What is Lymphedema?

Lymphedema is a chronic disorder that results from the accumulation of protein-rich fluid in body tissues when lymphatic fluid is unable to circulate properly. If untreated, body parts (Usually an arm or leg) become swollen and painful. Swelling may appear after simple accidents, which suddenly overload the system. Injury, scarring, infection, and cancer treatment involving lymph node removal and/or radiation therapy often cause symptoms.

What are the signs and symptoms?

• Feeling of tightness or heaviness.
• Difficulty bending or using the at-risk limb.
• Clothes or jewelry are tight or don’t fit like they used to.
• One limb may look larger than the other.

Causes of lymphedema

Anyone who has been treated for cancer with lymph nodes dissection and/or radiation therapy is at risk for developing lymphedema. Lymphedema can occur immediately post-operatively, within a few months, or 20 years or more after cancer therapy. With proper education and care, the risk of lymphedema can be reduced, or if it develops, kept well under control.

Primary lymphedema occurs when the lymphatic system has been inadequately formed. Swelling may be present at birth or may not appear until hormonal changes such as puberty or pregnancy. Primary lymphedema is much more commom in females (87%) than males (13%). Swelling usually appears in one or both legs, but can involve any area of the body.

Why should lymphedema be treated?

Lymphedema causes discomfort, decreased mobility, a need for frequent medical attention, and the embarrassment of a disfigured limb. Swelling and tightness gradually worsens over time and, without intervention, increased heaviness and decreased range of motion of the affected limb can occur. Patients are frequently hospitalized due to infection associated with lymphedema. Complete Decongestive Therapy can reduce swelling, improve wound healing and prevent life-threatening infection.

Lymphedema Risk Reduction Practices

I. Skin Care – Avoid trauma/injury and reduce infection risk

• Keep extremity clean and dry.
• Apply moisturizer daily to prevent chapping/chaffing of skin.
• Attention to nail care; do not cut cuticles.
• Protect exposed skin with sunscreen and insect repellent.
• Use care with razors to avoid nicks and skin irritation.
• If possible, avoid punctures such as injections and blood draws.
• Wear gloves while doing activities that may cause skin injury (i.e., gardening, working with tools, using chemicals such as detergent).
• If scratches/punctures to skin occur, wash with soap and water, apply antibiotics, and observe for signs of infection (i.e., redness).
• If a rash, itching, redness, pain, increased skin temperature, fever or flu-like symptoms occur, contact your physician immediately.

II. Activity/Lifestyle

• Gradually build up the duration and intensity of any activity or exercise.
• Take frequent rest periods during activity to allow for limb recovery.
• Monitor the extremity during and after activity for any change in size, shape, tissue, texture, soreness, heaviness or firmness.

III. Maintain optimal weight.

• Avoid limb constriction
• If possible, avoid having blood pressure taken on the at-risk arm.
• Wear loose fitting jewelry and clothing.

IV. Compression Garments

• Should be well-fitting.
• Support the at-risk limb with a compression garment for strenuous activity (i.e., weight lifting, prolonged standing, running).
• Wear a well-fitting compression garment for air travel.

V. Extremes of Temperature

• Avoid exposure to extreme cold, which can be associated with rebound swelling, or chapping of skin.
• Avoid prolonged (>15 minutes) exposure to heat, particularly hot tubs and saunas.
• Avoid immersing limb in water temperatures above 102 oF.

VI. Additional practices specific to lower extremity lymphedema

• Avoid prolonged standing or sitting.
• When possible, avoid crossing legs.
• Wear proper, well-fitting footwear.