Lymphedema: Symptoms, Causes, Treatments

Lymphedema is the swelling of the body tissues due to damage in the lymphatic system and mainly occurs in the arms and the legs. It is a long-term chronic disease marked by the collection of excessive fluid in the body tissues. Lymphedema mostly happens after the treatment of cancer, in which the lymph nodes are removed, and the obstruction of the fluid in the nodes causes lymphedema. A person with lymphedema becomes unable to move and develops a high risk of skin infections.

Symptoms of lymphedema

Lymphedema develops slowly with time, and its symptoms can vary from person to person, but the most common symptoms are given below:

  • Swelling on the arms, legs, fingers, and the toes
  • Tightness of the skin
  • Itching and heaviness on the leg
  • Leaking of fluid from the skin
  • Repetitive skin infections
  • Thickening and hardness in the skin
  • Puffiness of the skin
  • Severe pain in the affected area

The signs and the symptoms of lymphedema can be mild or severe with time.

Causes of lymphedema

Several factors cause lymphedema. Some of the common causes are listed below:

1. Cancer:

Cancer is caused due to uncontrolled division of the cells, which blocks the lymphatic system; as a result, lymph nodes and vessels block the drainage of lymphatic fluid then a person suffers from lymphedema.

2. Radiation therapy:

During this therapy, the cancerous substances are killed with powerful radiation, and some healthy tissues are damaged; as a result, the lymphatic system also gets damaged, and the person develops lymphedema.

3. Infections:

Infection causes damage to the healthy tissues of lymph nodes and vessels; as a result, a person develops lymphedema.

4. Cardiovascular diseases:

Cardiovascular diseases like heart attack and heart stroke affect blood flow throughout the body. Persons with cardiovascular diseases have a high risk of getting lymphedema.

5. Injuries:

Sudden injuries like accidents and burning of the skin tissues damage the lymphatic system, and the person develops lymphedema.

6. Inflammations:

Frequent swelling of the skin tissues like eczema and arthritis can permanently damage the lymphatic system.

7. Obesity:

Being overweight and fat can also cause lymphedema.

8. Paralysis:

Limited movements of the muscles and strokes can also cause lymphedema.

9. Kidney diseases:

The primary function of the kidneys is to remove the excessive fluids from the body, but if the functioning of the kidneys is affected, the waste cannot pass out from the body; as a result, a person develops lymphedema.

Types of lymphedema:

There are the two types of lymphedema:

1. Primary lymphedema:

Primary lymphedema develops at birth or in the early time of puberty and after the age of 35. It is a rare disease that happens due to damage to the lymphatic system. The most common reason for primary lymphedema is a genetic disorder. This type of lymphedema leads to the development of many syndromes like turner syndrome, yellow nail syndrome, and Noonan syndrome, and swelling on the legs and arms.

2. Secondary lymphedema:

This type of lymphedema results from some injury or an accident that damages the lymphatic system or leads to the overload of the lymphatic fluid. It is caused by skin infections, trauma, or sudden strokes.

Diagnosis of lymphedema:

Lymphedema is diagnosed based on its symptoms. If you felt any unusual swelling in your body after cancer treatment. Consult with your doctor immediately in that case. Your doctor will ask you about your complete medical history and order different tests for a complete diagnosis. Your doctor may ask for the following tests:

1. Doppler Ultrasound:

Doppler ultrasound is used to diagnose blood flow and pressure in vessels through high-frequency sound waves. It is mainly used to find clots and to swell in the body.

2. CT scan:

CT scan is a computed tomography scan to diagnose the blockages in the lymphatic system through X-rays.

3. Lymphoscintigraphy:

The lymphoscintigraphy test is used to diagnose the abnormalities in lymph structure and lymph flow through a radiotracer.

4. MRI:

Magnetic resonance imaging is a test used to get a clear image of the internal parts of your body through radio waves, a large magnet, and a computer. It is also used to get pictures of extra fluids in your body.

5. Bioimpedance spectroscopy:

Bioimpedance is a noninvasive test mainly used to measure the total extracellular and intracellular patient’s body water to check for any changes in volume.

6. Indocyanine green lymphography:

Indocyanine green lymphography is an imaging technique used to visualize superficial lymph flow and diagnose abnormalities in the lymphatic system.

Treatment of lymphedema:

The treatment of lymphedema usually depends on the symptoms and the severity of the disease. Some of the common methods used to cure lymphedema are the following:

1. Through antibiotics and painkillers:

Antibiotics are usually prescribed to get relief from infections. The antibiotic used for the treatment of lymphedema is penicillin. In some cases, patients have a penicillin allergy. In these cases, clindamycin or clarithromycin are used to treat lymphedema. Painkillers such as NSAIDs including ibuprofen, aspirin, and naproxen and Non-NSAIDs such as Acetaminophen can also reduce swelling and pain during lymphedema.

2. Compression garments:

Compression garments such as compression sleeves and stockings are used to get relief from swelling in the arms and legs. Through compression garments, extra fluid circulates and filters out of the soft tissues, resulting in a reduction of swelling in the body.

3. Compression devices:

Compression devices such as pneumatic pumps can also be used to relieve swelling. During this process, the pump is connected with a sleeve wrapped around that body part suffering from lymphedema to get extra fluid out from the body through compression.

4. Multi-layer compression banding:

Stretch bandages help to reduce the swelling of soft tissues. During this process, a bandage is wrapped around the swollen part of the body to increase pressure and get extra fluids out of the body.

5. Exercises:

Physical exercises and decongestive exercise are used to treat lymphedema and increase the lymph flow in the body to filter out excessive fluids.

6. Manual lymphatic drainage(MLD):

Manual lymphatic drainage is a very light form of massage given by a therapist for the gentle stretch of soft tissues and to transfer the fluid to the working lymph vessels.

7. Surgical treatment:

Patients get surgical treatment only in severe cases. Some of the common surgical treatments are the following:

  • Liposuction: In this process, extra fat and other swelled tissue are removed through a small incision.
  • Debulking: Debulking is the surgical removal of all skin, fat, and tissues of the affected area and replacing it with a skin graft. This technique is only applicable in severe cases.
  • Lymphatic bypass procedure: It is a surgical process in which the lymphatic veins and vessels are again connected so that lymph fluid can quickly move out from the body without any obstruction.
  • Lymph node transfer: During this process, the lymph nodes are transferred to other parts of the body and placed in that area where there is an impairment to the lymphatic system. This process is used to restore a healthy lymphatic system.

References:

  • https://www.mayoclinic.org/diseases-conditions/lymphedema/symptoms-causes/syc-20374682
  • https://www.medicalnewstoday.com/articles/180919#_noHeaderPrefixedContent
  • https://my.clevelandclinic.org/health/diseases/8353-lymphedema
  • https://www.nhs.uk/conditions/lymphoedema/
  • https://www.lymphcare.com/na-en/what-is-lymphedema/causes-and-types-of-lymphedema/

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