Description

Lymphedema refers to swelling of the tissue caused by an accumulation of protein-rich fluid that normally drains out through the body's lymphatic system. It most commonly affects the arms or legs, but it can also occur in the wall of the chest, abdomen, neck and genitals.

Lymph nodes are an important part of your lymphatic system. Lymphedema can be caused by cancer treatments that remove or damage of lymph nodes. Any type of problem that blocks the lymph drainage can cause lymphedema.

Severe cases of lymphedema may affect the ability to move the affected limb, increase the risk of skin infections and sepsis, and that can lead to changes in the skin and decomposition. Treatment may include compression bandages, massage, compression stockings, sequential, pneumatic pump, care of skin, and in rare cases, surgery to remove the inflamed tissue or to create a new system of drainage routes.

Symptoms

Lymphedema signs and symptoms include:

  • Swelling of part or all of the arm or leg, including fingers or toes
  • A feeling of heaviness or tightness in the
  • Restricted range of motion
  • Recurrent infections
  • The hardening and thickening of the skin (fibrosis)

Signs and symptoms may vary from mild to severe. Lymphedema caused by cancer treatment may not occur until months or years after treatment.

When to see a doctor

Make an appointment with your doctor if you experience persistent swelling in your arm or leg. If you've already been diagnosed with lymphedema, consult your doctor if there is a sudden dramatic increase in the size of the affected limb.

Causes

The lymphatic system is a network of blood vessels that carry the protein-rich lymph fluid throughout the body. It is part of your immune system. The lymph nodes act as filters and contain cells that fight infections and cancer.

The lymph, the fluid is pushed through the lymph vessels by muscle contractions as you move through the tasks of their day, and small pumps on the wall of the lymph vessels. Lymphedema occurs when the lymph vessels are unable to adequately drain the lymphatic fluid, usually of an arm or a leg.

The most common causes of lymphedema are:

  • Cancer. If the cancer cells block the lymph vessels, lymphedema can result. For example, a tumor that grows near a lymph node or lymph vessels, you can expand enough to block the flow of lymphatic fluid.
  • Radiation treatment for cancer. The radiation can cause scarring and inflammation of the lymph nodes or lymph vessels.
  • Surgery. In surgery for cancer of the lymph nodes are often removed to see if the disease has spread. However, this does not always result in lymphedema.
  • Parasites. In developing countries in the tropics, the most common cause of lymphedema is the infection thread-like filarial worms that clog the lymph nodes.

Less commonly, the lymphedema results of inherited disorders in which the lymphatic system does not develop properly.

Risk factors

Factors that may increase the risk of developing lymphedema include:

  • Age
  • Excess weight or obesity
  • Rheumatoid or psoriatic arthritis

Complications

Lymphedema complications may include:

  • Infections of the skin (cellulitis). The trapped fluid provides a fertile breeding ground for germs, and the smallest injury to the arm or leg may be a point of entry for the infection. Affected skin appears swollen and red and is typically painful and warm to the touch. The doctor may prescribe antibiotics to keep on hand so that you can start taking the drug immediately.
  • Sepsis. Without treatment, the cellulite can spread into the bloodstream and cause sepsis — a life-threatening condition that occurs when the body's response to an infection damages its own tissues. Sepsis requires emergency medical treatment.
  • Leakage through the skin. With the severe swelling, lymph, the fluid can drain through small wounds in the skin or cause blisters.
  • Changes in the skin. In some people with severe lymphedema, the skin of the affected limb may swell and stiffen so that it resembles the skin of an elephant.
  • Cancer. A rare form of cancer of the soft tissue can be the result of the more severe cases of untreated lymphedema.

Diagnosis

If you're at risk of lymphedema — for instance, if you've recently had cancer surgery involving your lymph nodes — your doctor may diagnose lymphedema based on your signs and symptoms.

If the cause of your lymphedema is not as obvious, your doctor may order imaging tests to get a look at your lymph system. Tests may include:

  • Magnetic resonance imaging. The use of a magnetic field and radio waves, an mri produces 3D, high-resolution images of the tissue involved.
  • Computed tomography. This X-ray technique produces detailed, cross-sectional images of body structures. The ct scan can reveal blockages in the lymphatic system.
  • Ultrasound. This test uses sound waves to produce images of the internal structures. You can help to find blockages in the lymphatic system and the vascular system.
  • Lymphoscintigraphy. During this test, the person is injected with a radioactive tracer and scanned by a machine. The images show the dye moving through the lymph vessels, highlighting the locks.

Treatment

There is No cure for lymphedema. The treatment focuses on the reduction of the swelling and prevent complications.

