What is Lymphedema?

Lymphedema is a condition whereby an excessive amount of lymph fluid collects in the legs or arms which results in swelling (edema).

Lymph fluid is the small amount of fluid that exists around the cells in tissues of the body. Lymph fluid helps deliver nutrients to cells, remove waste products and remove bacteria. Lymph fluid originated from the small arteries and veins in the area. The lymph fluid is drained via the lymphatic drainage system, a system of small channels similar to vein except they carry lymph fluid, not blood. The lymphatic system drains the lymph fluid through small channels that pass the fluid through lymph nodes to filter any infection and waste products before the lymph fluid drains back into the blood circulation.

Although there is not a cure for Lymphedema, VEINatlanta vein specialists can help you diagnose and manage your condition.

What causes Lymphedema?

Lymphedema can develop when the lymphatic system does not function properly, or when another medical condition causes too much lymph fluid to be produced. Lymphedema can be caused by:

  • Venous insufficiency
  • Randomly, for no known reason
  • Congenital anomalies
  • Trauma
  • Surgery
  • Allergic reactions
  • Lymphatic valves that do not work properly
  • Malfunction of the pumping mechanism of the lymphatic vessels
  •  Cancer
  •  Infection
  • Radiation therapy
  • Pregnancy

Venous insufficiency in leg veins can lead to Lymphedema (Veno-Lymphedema). The increased venous pressure causes more lymph fluid to leave the circulation and become deposited in the tissues, thus overloading the lymphatic drainage system.

What are the types of Lymphedema?

Lymphedema can be classified as two types:

  1. Primary Lymphedema. Primary Lymphedema occurs when there is an intrinsic abnormality of the lymphatic system, such as congenital abnormalities, failure of the one-way valves, or failure of the pumping mechanism. Lymphedema praecox, the development of leg swelling in young adults, is an example of primary Lymphedema.
  2. Secondary Lymphedema. Secondary Lymphedema is caused by some other issue that affects the lymphatic system. Venous insufficiency is another example of secondary Lymphedema (Veno-Lymphedema).

 

What are symptoms of Lymphedema?

Lymphedema most commonly occurs in the legs and arms and tends to be a chronic condition. Swelling is the most common sign or symptom of Lymphedema. Additional symptoms can be present:

  • Limb swelling
  • Hardening of the skin
  • Thickening of the skin
  • Redness of the skin Pain or discomfort
  • Feeling tired or tight
  • Recurrent infection

Symptoms can range from mild, where you don’t notice any signs, to severe where you have difficulty moving your limb. In the legs, Lymphedema can occur in one leg or both legs.

What are the risk factors of Lymphedema?

Most Lymphedema of the legs in the United States is idiopathic, meaning no know reason for occurring, a random event. Women are more likely to develop Lymphedema than men. There are several factors that increase your risk of developing Lymphedema including:

  • Venous insufficiency
  • Female gender
  • Cancer or cancer treatment such as surgical removal of lymph nodes or radiation therapy
  •  Age
  • Obesity

 

How is Lymphedema diagnosed?

A history and physical examination is usually all that is needed to diagnose Lymphedema. It is primarily a clinical diagnosis. At VEINatlanta, we frequently do a venous ultrasound of the legs to determine if there is also venous insufficiency or deep vein thrombosis that may be causing or contributing to the Lymphedema. On rare occasion, additional testing may be done such as a radionuclide lymphoscintigram, or testing to check kidney, heart, and liver function.

What are treatments for Lymphedema?

The goal of Lymphedema treatment is to control the swelling. Compression stockings are a first-line treatment or Lymphedema.

Other Lymphedema treatments may include:

  • Elevating the leg several times per day
  • Manual lymphatic drainage, a type of physical therapy
  • Complete decongestive therapy, including physical therapy, wrapping, and compression garments
  • Pneumatic lymphatic pumps can help with long-term control of swelling.

It is also important to treat any other underlying problems, such as infection or venous insufficiency to most effectively treat Lymphedema.

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