What is Lymphedema?

Lymphedema is a swelling of a part of the body, generally in the arm and leg appendages. The swelling is caused by an accumulation of lymph fluid in the swollen area. Lymphedema is a chronic and progressive condition but it can be controlled by proper care and attention to basic rules that can lead to a normal and active lifestyle.
Surprisingly, lymphedema affects about 1% of the population. Lymphedema generally results in a feeling of heaviness or cosmetic enlarging of the affected arm or leg, and a slight to severe discomfort. Repeated episodes of infection (erysipelas – an acute streptococcus bacterial infection of the dermis resulting in inflammation and characteristically extending into underlying fat tissue and lymphangitis – is an inflammation of the lymphatic channels that occurs as a result of infection (most common is Streptococcus Pyrogenes) at a site distal to the channel. Severe cases are associated with thickening of the skin, hardening of the limb, leakage of lymph and massive swelling.

Lymphedema is either primary or secondary lymphedema.

primary-lymphedemaPrimary lymphedema are those cases that occur without any obvious cause. Primary lymphedema may be present at birth or may develop after age 35. Primary lymphedema is generally more present in females and generally occurs more frequently in the legs. Secondary lymphedema is generally caused by an injury, scaring secondaryLymphedemaand radiation or surgery in the area of the lymph nodes. It is estimated that there is approximately two million cases of secondary lymphedema with most caused by breast cancer therapy.

So, what is the lymphatic system?

lymph-systemThe body has two circulatory systems which move liquid through the body; one is the blood system that circulates the blood in the veins and arteries and the other is the lymphatic system that which carries lymph thru the body and back to the large veins in the neck. Lymph is a colorless transparent fluid that originates in the tissue space throughout the body. It differs from blood in that it contains less protein and no red blood cells. The lymphatic systems responsibilities are to remove excess body fluids, bacteria, viruses, proteins, and waste products from the body tissues. As the lymph is passing from one part of the body it passes thru the regional lymph nodes where it is filtered. The lymph nodes, thymus gland, tonsils and spleen are all a part of the immune system. They produce lymphocytes which are important in fighting infection and enhance the body’s immune capabilities. When the lymphatic system is disrupted, the lymph pools in the interstitial spaces and swelling occurs.

The lymph is assisted in passing thru the body by muscular action, by contractions of the vessels, by movement of the diaphragm and by changes in pressure of the diaphragm (breathing). From here the lymph is propelled toward the veins in the neck where it joins with the blood on the way to the heart.

Factors that contribute to lymphedema are:

  • Surgery and/or radiation therapy
  • Post operative infections
  • Obesity
  • Infections (insect bites, athlete’s foot, paronychia – bacterial or fungal infection where the nail and skin meet at the side or the base of a finger or toe)
  • Sedentary lifestyles
  • Dependent limb position
  • Recurrent tumor
  • An inappropriately heavy breast prosthesis
  • Trauma to remaining lymphatics

There are many medications that have been tried to control lymphedema with little success. Surgery has never solved the problem. What is necessary is for you to educate yourself on lymphedema by talking to your physician or therapist. What has proven to be effective is Manual Lymph Drainage/Complete Decongestive Therapy (MLD/CDT), coupled with compression bandaging the affected limb and then followed by the application of compression sleeves or compression stockings.

Lymphedema should not be confused with edema. Edema is caused by an accident, surgery or injury resulting in the building up of excessive fluids in the tissue and can be treated by the application of a compression garment such as an arm sleeve or stockings. Untreated edema can progress to venous/lymphatic disorder which is treated as lymphedema.

Come back for the more information on lymphedema next month.

Data and Graphics courtesy Lohmann & Rauscher.