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Lymphedema

Authors:
  • Amy Scholten, MPH
Publication Type:

Condition

Lymphedema

(Primary Lymphedema; Secondary Lymphedema)

Definition

Lymphedema is swelling in the tissues. It occurs when the lymph system is not working well. The lymph system is made of organs, vessels, nodes, and fluids. It is part of the immune system.

There are two types:

  • Primary
  • Secondary
Damaged Lymph Nodes

damaged lymphhttp://services.epnet.com/getimage.aspx?imageiid=77537753FY00010_105433_1.jpgFY00010NULLjpgdamaged lymphNULL\\hgfiler01a\intellect\images\FY00010_105433_1.jpgNULL93NULL2008-12-16394385Copyright © Nucleus Medical Media, Inc.

Causes

Primary lymphedema is caused by problems with the nodes or vessels. It is due to a problem that was present at birth or a change in genes. It is found in health issues such as:

  • Milroy’s disease
  • Meige disease

Secondary lymphedema is caused by a block in the flow of fluid. Things that may be causing the block include:

  • Infection
  • An abnormal growth in the area
  • Health issues
  • Medical treatments—such as removing lymph nodes during a surgery to remove cancer, for example
  • Injury
Planned Lymph Removal for Cancer Treatment

lymph nodes to be removedhttp://services.epnet.com/getimage.aspx?imageiid=77507750si1566_105433_1.jpgsi1566NULLjpglymph nodes to be removedNULL\\hgfiler01a\intellect\images\si1566_105433_1.jpgNULL72NULL2008-12-16293394Copyright © Nucleus Medical Media, Inc.

Risk Factors

Things that raise the risk of lymphedema are:

  • Surgery that includes the removal of lymph nodes
  • Cancer and radiation for treating cancer
  • Infections
  • Rheumatoid arthritis
  • Blood vessel problems
  • Burns
  • Obesity
  • Immobility

Symptoms

Symptoms of lymphedema include:

  • Swelling in arms, legs, fingers, or toes
  • Clothes, shoes, or jewelry may feel tight—not due to weight change
  • Heaviness in one or more limbs
  • A feeling of tightness, hardening, or reddening of the skin
  • Loss of flexibility in nearby joints
  • Aching, pain, discomfort, or tingling in the limb

Lymphedema can also lead to problems such as:

  • Breakdown of the skin
  • Infections of the skin
  • Changes in the size and shape of the limb

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done. Lymphedema may be diagnosed based on the exam.

If the cause is unclear, more tests may be needed, including blood tests. Images may be taken such as:

Treatment

The goals of treatment are to improve the flow of fluid and ease symptoms. How this is done depends on the cause. Options may be:

  • Exercise—strength training and range of motion to help reduce swelling
  • Supportive care such as gentle pressure or massage—to help move fluids
  • Wearing compression garments
  • Diet—avoiding foods that increase swelling
  • Reaching and keeping an ideal weight
  • Avoiding positions that block fluid such as crossing legs and carrying items on the shoulder

Good skin care can help prevent skin damage and infections.

If the lymphedema is severe surgery may be done to unblock the lymph vessels.

Prevention

The risk may be lowered by managing health problems that cause lymphedema. Early treatment can make a big difference.

RESOURCES:

CANADIAN RESOURCES:

CANADIAN RESOURCES:

References

  • Borman, P. Lymphedema diagnosis, treatment, and follow-up from the view point of physical medicine and rehabilitation specialists. Turkish Journal of Physical Medicine and Rehabilitation, 2018; 64 (3): 179–197.
  • Lymphedema—approach to the patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/lymphedema-approach-to-the-patient.
  • Lymphedema. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-conditions/lymphedema.
Last Updated:
2023-10-01

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.