What Is Lymphedema? - Symptoms and Treatment

Our cells exist in a fluid environment. This fluid is called lymph. The system balancing fluid levels in the body is called the lymphatic system . It consists of lymph vessels, lymph capillaries, lymph cells, lymph nodes, tonsils, thymus and spleen. The fluid surrounding cells supplies nutrients and oxygen. After these needs are met, waste released into it is filtered and cleaned by lymph nodes, and lymph joins the circulatory system. Working with the immune system, the lymphatic system serves as a protective filter for the body's defenses.

Because there is no mechanism supporting circulation like the arteries and heart in blood circulation, lymph moves through lymph channels by muscular force. If lymph fluid exceeds the lymphatic system's transport capacity, lymphedema occurs. In other words, it is swelling caused by lymph leaking and accumulating between tissues. Commonly also called elephantiasis, lymphedema may be congenital or have an unknown cause. Swelling may also follow surgery, radiotherapy, infection or trauma.

It particularly occurs in cancer patients' arms and legs after radiotherapy or removal of lymph vessels or nodes in the groin or armpit.

Although there is no definitive treatment, lymphedema can be controlled.

What Are the Symptoms and Causes of Lymphedema?

The clearest symptom is swelling in the arms and legs. The skin appears hard and tight. Swelling restricts leg mobility, causes tightness and tenderness at the elbow or behind the knees, and produces sensory loss and joint stiffness in the limbs.

Symptoms:

• Swelling in the legs or hands, including fingers and toes
• Heaviness and tightness in the legs or arms
• Limited movement in the arms or legs
• Pain and discomfort in the arms or legs
• Recurrent infections in the arms or legs
• Thickening and hardening of skin on the limbs

Causes:

Lymphedema occurs when lymph nodes or lymph vessels fail to maintain effective lymph flow. It may originate from the lymphatic system itself (primary lymphedema) or from a specific disease (secondary lymphedema).

1. Causes of Primary Lymphedema: Primary lymphedema occurs rarely with genetic conditions because of problems in the body's lymph vessels. The legs are affected more than the arms.
2. Causes of Secondary Lymphedema: It results from damage to lymph nodes or vessels;
3. Surgery: Removal or cutting of lymph nodes and vessels causes it when the remaining nodes and vessels cannot compensate for those removed.
4. Radiotherapy: It results from reduced lymph flow due to scarring or inflammation during radiotherapy.
5. Cancer cells: It may occur when cancer cells block lymphatic vessels close to lymph nodes and vessels.
6. Infection: Infection of lymph nodes and vessels can obstruct lymph flow and cause lymphedema.
7. Injury: Any damage to lymph nodes or vessels can likewise cause lymphedema.

How Can We Prevent Lymphedema?

First, ask your doctor whether surgery involves any lymph nodes or vessels. To reduce risk:

Protect the arms and legs: avoid injuries inviting infection, such as burns and cuts. Avoid sharp tools such as razors. Choose an electric shaver and wear gloves when cooking or gardening.

• Avoid Heat: Do not use heating pads on the affected arm or leg.
• Elevate: If possible, elevate the affected arm or leg frequently.
• Avoid Tight Clothing: Do not slow blood circulation by wearing tight clothing on the affected limb.
• Keep Your Arm or Leg Clean: Inspect and clean the affected limb daily. Cleaning prevents skin infection.

What Treatments Are Appropriate?

Lymphedema treatment aims to reduce swelling and control pain.

Exercise

Gentle exercises with the affected limb promote lymph movement. Movements should be soft and light without tiring muscles. Your physiotherapist will prepare exercises and help you perform them. Warm-up, gentle stretching, breathing and pumping exercises may be most suitable. Muscle activities helping fluid drainage should be performed with bandages or compression stockings.

Bandaging

A bandage worn on the affected limb during exercise provides high pressure, accelerating lymph flow and distributing it through the body. At rest, it applies low pressure to prevent fluid accumulating again.

Manual Lymphatic Drainage

This special massage is performed by a specially trained physiotherapist. Gentle pressure drains lymph toward healthy lymph nodes. Do not have massage if you have a skin infection, blood clots, heart problems or active cancer.

Compression Garments

A garment covering the affected arm or leg moves lymph out of the swollen area. It is made using special techniques and individual measurements. Accurate measurements are important for pressure adjustment.

Skin Care

Use moisturizer because skin in the swollen area becomes dry. Consult your doctor about the moisturizer. Your doctor will also monitor possible fungal infections in the affected skin.

For severely painful lymphedema, surgery may be used to reduce swelling. However, it is not a cure.

Consult your doctor promptly if limb complaints worsen. Never follow hearsay advice on your own without your doctor's knowledge. Your doctor will perform necessary tests and make any additions and/or changes considered necessary.