It works with arteries and veins of the cardiovascular system to collect bacteria, viruses and other waste products of the body and disposes of them. Edema is the medical term commonly used for swelling.
The textbook definition of Lymphedema is “localized swelling of the body caused by an abnormal accumulation of lymph.” This most commonly occurs in the arms or the legs, but can also be present in the genitals, abdomen or trunk, as well as the face and neck.
Lymphedema can be broken down into two types: primary and secondary lymphedema.
Primary Lymphedema
Primary lymphedema is hereditary, meaning you are born with it; it’s in your genetics. Specific causes of primary Lymphedema are as followed:
- Milroy’s disease (congenital lymphedema)- The abnormal forming of one’s lymph nodes occurring in infancy
- Meige’s disease (lymphedema praecox)- will typically cause lymphedema during puberty or pregnancy, however, it also has the potential for late-onset until age 35.
- Late-onset lymphedema (lymphedema tarda)-Rarest of the 3 and occurs after age 35
Secondary Lymphedema
Secondary lymphedema is brought on by some sort of outside occurrence. These include:
- Cancer Treatment- Radiation for cancer treatment or lymph node removal for biopsies can damage the lymphatic system. Radiation sometimes causes scarring or inflammation of lymph vessels, causing edema.
- Post-Surgery- any procedure involving blood vessels in limbs can put you at risk for damaging lymph vessels leading to edema.
- Infection- lymph node infections or the presence of a parasite has the potential to restrict lymph flow. These are more prevalent in tropical and sub-tropical climates of the developing world.
Symptoms
Symptoms include:
- Swelling, typically in the arms or legs, sometimes into the fingers and toes, but also in other parts of the body as well.
- Heaviness or tightness sensation in the affected areas
- Impeded range-of-motion
- Aching pain or discomfort
- Infections
- Fibrosis, the hardening or thickening of the skin
Stages of Lymphedema
Stage 0 (Latent Stage)
No swelling or changes to the body can be seen, but you may feel a mild tingling or slight tightness or heaviness to the skin. Stage 0 may last for months or even years before more obvious symptoms develop.
Stage 1 (Mild Stage)
The arm, leg, hand, foot, or other area looks slightly swollen as lymph fluid builds up. Pressing the skin will cause a temporary dent (or pit) to form. Elevating the affected limb can help to reduce the swelling, and wearing compression garments will help keep fluid from pooling. This stage is considered reversible with proper management and treatment.
Stage 2 (Moderate Stage)
Elevating the limb alone no longer helps to reduce the swelling, and it continues to worsen. Pressing on the skin doesn’t leave a pit, as the skin thickens and hardens. The swelling is managed with the daily wearing of compression garments, both during the day and at night.
Stage 3 (Severe Stage)
The affected limb becomes large and misshapen, and the hardened skin takes on a leathery, wrinkled appearance. Lymph fluid may leak from breaks or folds in the skin and should be kept clean and dry to avoid infection. Special or customized compression garments and pumps can still help to manage symptoms.
Treatment
There currently is no cure for lymphedema, but there are known, successful treatment options available. Typically, a physician will refer you to a Certified Lymphedema Therapist (CLT) for a multi-step decongestive therapy regimen which includes:
- Exercise– this will help strengthen your body and improve mobility, flexibility, and drainage
- Manual Lymph Drainage– this gentle skin massaging technique helps direct lymph flow out of the affected limb into an area functioning properly
- Elevation– elevating the affected limb allows gravity to assist in the draining of the lymph fluid
- Compression Bandaging– a CLT may use a combination of foam padding and short-stretch bandages to help compress the limb in the reduction phase
- Diet– Obesity can sometimes attribute to the severity of lymphedema, so maintaining a well-balanced, healthy diet helps treatment
- Compression Garments– Typically at the end of treatment and once you’re fully decongested, a therapist will recommend that you wear a compression garment daily to prevent the fluid from coming back. These can be off-the-shelf, or custom made. Both can be attained by consulting a professional fitter from Absolute Medical