Diseases & Conditions
Lymphedema
The Lymphatic System
Learning about the lymphatic system will help you to understand lymphedema: Lymph is a clear fluid that is found in tissue spaces throughout the body. Lymph vessels are a complex network of channels with one-way valves. Lymph vessels remove toxins, bacteria, wastes, proteins and excess water from body tissues. Lymph nodes act like filtering stations along these vessels to clean and purify. The human body has 600 to 800 lymph nodes. The neck, the armpits (axillary) and the groin (inguinal) are regions that are rich in lymph nodes. After fluid goes through the lymph system, it returns to the bloodstream.
What is Lymphedema?
Lymphedema is the build-up and pooling of protein rich fluid within body tissues. The most common signs of lymphedema in a limb or in a body part are swelling, a feeling of heaviness and discomfort.
These signs may occur in an arm, leg or body part nearest to the site of surgery, radiation, infection or trauma to lymph nodes. This arm or leg is referred to as your “affected limb.” If not treated, lymphedema may get worse. Other problems may include fibrosis (a hardening of the tissue) or repeated infections.
What Causes Lymphedema?
There are two types of lymphedema.
Primary lymphedema occurs with no known cause. It may be present at birth or occur later in life. Primary lymphedema is more common in females and most often affects the legs.
Secondary lymphedema occurs as a result of changes to the lymph system that can result from surgery that removes lymph nodes (in armpit, groin or neck), radiation, infection and trauma.
Breast cancer patients are at high risk for developing lymphedema. About 50 to 70 percent of patients that have had axillary node surgery get lymphedema. Those who have both surgery and radiation treatment are at even greater risk. Also, those that have had surgery for cervical, ovarian, testicular and prostate cancers are at risk for getting lymphedema in their legs.
Lymphedema can occur just after surgery or years later. This is why those who are at risk should pay close attention to the guidelines for prevention.
Treatment for Lymphedema
Although lymphedema is a chronic problem, there is treatment available that is very effective. By the end of the treatment sessions, you will learn the tools to manage lymphedema on your own. This treatment is called Complete Decongestive Physiotherapy (CDP). CDP consists of four parts:
- Manual lymph drainage (MLD) - This is a special, gentle massage that re-routes excess fluid to healthy lymph vessels. MLD removes excess water, protein and wastes via the lymphatic system back to the bloodstream.
- Compression Bandaging - Low-stretch bandages are applied to increase tissue pressure, make the muscles pump fluid better, and decrease the size and improve the shape of the limb. The patient also is fitted with a compression garment (sleeve or stocking) to help support the skin and to prevent the fluid from pooling again.
- Exercise - Exercise prevents tightness in muscles and joints, and improves lymph and blood flow. Patients are taught exercises to improve range of motion, strength and posture.
- Education - Patients are taught good skin care and other tips for prevention.
Guidelines for prevention
If you are at risk for lymphedema or if you have lymphedema, here are some things that you can do to prevent lymphedema or to keep it from getting worse:
- Call your doctor if you see any swelling, reddening, blistering or a rash on the affected limb. You also may run a fever.
- Never allow needles, injections or blood to be drawn from the affected limb. Also, never allow blood pressure readings to be taken on the affected limb.
- Avoid infections, insect bites, skin cuts and punctures, pet scratches, and manicures and pedicures on the affected limb.
- Avoid extreme temperatures, including burns from the sun or cooking, hot tubs, saunas, hot showers and very hot climates.
