Lymphedema is a common cause of leg and arm swelling due to lymph fluid retention. This most commonly damages the delicate vessels (lymphatics) that hold lymph fluid, which causes lymph fluid to accumulate in arm or leg tissue and leads to swelling.
Primary lymphedema develops without any external injury to the lymphatics; one form is an inherited condition that begins during childhood or puberty.
When the lymphedema is due to one of the following causes, it is called secondary lymphedema:
- Surgery or radiation to treat cancer
- After other types of surgery
Lymphedema presents as swelling, and if it occurs following surgery or radiation for cancer, it will present on the same side as where the cancer was treated. The swelling usually involves the feet and legs (or, in the case of arm edema, the hands in addition to the arms).
In advanced cases, the swelling may become quite severe and disfiguring, interfering with daily activities and causing emotional distress. 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.
It is important to differentiate lymphedema from other causes of swelling, such as a deep vein thrombosis, congestive heart failure, or kidney disease. Therefore, your physician may perform one or more tests, including 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 or three weeks, followed by long-term stocking (or glove) use.
Because lymphedema can predispose to skin infection, personal hygiene and skincare are important.
Other treatments may include:
- Manual lymphatic therapy
- Gradient compression bandaging of the limb
- Fitness programs for flexibility and strength
- Posture and breathing exercises
- Aerobic and conditioning exercise
- Therapy for frozen or weakened shoulder or other muscle imbalances
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