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Leg Swelling (Lymphedema)

Leg Swelling (Lymphedema)

For some people, varicose veins are little more than a cosmetic issue. For others, varicose veins cause a variety of troubling and often uncomfortable symptoms. The same symptoms associated with varicose veins can also be attributed to other conditions, which require professional assessment and diagnosis so the appropriate treatment can be administered. Please contact us today at the Vein Care Center, serving the residents of Lima, Celina and the surrounding areas of Auglaize County, OH, to discuss your symptoms. We’re here to help!

What is Lymphedema?

Lymphedema, also known as lymphatic obstruction, occurs when fluid builds up in the soft tissue because of dysfunction within the lymphatic system. This system is responsible for supporting the immune system in removing toxins and foreign substances from the body. Lymph vessels carry excess fluid to the lymph nodes, where the harmful substances are filtered out, and the clean fluid can be recirculated through the bloodstream. When the lymph nodes or vessels become damaged or are removed due to cancer treatment, it can lead to a fluid buildup. This process can occur within days after injury to the lymphatic system or develop months or even years after the injury.

Lymphedema can present at any time throughout a person’s lifetime, and the medical community has yet to pinpoint the exact cause. However, risk factors exise that are known to be associated with this condition, which should be explored as a part of the diagnostic process. For example, people that have been through cancer treatment are much more likely to develop lymphedema, due to the way the therapy impacts the lymphatic system.

Lymphedema and Venous Insufficiency Although leg swelling (edema) can be a sign of both lymphedema and venous insufficiency, the two conditions are entirely separate. Although lymphedema may be associated with vascular abnormalities, it is more frequently the result of poorly developed or missing lymph nodes. However, in some cases, untreated venous insufficiency can progress into a combination of a venous and lymphatic disorder, which is typically treated in the same way as lymphedema.

What are the Risk Factors for Leg Swelling/Lymphedema?

A previous cancer diagnosis and treatment have already been cited as a risk factor for lymphedema. However, it is not the only one. Genetics may also pose a risk as the condition may run in families. It might also explain in some part why the disorder is occasionally present at birth. Two hereditary diseases might contribute to the onset of lymphedema. One of those is Milroy disease, which causes the structures of the lymphatic system to develop abnormally. The other is Meige disease, although the genetic link for this condition has not yet been identified.

Beyond these factors, you could be more prone to lymphedema if you are:

  • In the middle to later years of life
  • Very overweight or obese
  • Diagnosed with psoriatic or rheumatoid arthritis

Primary vs. Secondary Lymphedema

There are two types of lymphedema:

  • Primary or hereditary lymphedema occurs because of missing or lymphatic vessels at birth. It is a much less common form of lymphedema and may be linked to a family history of the disorder or a history of Milroy or Meige disease.
  • Secondary lymphedema is frequently attributed to damage to the lymph nodes or vessels due to cancer treatment, scar tissue after cancer treatment or infection. Secondary lymphedema commonly occurs after breast cancer, when the patient undergoes a mastectomy and possible additional treatments like radiation or chemotherapy.

Lymphedema Symptoms

The symptoms of lymphedema will vary somewhat, based on the severity of the condition. Some of the symptoms you might notice include:

  • Swollen limb or portion of the limb
  • Feeling of heaviness or tightness in the arm or leg
  • Restricted range of motion in the affected limb
  • Deformity of the limb in severe cases
  • Aching, tingling or discomfort in the affected limb
  • Swelling in other areas, including the head and neck
  • Changes in the skin including hardening and discoloration
  • Recurring skin infections
  • Significant fatigue that affects your daily function

These symptoms might appear soon after the lymphatic system has been affected by injury or other factors. However, it is just as common to see symptoms develop many months or years after the initial event. For people that have undergone cancer treatment, this means the risk for lymphedema is an ongoing concern throughout their lives.

Diagnosing Lymphedema

The diagnosis of lymphedema is a process that begins with a physical examination and a discussion of your medical history. Imaging tests using a contrast dye may also be ordered to detect any disruptions or abnormalities in the lymphatic system. Once the condition is diagnosed, it may also be classified based on its severity. This classification will help us to know which treatment is needed to resolve the swelling and manage the symptoms. The classification includes the following stages:

  • Stage 0 – also known as the latent stage, there may be few symptoms in this early phase other than some aching or tightness in the limb
  • Stage 1 – this mild stage of lymphedema might include swelling that comes and goes, as well as some early changes in the tissue you might notice if you press down on the area
  • Stage 2 – persistent swelling characterizes the moderate stage, and tissue that feels spongy and inflammation of the skin
  • Stage 3 – during the severe phase, you will see ongoing fluid retention, permanent skin changes and loss of motion in the limb

Potential Lymphedema Complications

In addition to the general discomfort and potential debility caused by lymphedema, people with this condition need to be aware of possible complications that can occur. One of the most concerning is the propensity to infection if the skin is injured in even the slightest way. A painful and sometimes dangerous skin infection known as cellulitis is common in individuals with lymphedema. Infection can also originate within the lymphatic system, which can spread and lead to cellulitis or a blood infection known as sepsis.

It is critical for people with lymphedema to avoid injury to the limb as much as possible. Patients may always be advised to wear shoes to prevent cuts to the feet or gloves when cooking, cutting or gardening. It is also critical to avoid constriction of the area, such as with tight clothing, to avoid exacerbating the fluid retention.

Treatment Options for Lymphedema

Your treatment plan will be based on the severity of the swelling and the degree of fibrosis (thickening and scarring of your connective tissue). You will likely need to follow a daily regimen of treatment to resolve swelling in the limb and manage other symptoms. Treatment typically involves a combination of the following:

  • Compression stockings or bandaging to promote movement of the lymph fluid
  • Manual lymph drainage, in which a trained specialist uses a gentle massage therapy technique to move lymph fluid out of the limb
  • Pneumatic compression, which applies pressure and a pumping action to move the fluid out of the affected area

The goal of all these therapies is to move lymph fluid back into the bloodstream where it can normally circulate once again. Because the lymphatic system doesn’t have a way to pump fluid like the heart pumps blood, the movement must be initiated manually through a combination of the steps listed above.

Treating vein disease and related conditions early can prevent more severe complications in the future. Let the caring and knowledgeable staff at the Vein Care Center help you look and feel your best. What’s your next step? Contact us, and we’ll take it from there!

We will have an in-house Lymphedema specialist from September 2018. To schedule an appointment in advance, please contact The Vein Care Center today at 419-227-4472, so we can help you find relief from this uncomfortable condition.

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