(Primary Lymphedema; Secondary Lymphedema)
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:
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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:
- An abnormal growth in the area
- Medical conditions
- Medical treatments—such as removal of lymph nodes
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Things that raise the risk are:
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
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 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.
The risk may be lowered by managing health problems that cause lymphedema. Early treatment can make a big difference.
- 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.
- Marcin Chwistek, MD
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