Lymphedema is a condition in which the lymph nodes—a series of vaguely bean-shaped organs scattered throughout the body—fail to drain the body of lymphatic fluid, resulting in swelling. I’ll get into what causes lymphedema and lymphedema treatments shortly, but first let’s take a look at the functions of the lymph nodes.
The main function of the lymph nodes is to serve as repositories of foreign particles, pathogens, and toxins prior to disposal—essentially they are the body’s garbage cans. Lymph nodes are aided by lymphatic fluid, a protein-rich solution that circulates throughout the body collecting pathogens and waste products before draining into the lymph nodes, at which point the materials are filtered and flushed from the body.
This is how the lymphatic system is supposed to work, but, as with much of your bodily functions, sometimes things can go wrong.
If something is preventing the lymph fluid from properly draining, it will build up and form a swelling known as lymphedema. This can create a problematic situation since you effectively have a pool of bacteria, toxins, and other nasty things sitting around and growing instead of getting filtered. As the lymph fluid builds and stagnates, you become at risk for even more infections.
Lymphedema comes in three stages depending on how advanced the condition is. Some of the symptoms change depending on the stage while others don’t appear until later. Symptoms of lymphedema include:
- Swelling: The primary symptom of lymphedema is swelling in the area where the lymph fluid can’t drain properly. The most common sites are in one of your arms or legs, including your fingers and toes. Normally only one limb is affected but it is possible for both to experience swelling. In stage one, the swelling is milder and tends to only appear during the day. If you press on the skin, it will hold an indentation; in stage two, it will feel spongy.
- Ache: Lymphedema is often accompanied by a dull ache and sense of heaviness in the affected limb. More intense pain may be a sign that your swelling is not caused by lymphedema.
- Hardened and thickened skin: As the fluid builds up, the area will begin to experience an immune reaction to all of the pathogens swimming about. This results in the buildup of a type of scar tissue called fibrosis. In addition to making the skin of the area feel hard, stiff, and thick, fibrosis makes it even harder for the fluid to drain from the area and can be accompanied by increased swelling, decreased wound healing, or decreased sensation around the site due to lower blood oxygen. Fibrosis tends to occur around stage three.
- Recurrent infections: By definition, lymphedema means your lymphatic system isn’t performing at its normal capacity. This makes you less able to fight off infections and makes you more prone to recurrent illness. This can include more regular illnesses like the flu or more opportunistic infections like cellulitis. In particular, you should keep an eye out for signs of lymphangitis—a bacterial infection of the lymph vessels. Symptoms of note would be a red streak or blotchy rash on the swollen limb.
What Causes Lymphedema?
- Genetics: It is possible, but rare, to be born with an obstructed swollen lymph node that makes you vulnerable to developing lymphedema. This is called primary lymphedema and is the only kind of lymphedema that happens on its own as opposed to being triggered by something else (secondary lymphedema). The obstruction can be present at birth or develop later in life.
- Surgery: Various surgical procedures can result in injury or outright removal of a lymph node. For instance, lymph nodes can be damaged during certain vascular surgeries and node tissue is often removed as part of breast cancer testing or mastectomies.
- Cancer or cancer treatment: Tumors can form in or near lymph nodes and block the flow of lymphatic fluid, resulting in a buildup and edema. Additionally, lymph nodes and vessels have been known to become swollen or scarred as a side effect of radiation treatment.
- Infection: Lymph nodes naturally swell while the body is battling an infection but some parasites and diseases can result in impairment of the node and restriction of lymph fluid. This lymphedema cause is more common in tropical or developing regions but can happen from more temperate infections as well.
Lymphedema does not have a cure and in some cases the condition may be permanent. However there are numerous treatments that can be used to maintain quality of life and ease the burden caused by the swelling.
- Wrapping: Bandaging the affected limb can press the lymph fluid and encourage it to flow back into your torso. Ideally, the wrappings are tightest around the fingers or toes and get progressively looser as you move along the limb. Due to the importance of not cutting off your circulation, it is highly advisable that you only do this technique after your doctor demonstrates it.
- Exercise: Light exercise can promote lymph drainage and help restore some range of movement in advance of other activities. The ideal lymphedema exercise is gentle and focuses on contracting the muscles of your affected limb.
- Massage: There are special massage techniques designed to promote lymph drainage and promote the flow of lymphatic fluid. Unlike some other massage approaches, this one is best only done by someone who has received special training for it. Also, it is inadvisable to undergo a lymph massage if you have a skin infection, blood clots, congestive heart failure, cancer, or have recently had radiation treatment on the affected limb.
- Compression: You can use special compression garments with long sleeves or stockings to promote the flow of lymph fluid. Alternatively, you can use a pneumatic compression device, which is a sort of pump sleeve that operates similar to a blood pressure cuff but in a more intermittent fashion.
When to See Your Doctor for Lymphedema Treatment
Unexplained swelling is always a good reason to consult your doctor. If you have a confirmed case of lymphedema, you should consult your doctor about specialists and resources for the lymphedema treatments listed above. Lymphedema does not have many serious complications, but the vulnerability to infection can become a concern. Make an appointment with your doctor if any of the following happen:
- You develop swelling. Lymphedema is not the only cause of swelling and you shouldn’t assume on a cause without a diagnosis.
- The affected limb hurts more than a dull ache.
- You develop a skin infection on or near the affected limb.
- The swelling worsens or spreads.
Sources for Today’s Article:
“Lymphedema,” Mayo Clinic web site, October 23, 2014; http://www.mayoclinic.org/diseases-conditions/lymphedema/basics/definition/con-20025603.
“Lymphedema Causes,” Mayo Clinic web site, October 23, 2014; http://www.mayoclinic.org/diseases-conditions/lymphedema/basics/causes/con-20025603.
“Lymphedema Symptoms,” Mayo Clinic web site, October 23, 2014; http://www.mayoclinic.org/diseases-conditions/lymphedema/basics/symptoms/con-20025603.
“Lymphedema Treatments and Drugs,” Mayo Clinic web site, October 23, 2014; http://www.mayoclinic.org/diseases-conditions/lymphedema/basics/treatment/con-20025603.
Roth, E., et al., “Lymphatic Obstruction (Lymphedema)” Healthline web site, November 25, 2015; http://www.healthline.com/health/lymphatic-obstruction#Overview1.
“What Is Lymphedema?” National Lymphedema Network web site; http://www.lymphnet.org/le-faqs/what-is-lymphedema.