Your lymphatic system is crucial to keeping your body healthy. It circulates protein-rich fluid throughout the body, collecting bacteria, viruses, and waste, flushing them from your system. Lymphedema is a swelling that occurs when a blockage in your lymphatic system prevents the lymph fluid from draining adequately (most often occuring in the arms or legs, although it can happen anywhere). You can see a detailed look at a typical lymphatic system by clicking on the poster below.
Who is at Risk for Lymphedema?
Some people are born with lymphedema (known as primary lymphedema), although it is more commonly caused by damage to the lymph nodes or vessels (known as secondary lymphedema).
Primary lymphedema is pretty rare and typically affects women, usually in their legs. It's an inherited condition that's caused by problems with the development of the body's lymph system. The most common cause of primary lymphedema are:
- Milroy Disease (congenital lymphedema) is a malformation of the lymph nodes that begins at infancy.
- Meige Disease (lymphedema praecox) is a hereditary condition that causes lymph vessels to form without valves, making it hard for the arms or legs to properly drain lymph fluid. Meige's typically begins during childhood or puberty.
- Late-Onset Lymphedema (lymphedema tarda) is a rare condition that usually occurs after the age of 35.
Secondary lymphedema is more common than primary lymphedema and is typically caused by:
- Surgery can cause lymphedema to develop if lymph nodes or vessels are removed, damaged, or severed during surgery. For instance, lymph nodes are sometimes removed during surgery for breast cancer to determine if the cancer has spread, which may result in lymphedema if the remaining nodes aren't able to compensate.
- Cancer cells or tumors growing near lymph nodes or vessels can cause blockages, preventing the lymph fluid from draining properly.
- Radiation Treatment may cause scarring or inflammation of the lymph nodes or vessels, restricting lymph flow.
- Infections or Parasites can also compromise the lymph system. This type of lymphedema (filarial lymphedema) is most commonly found in tropical regions from around the world such as India, China, or Indonesia.
- Injury that damages lymph nodes or vessels may also compromise the lymph system, causing lymphedema.
If you feel that you may be at risk for lymphedema, please see your therapist or doctor for more information and view the National Lymphedema Network's paper on Lymphedema Risk Reduction.
What are Symptoms of Lymphedema?
Some symptoms of lymphedema can include:
- Prolonged swelling of part of your body (typically in your arm or leg)
- A feeling of heaviness or tightness in the suspected area
- Restricted range of motion
- Aching or discomfort
- Recurring infections
- Hardening and thickening of the skin
If you notice any of these symptoms or suspect that you might have lymphedema, please see your therapist or doctor for more information.
Can I Prevent Lymphedema?
While there are no guarantees when it comes to preventing lymphedema, however, there are still significant steps that you can take to reduce your chances of developing it. If you're at risk for secondary lymphedema, first and foremost be sure to talk about a care and prevention plan with your medical professional. Secondly, you should take a look at these general guidelines as well:
- Protect your arm or leg. Avoid any injury to your affected limb. Cuts, scrapes and burns can all invite infection, which can cause lymphedema. Protect yourself from sharp objects. For example, shave with an electric razor, wear gloves when you garden or cook, and use a thimble when you sew. If possible, avoid medical procedures, such as blood draws and vaccinations, in your affected limb.
- Rest your arm or leg while recovering. After cancer treatment, avoid heavy activity with that limb. Early exercise and stretching are encouraged, but avoid strenuous activity until you've recovered from surgery or radiation.
- Avoid heat on your arm or leg. Don't apply heat, such as with a heating pad, to your affected limb.
- Elevate your arm or leg. When you get a chance, elevate your affected limb.
- Avoid tight clothing. Avoid anything that could constrict your arm or leg, such as tight fitting clothing and, in the case of your arm, blood pressure readings. Ask that your blood pressure be taken in your other arm.
- Keep your arm or leg clean. Make skin care and nail care high priorities. Inspect the skin on your arm or leg every day, keeping watch for changes or breaks in your skin that could lead to infection.
Is Lymphedema Treatable?
Unfortunately there isn't a cure for lymphedema just yet, but it can still be treated and managed
- Compression garments. Compression garments include long sleeves or stockings made to compress your arm or leg to encourage the flow of the lymph fluid out of your affected limb. Once you've reduced swelling in your arm or leg through other measures, your doctor may suggest you wear compression garments to prevent your limb from swelling in the future. Obtain a correct fit for your compression garment by getting professional help — ask your doctor where you can buy compression garments in your community. Some people may require custom-made compression garments.
- Exercises. Light exercises that require you to move your affected arm or leg may encourage movement of the lymph fluid out of your limb. These exercises shouldn't be strenuous or make you tired. Instead, they should focus on gentle contraction of the muscles in your arm or leg. Exercises help pump the lymph fluid out of your affected limb. Your doctor or a physical therapist can teach you exercises that may help.
- Wrapping your arm or leg. Bandages wrapped around your entire limb encourage lymph fluid to flow back out of your affected limb and toward the trunk of your body. When bandaging your arm or leg, start by making the bandage tightest around your fingers and toes. Wrap the bandage more loosely as you move up your arm or leg. A lymphedema therapist can show you how to wrap your limb.
- Massage. A special massage technique called manual lymph drainage may encourage the flow of lymph fluid out of your arm or leg. Manual lymph drainage involves special hand strokes on your affected limb to gently move lymph fluid to healthy lymph nodes, where it can drain. Massage isn't for everyone. Avoid massage if you have a skin infection, active cancer, blood clots or congestive heart failure. Also avoid massage on areas of your body that have received radiation therapy.
- Pneumatic compression. If you receive pneumatic compression, you'll wear a sleeve over your affected arm or leg. The sleeve is connected to a pump that intermittently inflates the sleeve, putting pressure on your limb. The inflated sleeve gently moves lymph fluid away from your fingers or toes, reducing the swelling in your arm or leg.
- Support groups. Another important part of managing your lymphedema is making sure that you have a great support system. Lymphedema is a life-long condition that can be burdensome dealing with on your own, just like with any condition. You can find support groups in your area at the National Lymphedema Network's website.
In cases of severe lymphedema, your doctor may consider surgery to remove excess tissue in your arm or leg. While this reduces severe swelling, surgery can't cure lymphedema.