Lymphedema is a common cause of leg and arm swelling and is due to the collection of too much lymph fluid. The most common is damage to the delicate vessels that hold the lymph fluid, called lymphatics.
When the lymphatics are damaged, the lymph fluid accumulates in the tissues of the arm or leg and causes swelling.
Common causes of lymphatic damage include:
- Surgery or radiation to treat cancer
- After other types of surgery
When the lymphedema is due to one of these causes, it is called secondary lymphedema.
In some cases, lymphedema may develop without any external injury to the lymphatics. This is called primary lymphedema. One form of primary lymphedema is an inherited condition which begins during childhood or puberty.
Symptoms of Lymphedema
Lymphedema presents as swelling of one or both legs or arms. If it occurs following surgery or radiation for cancer, it will present on the same side as where the cancer was treated.
In more advanced cases, the swelling may become quite severe and disfiguring, so as to interfere with daily activities and cause emotional distress. The swelling usually involves the feet and legs (or, in the case of arm edema, involves the hands in addition to the arms).
Occasionally, patients with lymphedema may develop skin infections, called cellulitis and lymphangitis. The skin will be red, painful, and warm, and fever may be present. If this develops, it is important to see a physician, so that appropriate antibiotics and skin care may be prescribed.
- You doctor will usually be able to diagnose lymphedema with an appropriate history and physical exam.
- It is important to differentiate lymphedema from other causes of swelling, such as a Deep Vein Thrombosis, congestive heart failure, or kidney disease. Therefore, you may undergo one or more tests such as a Duplex ultrasound, CT scan, or blood tests.
The most important and effective treatment is compressive therapy. This usually means some type of prescription strength compression stocking or glove.
In addition, a type of specialized massage called manual lymphatic drainage can be an important part of treatment. This is usually performed on an outpatient basis for two-three weeks, followed by long-term stocking (or glove) use. Because lymphedema can predispose to skin infection, personal hygiene and skincare are very important.
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