Learn About Lymphedema

What is the definition of Lymphedema?

Lymphatic obstruction is a blockage of the lymph vessels that drain fluid from tissues throughout the body and allow immune cells to travel where they are needed. Lymphatic obstruction may cause lymphedema, which means swelling due to a blockage of the lymph passages.

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What are the alternative names for Lymphedema?

Lymphedema

What are the causes of Lymphedema?

The most common reason for lymphatic obstruction is the removal or enlargement of the lymph nodes.

Other causes of lymphatic obstruction include:

  • Infections with parasites, such as filariasis
  • Injury
  • Radiation therapy
  • Skin infections, such as cellulitis (more common in obese people)
  • Surgery
  • Tumors

A common cause of lymphedema is removal of the breast (mastectomy) and underarm lymph tissue for breast cancer treatment. This causes lymphedema of the arm in some people, because the lymphatic drainage of the arm passes through the armpit (axilla).

Rare forms of lymphedema that are present from birth (congenital) may result from problems in the development of the lymphatic vessels.

What are the symptoms of Lymphedema?

The main symptom is persistent (chronic) swelling, usually of the arm or leg.

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What are the current treatments for Lymphedema?

Treatment for lymphedema includes:

  • Compression (usually with wrapping in bandages or stockings)
  • Manual lymph drainage (MLD)
  • Range of motion or resistance exercises

Manual lymph drainage is a light massage therapy technique. During massage, the skin is moved in certain directions based on the structure of the lymphatic system. This helps the lymph fluid drain through the proper channels.

Treatment also includes skin care to prevent injuries, infection, and skin breakdown. Light exercise and movement programs may also be prescribed. Wearing compression garments on the affected area or using a pneumatic compression pump may be helpful. Your provider and physical therapist will decide which compression methods are best.

Surgery is used in some cases, but it has limited success. The surgeon must have a lot of experience with this type of procedure. You will still need physical therapy after surgery to reduce lymphedema.

Types of surgery include:

  • Liposuction
  • Removal of abnormal lymphatic tissue
  • Transplant of normal lymphatic tissues to areas with abnormal lymphatic drainage (rarely done)

In rare cases, surgery to bypass abnormal lymph tissue using vein grafts is done. These procedures are most effective for early lymphedema and should be performed by an experienced surgeon.

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What is the outlook (prognosis) for Lymphedema?

Lymphedema is a chronic disease that usually requires lifelong management. In some cases, lymphedema improves with time. Some swelling is usually permanent.

What are the possible complications of Lymphedema?

In addition to swelling, the most common complications include:

  • Chronic wounds and ulcers
  • Skin breakdown
  • Cancer of the lymph tissue (rare)
When should I contact a medical professional for Lymphedema?

See your provider if you have swelling of your arms, legs, or lymph nodes that does not respond to treatment or go away.

How do I prevent Lymphedema?

Most surgeons now use a technique called sentinel lymph node sampling to reduce your risk for lymphedema after breast cancer surgery. However, this technique is not always appropriate or effective.

Lymphatic system
Yellow nail syndrome
What are the latest Lymphedema Clinical Trials?
Lymphovenous Bypass (LVB) Promotes Healing Process of Venous Leg Ulcers
Summary: Leg ulcers are areas of epidermal discontinuity in lower limbs with causes of venous, arterial, diabetic, pressure, traumatic, allergic, or inflammation. Chronic venous leg ulcers (VLUs) are defined as leg ulcers persisting for 4 weeks or more, a.k.a C6 in CEAP classification of chronic venous insufficiency (CVI) and account for up to 70% of all chronic leg ulcers exhibiting overall prevalence of ...
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Evaluating the Effectiveness of Photobiomodulation Therapy in the Management of Breast Cancer-Related Lymphedema: a Randomized Controlled Trial
Summary: Up to one out of five patients with breast cancer will develop lymphedema in the upper extremity after cancer treatment. Patients with breast cancer-related lymphedema (BCRL) suffer from pain, heaviness, tightness, and a decreased range of motion. Photobiomodulation therapy (PBMT) is a non-invasive therapy based on the application of visible and/or near-infrared light produced by a laser diode or ...
What are the Latest Advances for Lymphedema?
The effect of the combined use of complex decongestive therapy with electrotherapy modalities for the treatment of breast cancer-related lymphedema: a randomized clinical trial.
Summary: The effect of the combined use of complex decongestive therapy with electrotherapy modalities for the treatment of breast cancer-related lymphedema: a randomized clinical trial.
Clinical application of low-level laser therapy (Photo-biomodulation therapy) in the management of breast cancer-related lymphedema: a systematic review.
Summary: Clinical application of low-level laser therapy (Photo-biomodulation therapy) in the management of breast cancer-related lymphedema: a systematic review.
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Effect of Lymphaticovenous Anastomosis on Muscle Edema, Limb, and Subfascial Volume in Lower Limb Lymphedema: MRI Studies.
Summary: Effect of Lymphaticovenous Anastomosis on Muscle Edema, Limb, and Subfascial Volume in Lower Limb Lymphedema: MRI Studies.
Who are the sources who wrote this article ?

Published Date: January 17, 2021
Published By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Jackson KA, Feldman JL, Armer JM. Lymphedema risk reduction and management. In: Cheng MH, Chang DW, Patel KM, eds. Principles and Practice of Lymphedema Surgery. 2nd ed. St Louis, MA: Elsevier; 2022:chap 10.

Rockson SG. Lymphedema: evaluation and decision making. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 168.