Drugs

Lymphedema significantly increases the risk of skin infections (cellulitis). The doctor may prescribe antibiotics for you to have on hand so that you can begin to take immediately once the symptoms appear.

Therapy

Specialized lymphedema therapists can teach you the techniques and equipment that can help to reduce lymphedema swelling. Examples include:

  • Exercises. Gentle contraction of the muscles in the arm or leg can help move excess fluid out of the swollen limb.
  • Manual lymphatic drainage. Trained therapists this massage as a technique for use very light pressure to move the fluid trapped in the swollen member into a work area of the lymph vessels. People should avoid the manual lymphatic drainage if you have a skin infection, blood clots, or active cancer in the affected limb.
  • Compression bandages. The use of low-stretch bandages to wrap the whole limb stimulates the lymph to flow back up into the trunk of the body.
  • The compression garments. Snap closure elastic sleeves or stockings can compress the arm or the leg to encourage the lymph fluid drainage. These garments often require a medical prescription to ensure that the amount of compression that is used. You need to be measured by a professional to ensure a proper fit.
  • Sequential pneumatic compression. A sleeve that is placed on the arm or the affected leg is connected to a pump that intermittently inflates the cuff, putting pressure on the limb and the movement of lymph fluid away from the fingers of the hands or feet.

Surgical and other procedures

The surgical treatment for lymphedema may include:

  • Lymph node transplantation. The lymph nodes are taken from a different area of the body and then connects to the network of lymphatic vessels in the affected limb. Many people with early-stage lymphedema see good results from this surgery and may decrease the amount of compression required.
  • New drainage paths. Another option for the early stages of lymphedema, this procedure creates new connections between the lymph and the network of blood vessels. The excess lymph fluid is then removed from the limb through the blood vessels.
  • The removal of fibrous tissue. In severe lymphedema, soft tissue in the extremities become fibrous and tempered. The removal of some of this hardened tissue, often through liposuction, you can improve the limb function. In very severe cases, hardening of the tissues and the skin can be removed with a scalpel.

Lifestyle and home remedies

To reduce the risk of complications of lymphedema, to avoid injury to the affected limb. Cuts, scrapes, and burns, it can invite infection. Protect against sharp objects. For example, shaving with an electric razor, wear gloves to the garden or cook, and the use of a thimble for sewing.

Coping and support

It can be frustrating to know that there is no cure for lymphedema. However, you can control some of the aspects of lymphedema. To help deal with the situation, try the following:

  • Find out all you can about lymphedema. Know what lymphedema is and what causes it can help communication with your doctor or physical therapist.
  • Take care of the affected extremity. Clean your skin every day, looking over every inch of the affected extremity for signs of problems, such as cracks and cuts. Apply the lotion to prevent dryness of the skin.
  • Take care of your entire body. Eating a diet rich in fruits and vegetables. Daily exercise, if you can. Reduce stress. Try to get enough sleep. Take care of your body, gives you more energy and promotes healing.
  • Get the support of other people with lymphedema. If you are attending support group meetings in your community or participate in message boards, on-line, it is useful to talk with people facing similar difficulties.

Preparing for your appointment

Here's some information to help you prepare for the appointment with your doctor.

What you can do

List of the following:

  • Your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment
  • Key personal information, including major illnesses or injuries, treatments for cancer or recent life changes
  • The drugs, vitamins, and supplements you take
  • Questions to ask the doctor

For lymphedema, some basic questions to ask the doctor include:

  • What is the most likely cause of this inflammation?
  • Could there be another cause?
  • What tests do I need? Do these tests require special preparation?
  • Swelling is temporary or long lasting?
  • What is the treatment for lymphedema?
  • There are alternatives to the approach that you're suggesting?
  • What medications are available to relieve the swelling?
  • I have other health conditions. How can I best manage them together?
  • I need to restrict my diet or activities?
  • Do you have brochures or other printed material that I can take? What sites do you recommend?

Do not hesitate to ask other questions as well.

What to expect from your doctor

Your doctor may ask you a series of questions, such as:

  • When he began the inflammation?
  • Did anything precede inflammation, such as surgery, trauma, radiation therapy or new drugs?
  • Do you have other signs or symptoms?
  • Has the swelling been continuous or occasional?
  • Does anything seem to improve the swelling?
  • Does anything seem to make symptoms worse?
  • What have you tried to treat edema, and how does it work?

What you can do in the meantime

Keeping the swelling of the limb elevated as much as possible and to protect your skin from injury. The swelling of lymphedema can dull the pain of a burn or injury, so do not use heating pads on the affected limb. Moisturize your skin daily.

The symptoms and treatment of Lymphedema