Lymphedema: Causes, Symptoms, Treatments And Prevention
Lymphedema (a.k.a Lymphatic Obstruction) is a medical condition caused due to the blockage of the lymphatic system. The lymphatic system is the part of immune system that protects an individual from infections and diseases.
Lymph is a thin, pale fluid helps in removing the waste products from the tissues and maintains the fluid balance. The lymph after filtering the waste usually returns to the bloodstream, but when the lymph vessels get blocked and fail to carry the lymph away from the tissues swelling occurs and result in lymphedema.
- What is Lymphedema?
- Types of Lymphedema:
- What Causes Lymphedema?
- Symptoms of Lymphedema:
- Risk factors for Lymphedema:
- Complications of Lymphedema:
- Diagnosis of Lymphedema:
- Treatment for Lymphedema:
- Prevention of lymphedema:
What is Lymphedema?
Lymphedema is a medical condition that results in swelling of the tissue due to the accumulation of fluid inside the lymphatic system. Lymphedema usually occurs in any one of the arms or legs, but in some cases, either arms or both legs get affected.
Types of Lymphedema:
Lymphedema is usually of two types, they are:
- Primary Lymphedema: It is a genetic problem due to improper development of lymph nodes or vessels. It is mostly present during birth.
- Secondary Lymphedema: It develops due to the inflammation of the tissue caused due to some other underlying medical condition.
What Causes Lymphedema?
The cause of lymphedema depends on the type.
Primary lymphedema is usually caused due to mutations (sudden changes) in the genes that help in the development of the lymphatic system. These faulty genes reduce the ability to drain fluid.
Secondary lymphedema is caused due to other underlying conditions that affect the lymph vessels or lymph nodes, such as:
- Cancer Surgery: In cancer surgery the doctor sometimes removes the lymph node to stop the spread of cancer, which may affect the lymphatic system and cause lymphedema.
- Radiation Therapy: Radiation is used to destroy the cancerous cells. Sometimes there may be damage to the lymphatic system that results in lymphedema.
- Infections: Infections that cause damage to the tissues around the lymph nodes or vessels and result in scarring, increases the risk of lymphedema.
- Inflammatory Diseases: Diseases, such as rheumatoid arthritis, eczema, and dermatitis causes inflammation of the tissues and may lead to damage to the lymphatic system.
- Cardiovascular Diseases: These diseases usually affect blood flow. Individuals with cardiovascular diseases have a greater risk of lymphedema.
- Injury and Trauma: In rare cases, any form of injury or trauma may cause lymphedema due to severe skin burn or due to excessive scarring.
Symptoms of Lymphedema:
Swelling of arms or legs or any other part of the body is the most common symptom of lymphedema. During the initial stage swelling may come and go, but it gets worse without treatment. The other symptoms of lymphedema include:
- Feeling of heaviness or tightness
- Draining of fluid from the skin
- Hard and thickened skin
- Wart-like growth on the skin
- Difficulty while walking
- Repeated skin infections
Risk factors for Lymphedema:
The risk of lymphedema increases with:
- Older age
- Obesity (excess weight)
- Rheumatoid arthritis or psoriatic arthritis
Complications of Lymphedema:
Lymphedema if left untreated may lead to serious complications, such as:
- Cellulitis (severe bacterial skin infection)
- Lymphangitis (inflammation caused due to an infection of the lymph vessels)
- Deep vein thrombosis (blood clots in the deeper veins)
- Lymphangiosarcoma (cancer of lymphatic vessels)
Diagnosis of Lymphedema:
The doctor initiates the diagnosis by reviewing the medical history and signs and symptoms of the individual. A physical examination is also performed to evaluate the cause of inflammation, such as congestive heart failure, blood clots, kidney failure or some other medical conditions.
The doctor recommends further diagnostic tests to determine the exact cause of lymphedema. This may include:
Magnetic Resonance Imaging (MRI):
An MRI scan is performed to capture the detailed images of the internal organs. In lymphedema, an MRI scan helps in defining the architecture of the lymph node and other abnormalities, such as tumours.
Computerized Tomography (CT) scan:
CT scan is a specialized X-ray that helps to examine the internal organs of the body. CT scan in lymphedema helps in revealing the blockage of the lymphatic system.
Doppler ultrasound scans use the sound wave to assess the blood flow, which helps in identifying the blood clot in the deeper veins.
Radionuclide Imaging of Your Lymphatic System (Lymphoscintigraphy):
Lymphoscintigraphy is a diagnostic procedure in which the individual is injected with a radioactive dye into the lymph vessel. The movement of the dye is followed by using a scanner, which helps in viewing the blood flow and the blockage.
Treatment for Lymphedema:
The most common approach for treating lymphedema is to reduce pain, inflammation and to control other symptoms. Treatment options for lymphedema include:
Complete Decongestive Therapy (CDT):
Complete decongestive therapy is multiple treatment programs that involve manual lymph drainage, compression training exercise, and self-care along with lifestyle modifications. CDT is not recommended in individuals having high blood pressure, blood clots, paralysis, diabetes or acute infections.
Long sleeves or stocking are used to compress the arms or legs and encourage the circulation of lymph fluid. If compression garments or compression wraps are not helpful, then the doctor may recommend compression device with fabric fasteners.
Compression devices are directly attached to a pump that removes pressure from the affected limb and prevents accumulation of lymph. These devices are used in preventing long-term scarring but are not advised in individuals having congestive heart failure, deep vein thrombosis, or some infections.
The doctor recommends certain exercises, which helps in draining out the lymph by encouraging the movement of an affected limb.
Bandages are used to encourage the flow of lymph towards the trunk. These are also helpful in preventing the flow of lymph fluid towards the affected region.
A special massage technique known as manual lymph drainage is performed by a trained professional to remove the lymph fluid from the inflamed areas.
Massage is not advised in every individual. Individuals with skin infections, blood clots, or any other conditions involving drainage of lymph should avoid massage.
Surgery is usually recommended in severe cases for:
- Removing excess tissue from the limbs to reduce swelling
- Removing fat from the affected area
- Restoring the flow of lymph
Prevention of lymphedema:
Lymphedema cannot be prevented completely, but the chance of developing lymphedema can be reduced by:
- Eating a healthy and well-balanced diet
- Maintaining healthy body weight
- Exercising regularly
- Moisturizing the skin daily to avoid drying and cracking of the skin