Definition

Lymphedema is a build up of fluid in the lymph system. This system is made of organs, vessels, nodes, and fluids. It is part of the immune system and balances fluids in the tissue.

The fluid build up leads to swelling in the area. It is most common in the arms and legs. It can spread to the core and head. Swelling may be mild to severe. It can dramatically increases the size of the limb. It can also cause color changes to the skin.

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Causes

Primary lymphedema is caused by defects of the nodes or vessels. It is due to a birth defect or change in genes. Parts may be missing or not work as they should. Conditions with primary lymphedema include:

• Milroy’s disease
• Meige disease

Secondary lymphedema is caused by an injury or illness that blocks the flow of fluid. Examples include:

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

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Risk Factors

Lymphedema is more common in older adults.

Factors that may increase the chances of lymphedema include:

• Surgery that includes the removal of lymph nodes
• Radiation therapy for cancer
• Cancer
• Infections
• Burns
• Obesity —may increase risk of lymphedema after breast cancer surgery
• Immobility

Symptoms

Symptoms of lymphedema include:

• Swelling in arms, legs, fingers, or toes
• Clothes, shoes, or jewelry may feel tight even though there is no weight change
• Heaviness in one or more limbs
• Changes in skin such as a feeling of tightness, hardening, or reddening of the skin
• Loss in range of motion and flexibility in nearby joints
• Aching, pain, discomfort, or tingling in the limb

Lymphedema can also lead to complications like:

• Breakdown of the skin
• Infections of the skin
• Massive changes in the size and shape of the limb

Diagnosis

The doctor will ask about any symptoms and past health. A physical exam will be done. The amount fo swelling and size of limb will be measured. The doctor may diagnose lymphedema based on the exam and past health.

More tests may be needed if the cause is unclear. Image tests may include:

• MRI scan
• CT scan
• Duplex ultrasound or Doppler ultrasound

Treatment

Treatment will depend on the cause. Lymphedema will stop after treatment for some. Others will have a continued risk of lymphedema. Treatment may include different steps:

• The first part of treatment may be more intense. It may be given over a few weeks.
• The next step may be a long-term plan. This will include finding what makes swelling worse.
• Managing lymphedema flare up early may prevent complications.

When lymphedema is present, it is important to reduce swelling. Too much swelling can cause complications. Options to treat swelling include the following:

Prevention

Certain conditions or treatment have a high risk of lymphedema. The medical care team will take steps to prevent lymphedema. Early treatment can make a big difference.

A strength and activity program in recovery may help prevent lymphedema after removing lymph nodes.