What is lymphedema?
Lymphedema is a collection of fluid that causes swelling (edema) in the arms and legs.
What causes lymphedema?
One of the causes of lymphedema is surgery to remove lymph nodes usually during cancer treatment. Normally, lymph nodes filter fluid as it flows through them, trapping bacteria, viruses, and other foreign substances, which are then destroyed by special white blood cells called lymphocytes. Without normal lymph drainage, fluid can build up in the affected arm or leg, and lymphedema can develop. Medicines such as tamoxifen (Nolvadex), radiation therapy, and injury to the lymph nodes can also cause lymphedema. This type is called secondary lymphedema.
Primary lymphedema can be present at birth or develop during puberty or adulthood. The cause of primary lymphedema is not known.
What are the symptoms?
Symptoms of lymphedema include feeling as though your clothes, rings, wristwatches, or bracelets are too tight; a feeling of fullness in your arms or legs; and less flexibility in your wrists, hands, and ankles.
How is it treated?
Treatment for lymphedema depends on its cause and includes wearing compression garments such as stockings or sleeves, proper diet and skin care, and fluid drainage.
Elevating an arm or leg that has swelling can help ease the drainage of lymph fluid from the affected limb. Whenever possible, rest a swollen arm or leg on a comfortable surface, above the level of your heart. Don't put pressure on your armpit or groin area, and don't hold a limb up without support for very long since this can increase swelling.
Gentle exercise can help reduce swelling. The use of muscles during exercise naturally helps lymph fluid to circulate, which can reduce swelling. However, exercise also increases blood flow to the muscles being used, which can increase the amount of lymph fluid present. If you have swelling, it is important to properly bandage an affected limb before exercising. Ask your health professional how to use a bandage for this purpose and what exercises are appropriate for your condition.
After surgery or radiation treatment
If you have had lymph nodes removed or have had radiation therapy as part of cancer treatment, you may be able to avoid lymphedema or keep it under control by following the tips below.
Contact your doctor promptly if symptoms of an infection-such as redness, pain, or increased swelling-develop in your arm, hand, leg, or foot.
Protect the area below the surgery from injury, even many years after surgery.
If you have had lymph nodes removed from under your arm:
If you have had lymph nodes removed from your groin:
Ask your doctor how to handle any cuts, scratches, insect bites, or other injuries that may occur.
Use sunscreen and insect repellent when outdoors to protect your skin from sunburn and insect bites.
Do not ignore a feeling of tightness or swelling in or around your arm, hand, leg, or foot. Let your health professional know about it immediately.
Ask your doctor to refer you to a physical therapist who specializes in lymphedema. Many insurance companies will not pay for physical therapy evaluations and treatments without a doctor's referral.
PT Hawaii Reference from WebMD Medical Reference and Healthwise (June 24, 2009)