(Primary Lymphedema; Secondary Lymphedema)
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:
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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:
- An abnormal growth in the area
- Health issues
- Medical treatments—such as removing lymph nodes during a surgery to remove cancer, for example
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Things that raise the risk of lymphedema are:
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
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:
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.
The risk may be lowered by managing health problems that cause lymphedema. Early treatment can make a big difference.
- 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.
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