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What Is Lymphedema?

Lymphedema is a chronic condition in which the lymph vessels are unable to transport lymph fluid from the tissue spaces back into the circulation. This results in the accumulation of fluid in the tissue of the leg and foot. This abnormal accumulation of protein rich fluid is known as lymphedema.

Who Is Affected by the Vein Disease Complications of Lymphedema?

Lymphedema most often affects the extremities, but can occur in other parts of the body, such as in the face, neck, abdomen or genitals. It is estimated that nearly 1 percent of the U.S. population (2.5 million Americans) are affected with lymphedema.

However, the seriousness of the pathological and clinical manifestations of this condition is poorly understood in the medical community. In America, the most significant cause of lymphedema is chronic venous insufficiency.

Complications and Issues from Lymphedema
Lymphedema May be Primary or Secondary
Patients with secondary lymphedema often have underlying vein disease.

Lymphedema May Be Primary or Secondary

Primary Lymphedema is caused by malformation in the lymphatic system. This malfunction is more common in women. Primary lymphedema is most common in the legs, but may occur in the arms and hands or other parts of the body. It may be present at birth, but may develop in infancy, adolescence or later in the 20s or 30s without obvious cause.

Secondary Lymphedema is a result of damage to the lymphatic system as a result of surgery, radiation therapy, trauma, injury, scarring, obesity, infection or chronic venous insufficiency. Patients with lymphedema often have underlying venous disease if they experience swelling over a long period.

The lymphatic and venous systems work intimately with each other. If venous disease is present, the increased pressure can overload the lymphatic system’s ability to keep up with the demands of fluid removal. Swelling and inflammation occur and are destructive to the delicate lymphatics and surrounding tissue. Failure to treat the venous disease can lead to further damage in the lower legs and the possibility of lymphedema with resultant swelling of the foot.

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What Symptoms and Signs Accompany the Stages of Lymphedema?

Stage 0 Example

Stage 0

No visible signs of swelling, usually sensations of heaviness and tightness in the affected limb. Even though swelling may not be visible, treatment usually with compression should be started to reverse the risk of worsening edema. Elevation, compression and manual lymphatic drainage may avoid progression to fibrosis.

Stage 1 Example

Stage I
Swelling consists of protein-rich fluid in the tissues and may become temporarily reduced by simple elevation of the limb. If left untreated, the disease can progress to Stage II. The foot may have a puffy appearance. Finger pressure may result in an impression in the skin- “pitting.”

Stage 2 Example

Stage II

Swelling doesn’t respond to elevation and the extremity and foot take on a spongy consistency. “Pitting” is less present. There is fibrosis in the tissue and the lower leg is permanently enlarged.

Stage 3 Example

Stage III

Significant increase in fluid volume, skin changes such as hardening and dryness of the dermal tissues, hyperkeratosis and papillomas occur (raised lumps in the skin). Swelling doesn’t subside with elevation. Fluid may leak from the skin or blisters may form.

Infections frequently develop in patients suffering from lymphedema and are most common in stage II and III lymphedema. Infections result in worsening of patient’s lymphedema and may also result in hospitalization with IV antibiotics.

Lymphedema is a chronic condition that can be managed, not cured, with complete decongestive therapy (CDT). CDT is a combination of manual lymphatic decompression (MLD), compression bandaging/garments, remedial exercises and meticulous skin and nail care.

What is the Treatment for Lymphedema?

Manual Lymphatic Drainage
This light, gentle massage technique helps move fluids away from the congested area into an unaffected area to reduce the swelling.

Compression Bandaging
This multilayer of short stretch bandages work with the patient’s movement for further reduction of swelling. More recently, Velcro compression makes application and daily hygiene easier, and patient tolerance is excellent.

Graduated Compression
These compression garments are worn during the day to help keep the swelling down, improve circulation, and prevent accumulation of lymph fluids in the involved area.

Pneumatic Compression Pumps
This mechanical device works as a sleeve with inflatable chambers to help mobilize the fluid from the limbs.

Skin Care
Meticulous skin care, including the application of a low PH lotion at least twice a day and avoiding nicks, cuts or abrasions, as the affected limb is more susceptible to infection.

Exercise
When used with compression, exercise utilizes the body’s natural muscle pumping action to increase venous and lymphatic fluid return to the circulatory system and out of the affected/swollen area. Recommended exercises are swimming, yoga, walking, biking and light weight training with compression, except with swimming. Avoid aggressive contact sports, exercise-to-fatigue sports or heavy weight lifting that may cause injury.

Some important tips to remember are maintaining a healthy weight, keeping hydrated with water and eating a well-balanced diet consisting of fruits, vegetables, whole grains and protein. Avoid carbohydrates when possible as well.

Do you have the warning signs and symptoms of vein disease?

Take this short, five-question quiz to find out if you’re at risk.

Do you have the warning signs of vein disease?

1

Do your legs often feel tired and heavy?