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What is Lymphedema?

The human body protects itself from infections through the release of the white blood cells (WBC). These cells are the gateway to the body’s defense mechanism. One special type of WBC is the lymphocytes. These are cells located in the lymphatic system which help the body fight viruses, bacteria and other disease-causing microorganism.

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Primary Lymphedema is a condition that results in the build-up of lymph fluid in the tissues. It is caused by abnormalities in the lymphatic system, which is responsible for draining fluid from the tissues. This can lead to swelling in the arms, legs, or other body parts. Primary lymphedema occurs as a genetic malformation of the lymph nodes as opposed to secondary lymphedema, which occurs due to external causes.

Primary lymphedema may be present at birth or occur after birth. If it occurs after birth but before the age of 35, it’s called lymphedema praecox, but if it occurs after the age of 35, it’s called lymphedema tardum. Primary lymphedema can be classified into three categories. The first one is called aplasia, where there is a lack of development of the lymph nodes or vessels. The second one is hypoplasia, where the lymph nodes or vessels are too few or too small. Finally, there is hyperplasia, where the lymph nodes or vessels are too large or too many.

 

Secondary Lymphedema is caused by outside factors such as trauma, injury, infection or cancer that may affect the lymphatic system. 

What are the symptoms?

The symptoms of Primary Lymphedema are similar to Secondary Lymphedema and can include feelings of tightness

and discomfort in the affected area, tingling sensations, and changes in skin texture or thickness along with the requisite edema. 

Getting Diagnosed

CT: Scan of lymphatic system provides a cross sectional view of the body and any blocks can be detected.

MRI: Lymphangiography provides detail view of lymphatic vessels.

Doppler Ultrasound: To check for abnormalities in the lymph nodes or other organs.

Lymphoscintigraphy: Imaging the lymph nodes after injecting a radioactive dye, to identify the causative factor.

Treatment and Management

Although Primary Lymphedema and Secondary Lymphedema are chronic conditions, and there is currently no cure. There are several approaches to treating it and managing symptoms, including:

Compression: Compression is one of the frontline treatments for managing the swelling caused by lymphedema. Lymphedema therapists can teach you how to wrap bandages around the affected area of the body to help move the excess fluid. Treatment may also involve wearing compression garments. You may use the garments by themselves or attached to a device that can apply additional pressure to promote movement of the fluid. 

Massage: Manual lymphatic drainage is a massage technique that helps move the fluid from the affected area of the body to other body parts with working lymph vessels. The massage is a gentle treatment your therapist can perform. Your therapist can also teach you how to do the technique at home. 

Exercise: Gentle forms of exercise can help promote fluid drainage in the affected areas. Your therapist can teach you how to do these exercises on your own. 

Complete decongestive therapy (CDT): CDT is an integrative approach to lymphedema treatment. It combines manual lymphatic drainage, compression therapy, different types of exercise and skincare. The first phase of this treatment approach focuses on decongestion, while the second is targeted at maintenance. Those with a history of blood clots, heart failure, high blood pressure or diabetes might not be recommended CDT. 

Surgery: Surgery may be suggested in more severe cases of lymphedema. Lymphatic bypass involves connecting lymphatic vessels to direct fluid away from obstructions and encourage proper draining. Healthy, functioning lymph nodes can also be transferred from other parts of the body to the affected areas. 

FINDING A CERTIFIED LYMPHEDEMA THERAPIST IS KEY TO TREATING AND MANAGING LYMPHEDEMA

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