Lymphedema by Patricia Griffin Kellicker, BSN

En Español (Spanish Version)

Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

The lymph system helps your body fight illness. Lymph fluid travels throughout the body in lymph nodes and vessels. If these nodes or vessels are damaged or missing the fluid builds up. Fluid build-up in the arms or legs is called lymphedema. There are two types of lymphedema:

• Primary lymphedema is uncommon and occurs because people are born without lymph nodes and vessels.
• Secondary lymphedema occurs when there is injury to the lymph nodes or vessels.

While there is no cure for lymphedema, it can be controlled. If you suspect you have this condition, contact your doctor promptly for treatment.

Causes

Lymphedema can be caused by a variety of factors:

• Primary lymphedema
  • Born without lymph vessels and nodes
  • Milroy’s disease
  • Meige disease
  • Late-onset lymphedema

• Secondary lymphedema
  • Surgery for cancer
  • Radiation treatment for cancer
  • Burns
  • Liposuction
  • Surgery on blood vessels
  • Infection
  • Trauma

Risk Factors

These factors increase your chance of developing lymphedema. Tell your doctor if you have any of these risk factors:

• Surgery that removed lymph nodes
  • Breast cancer surgery (eg, lumpectomy , mastectomy )

• Radiation treatment
• Cancer
• Infection
• Parasites—tropical/subtropical regions
• Overweight
• Poor diet

Symptoms

If you have any of these symptoms do not assume it is due to lymphedema. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

• Swelling in arms, legs, fingers, or toes
• Loss in range of motion
• Infection
• Aching, pain, or discomfort
• Heaviness or tightness of skin
• Your clothes, shoes, or jewelry feel tight
• Hardening of the skin
• Redness of skin

Diagnosis

Cases of lymphedema can vary from mild to severe. Your doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include the following:

• Measurement of your arms and/or legs—to assess the severity of fluid build-up
• Lymphoscintigraphy—test that uses dye to trace its travel through your lymph system
• MRI scan —magnetic waves are used to make pictures of body structures; used to look at tissue affected by lymphedema
• CT scan —type of x-ray that uses a computer to make images; used to look at tissues affected by lymphedema
• Duplex ultrasound or Doppler ultrasound —test that uses sound waves to make images; used to look at blood flow and rule out blood clot

Treatment

Talk with your doctor about the best plan for you. Options include the following:

Drainage

Your doctor or physical therapist may show you exercises to drain fluid out of your arm or leg. Massage may also be used to help fluid draining. Sometimes external pumps are used to help drain the fluid build-up.

Compression

Compression stockings, sleeves, or bandages are often used to direct fluid away from your affected arm or leg. You may be shown how to apply a compression device.

Medicine

Areas of lymphedema are at risk for infection. Your doctor may prescribe an antibiotic to prevent or treat infection. If the condition is painful your doctor may suggest or prescribe a pain reliever.

Surgery

Surgery to remove extra tissue from your arm or leg may be considered in severe cases.

Prevention

If you are at risk for developing lymphedema, there are measures you can take to help reduce your chance of getting the condition:

• Do not allow anyone to take blood or your blood pressure on your affected arm or leg.
• Wear a medical bracelet warning of your risk for developing lymphedema.
• Keep your affected arm or leg clean.
• Avoid crossing your legs or carrying items on your shoulder if either area is at risk.
• Keep hands and feet protected by wearing gloves and shoes.
• Maintain a healthy weight and eat properly.
• Use an electric razor to shave.
• Use sunscreen when outdoors.
• Avoid ice packs or heating pads to the affected area.
• If you had lymph nodes in your armpit removed during breast cancer surgery, participating in a physical therapy program may help to prevent lymphedema.