Lymphedema 101

Lymphedema is a medical disorder that is associated with swelling of either the legs or arms. In the majority of cases, lymphedema only affects one extremity. Worldwide, lymphedema of the left leg is most common. Often Lymphedema is confused with congestive heart failure or more commonly varicose veins. Many individuals are treated for varicose veins for years before the correct diagnosis is discovered.

What exactly is lymphedema?

All of us have veins and arteries in the body. Arteries take blood and nutrients to the tissues and veins take the blood back to the lungs, where it is reoxygenated. Also present in everyone are small vessels known as lymphatics. The lymphatics generally take all the extra fluid and byproducts from the tissues back to the veins. For example, when a person is injured and the skin has broken down, the site becomes red, swollen and tender. Often there is some clear fluid built up at the injured site. This fluid is cleared by the lymphatics. The tissue fluid drained by the lymphatics is normally rich in proteins and contains many different types of cells.

Lymphatics generally drain fluid towards the lymph nodes where the fluid is screened for bacteria or toxins and then the fluid is returned back to the veins. When the lymphatics get blocked for any reason, the fluids in the tissues will accumulate. Over time, the tissues will start to swell up and it is difficult to get rid of the fluid from the tissues. If the lymphatics in the leg get blocked, the leg will swell up.

Once lymphedema occurs, there is no cure. However, lymphedema can be controlled. Surgery used to be part of lymphedema many years ago but is almost rarely ever done today. Surgery, infact creates more complications and the majority of individuals fare worse with surgery. The best treatment for lymphedema is compression garments.

Signs and symptoms

Lymphedema typically affects the leg or the arm. The symptoms include the following:

Swelling of arm or leg may occur gradually. The swelling is almost always in one extremity and usually involves the entire arm/leg. The swelling may extend from the toes/fingers and involve the entire arm or leg. Often some individuals will notice that the swelling does vary with posture- the swelling usually is less while lying down and worse when standing up.

Tightness of the leg or arm is a common complaint. As the fluid builds up in the tissues, the arm or leg gets very hard and stiff. Heaviness of the extremity

Limited range of motion occurs as the fluid enters the joint. Ultimately this leads to an extremity which just remains straight.

Pain is minimal with lymphedema initially but as the fluid builds up, a constant ache develops.

Many individuals start to see clear fluid leaking from the skin. The skin becomes hard and leathery.

When breakdown of the skin occurs, infections are very common. Linear red lines (lymphangitis) are common with lymphedema.

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