Lymphedema

(Primary Lymphedema; Secondary Lymphedema)

How to Say It: lim-fah-DEE-ma

by Amy Scholten, MPH

Definition

Lymphedema is swelling in the tissues. It occurs when the lymph system is not working well. The lymph system is made of organs, vessels, nodes, and fluids. It is part of the immune system.

There are two types:

Primary
Secondary

Damaged Lymph Nodes

Causes

Primary lymphedema is caused by defects of the nodes or vessels. It is due to a birth defect or change in genes. It is found in conditions such as:

Milroy’s disease
Meige disease

Secondary lymphedema is caused by conditions that block the flow of fluid. Examples are:

Infection
An abnormal growth in the area
Medical conditions
Medical treatments—such as removal of lymph nodes
Injury

Planned Lymph Removal for Cancer Treatment

Risk Factors

Things that raise the risk are:

Surgery that includes the removal of lymph nodes
Cancer and radiation for cancer
Infections
Rheumatoid arthritis
Blood vessel problems
Burns
Obesity
Immobility

Symptoms

Symptoms of lymphedema include:

Swelling in arms, legs, fingers, or toes
Clothes, shoes, or jewelry may feel tight—not due to weight change
Heaviness in one or more limbs
A feeling of tightness, hardening, or reddening of the skin
Loss of flexibility in nearby joints
Aching, pain, discomfort, or tingling in the limb

Lymphedema can also lead to problems such as:

Breakdown of the skin
Infections of the skin
Changes in the size and shape of the limb

Diagnosis

The doctor will ask about your symptoms and health past. A physical exam will be done. Lymphedema may be diagnosed based on the exam.

If the cause is unclear, more tests may be needed, including blood tests. Images may be taken such as:

Treatment

Treatment depends on the cause. Options may be:

Exercise—strength training and range of motion to help decrease swelling
Supportive care such as gentle pressure or massage—to help move fluids
Diet—avoiding foods that increase swelling
Reaching and keeping ideal weight
Avoiding positions that block fluid such as crossing legs and carrying items on the shoulder

Good skin care can help prevent skin damage and infections.

For severe cases, surgery may be done to unblock the lymph vessels.

Prevention

The risk may be lowered by managing health problems that cause lymphedema. Early treatment can make a big difference.

RESOURCES:

National Cancer Institute
https://www.cancer.gov

National Lymphedema Network
https://www.lymphnet.org

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca

Lymphedema Association of Quebec
http://www.infolympho.ca

References:

Borman P. Lymphedema diagnosis, treatment, and follow-up from the view point of physical medicine and rehabilitation specialists. Turk J Phys Med Rehabil. 2018 Sep; 64(3): 179–197.

Lymphedema—approach to the patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/lymphedema-approach-to-the-patient . Accessed January 18, 2021.

Lymphedema. Society for Vascular Surgery website. Available at: https://vascular.org/patient-resources/vascular-conditions/lymphedema. Accessed January 18, 2021.

Last reviewed February 2020 by EBSCO Medical Review Board Marcin Chwistek, MD
Last Updated: 1/18/2021

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