What is lymphedema?

Lymphedema is the abnormal collection of high-protein fluid beneath the skin, most commonly in the arm and leg, but may also occur in other parts of the body. It causes one or more of your arms or legs to become swollen, due to a buildup of lymph fluid. 

This often occurs in people who have had a surgery during which their lymph nodes were damaged or removed. For example, up to 40 percent of those who undergo surgery for breast cancer will experience it, as this surgery usually involves biopsy of  lymph nodes (sentinel lymph node biopsy).

Primary lymphedema is lymphedema that happens on its own, not caused by another condition or injury. It can occur in children born with impaired or missing lymph nodes.

What causes lymphedema and when should I see a doctor?

Globally, a common cause of lymphedema is an infection by Wuchereria bancrofti roundworms. This is known as lymphatic filariasis. According to the World Health Organization, it’s responsible for causing lymphedema in over 15 million people worldwide. Lymphatic filariasis is one of the world’s leading causes of disability.

No matter the origin, everyone with lymphedema experiences pain and discomfort. It’s important to detect this condition as early as possible, so you can then focus on remedying the problem. See your doctor if you notice swelling in your limbs that persists, especially if you’ve recently undergone surgery that affects your lymph nodes.

How is lymphedema treated?

There is no cure for lymphedema, but it can be treated. Lymphedema treatment depends on the cause and the patient’s stage of Lymphedema. Treatments may include: gentle exercises, wraps, compression garments, proper diet and fluid drainage. Although surgery is an option, this is only considered in the most severe circumstances.

Most often, your doctor will recommend a noninvasive option called complete decongestive therapy (CDT). Also called complex decongestive therapy, CDT focuses on multiple methods of alleviating lymph fluid retention you’re experiencing.

There are several drainage-promoting therapies performed during a course of CDT:

  • WRAPPING AND COMPRESSION.  By using either bandages or special compression garments, you may be able to help the lymph fluid drain from your extremities through pressure. Affected body parts usually need to stay wrapped up 24 hours a day — except during bathing.
  • MANUAL LYMPHATIC DRAINAGE.  Manual lymphatic drainage, which is targeted massage or manipulation of soft tissue, can aid in draining lymphatic fluid. Your CDT provider will likely massage you and also show you some techniques that you can perform on yourself to promote drainage.
  • SKIN CARE REGIMEN.  Because lymphedema also affects the skin, people undergoing treatment need to practice special skin care techniques. The goal is to maintain clean and well-moisturized skin to ward off infection.
  • EXERCISES.  It’s important to stay as active as you can, as physical activity is one of the most effective ways to promote drainage. Your doctor will help you determine which types of exercises are right for you. Most will include stimulation of arm or leg muscles.
  • CDT DURATION AND AFTERCARE.
    • Lymphedema treatment with CDT lasts anywhere from two weeks to three months, depending on severity and how the body responds to the treatment.
    • Depending on the nature of your lymphedema, your doctor may begin with a treatment such as wrapping, and then move on to physical therapy.
    • Some people see benefits from ongoing physical therapy alone. Your doctor may recommend compression garments, especially during physical activity or while flying in an airplane to help keep swelling down.
    • Because everyone’s body reacts differently to therapies, talk to your doctor about the best route for treating your lymphedema.