The term edema refers to the accumulation of an excessive amount of fluid in cells, tissues, or organs, and is clinically characterized by swelling. A variety of conditions can produce edema, including chronic venous insufficiency, infection, and trauma. Lymphedema is a progressive condition that occurs when the lymphatic transport system falls below the capacity needed to handle the fluids that normally leak from the blood vessels into the lymph system. The obstruction of lymphatic vessels leads to an accumulation of fluid and subsequent swelling of subcutaneous tissue.
Although lymphedema can develop in any area where the normal flow of lymph fluid has been interrupted, it is most commonly seen in the extremities, and almost always occurs directly under the skin (subcutaneous). Lymphedema can develop in the head or neck region, upper and lower extremities, chest, back, breast, body cavities, pelvic region, and genitals. The severity of lymphedema ranges from mild swelling to severe, massive swelling that can be associated with life-threatening complications.
If lymphedema remains untreated, swelling becomes more severe and the risk of complications rises significantly. Complications of untreated lymphedema may include:
- Recurrent infections, especially cellulitis (skin infection) and/or lymphangitis (infection of the lymphatic vessels)
- Progressive, structural damage to the lymphatic vessels
- Cosmetic body changes
- Deep vein thrombosis
- Pain due to pressure on nerves near the swollen limb
- Lymphangiosarcoma - cancer of the lymphatic system
Clinical signs of lymphedema can include:
- Localized swelling of the skin and subcutaneous tissue
- Subcutaneous tissue changes such as fibrosis, scaly, rough, or elevated skin
- Positive "Stemmers" sign - skin between 2nd and 3rd toes or fingers cannot be lifted up
- Reduced joint flexibility
- Increased skin turgor
- Breakdown of the skin leading to leakage of lymph fluid through the skin in advanced lymphedema.
It is important for patients to be full partners in their treatment with their health care providers and to actively participate in all aspects of their own rehabilitation since they need to identify and carry out measures to minimize or prevent serious complications. One of the most effective ways to achieve this is for patients to become highly knowledgeable about lymphedema and the various treatment options. Management of lymphedema is a life-long endeavor and the more familiar patients are with the condition, its treatment, and parameters of risk, the better and more effectively they can control the symptoms.
The treatment of lymphedema is individualized for each patient and depends on numerous factors including the location and severity of the swelling, the presence of any complications, and the overall health status of the patient.
In general, the treatment options for patients with lymphedema include:
- Complete Decongestive Physiotherapy
- Pneumatic pumps
- Drug therapy
- Surgical therapy
The Medifocus Guidebook on Lymphedema is a unique, comprehensive patient education resource that contains vital information about Lymphedema that you won't find anywhere else in a single resource. The Guidebook will answer many of your questions about this condition that your healthcare provider may not have the time to answer. To learn more about the Guidebook, please click here