Lymphedema occurs when a block in the lymphatic system, a crucial part of the circulatory and immune system, causes swelling in one arm or one leg, although sometimes both arms or legs are affected. Fluid is unable to drain properly and builds up. Lymphedema has no cure, but treatment options are available, including the use of compression sleeves and stockings.
The signs and symptoms of lymphedema in the arm or leg are as follows:
- swelling of the limb, either in part or in whole, including the fingers
- a sensation of tightness or heaviness
- decreased range of motion
- discomfort, aching and pain
- recurrent infections like cellulitis
- thickening and hardening of the skin on the affected limb
Swelling can be so mild as to be barely noticeable or it can be so severe that it is disabling, making it impossible to use the affected arm or leg. It is important to make an appointment with a medical provider anytime unexplained persistent swelling occurs. Some patients do not report consistent pain with this condition.
Lymphedema is caused by a number of conditions, some primary and some secondary. Primary lymphedema is rare and caused by genetic conditions like Milroy's disease, a congenital condition, and Meige's disease, which occurs in childhood, around puberty. Secondary edema is caused when damage occurs to the lymph nodes or vessels because of cancer, surgery, radiation or infection, although infection is more common in tropical or sub-tropical underdeveloped parts of the world.
If not properly treated, lymphedema can lead to some serious complications, including infections of the skin and the lymph vessels. In very severe cases, lymphangiosarcoma, a rare cancer, can develop.
Treatment for lymphedema is usually a combination of one or more of the following:
- exercises that move the affected limb and help drain the fluid
- compression garments, like compression sleeves or compression stockings which encourage lymph fluid to drain
- a massage technique called manual lymph drainage
- tightly wrapping the affected limb with bandages as directed by a physician or therapist to encourage drainage
- pneumatic compression, in which a sleeve or stocking attached to a pump is placed on the limb and inflated and moves the fluid
When several of these techniques are combined, the therapy is called complete decongestant therapy, or CDT. CDT is not recommended for people with high blood pressure, blood clots, acute infections, heart failure or diabetes. Lymphedema therapy is usually performed by those who specialize in it, but it can be done by certified hand therapists and occupational therapists.
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