Lymphedema

What is lymphedema?

Lymphedema is a swelling of an area of the body caused by excess fluid accumulation when the lymphatic fluid is blocked.

What causes lymphedema?

Lymphedema can be a condition at birth, can be due to injury or surgery in an affected area, or can be due to unknown causes.

Who is at risk?

Breast cancer surgery patients who have had the lymph nodes under an arm removed are primarily at risk. Radiation therapy to the underarm can also cause this painful condition.

What are the symptoms?

Persistent swelling in the involved extremities.

What are the complications?

Untreated, the swelling increases in the extremity and the skin hardens, loosing its elasticity. Infection is also a potential complication.

How can lymphedema be prevented?

If you have had lymph nodes removed surgically in either the groin or under the arm, or if you have been treated with radiation therapy, it is important that you protect the limb closest to the treatment site from injury.

The following suggestions will help prevent lymphedema:

• Wear gloves while doing housework, gardening, or other types of work that can result in even minor injuries.
• Never allow an injection or blood drawing in the affected extremity. This includes finger sticks.
• Have blood pressures checked in the unaffected extremity.
• Avoid heavy lifting with the affected arm. Do not carry heavy handbags with over-the-shoulder straps.
• Avoid vigorous, repetitive movements against resistance with the affected arm or leg (rubbing, scrubbing, pushing or pulling).
• Elevate the affected arm or leg whenever possible.
• Consult your therapist about any sports activities in which you participate, as some may aggravate the condition. Swimming, bike riding, walking, and specially designed ballet or yoga classes are encouraged.
• Avoid extreme hot or cold temperature changes (over 90^oF or below 0^oF), such as in hot tubs, saunas or when sunbathing. At all times, keep the limb protected from the sun by using sunscreen of at least SPF15.
• Maintain good hygiene by keeping the skin clean and dry with hypoallergenic soap and deodorant.
• Use an electric razor rather than a safety razor. Do not use a depilatory (hair remover cream).
• Do not wear tight jewelry or elastic bands around affected fingers, arms or legs.
• Avoid cutting cuticles on the affected arm or leg.
• Maintain your ideal weight through a well-balanced, low-salt diet.
• Avoid smoking and alcoholic beverages.
• Use insect repellent to prevent insect bites.

Treatment

Treatment depends on the cause.

Lymphedema is not caused by infection.

Depending on the severity of the lymphedema, a treatment plan will be determined using a variety of approaches, which may consist of:

• manual lymphatic drainage (massage)
• bandaging
• proper skin care and diet
• sequential gradient pump
• compression garments
• remedial exercises
• self-manual lymphatic drainage and bandaging

Remember

At the first sign of lymphedema, consult your doctor. The earlier lymphedema is treated, the better the results.

Health Education Index