Lymphoedema - Symptoms, Risk factors and Treatment

Lymphoedema is a condition in which swelling of one or both limbs occurs due to problems with the lymphatic system.

How does the lymphatic system work?

The lymphatic system serves as a drainage system in the body. It collects the excess fluid from different organs and transports it back to the blood through different lymphatic ducts. Moreover, it plays a vital role in the body’s immune system as it contains immune cells. It also plays an important role in the transport of fat throughout the body. 

The lymphatic system comprises lymph vessels that contain the lymph and pass through various lymph nodes. These vessels end in structures called lymphatic trunks, which converge to form lymphatic ducts. These lymphatic ducts open in the bloodstream and are responsible for transporting the lymphatic fluid back into the bloodstream.

What causes lymphedema?

Lymphedema can be due to different causes. Depending upon the underlying mechanism, it can be divided into primary and secondary.

Primary lymphoedema:

Primary lymphedema is an inherited condition that occurs due to problems with some genes. In this type, the lymphatic system is underdeveloped. Lymphedema in this type can manifest itself at any age, but more commonly, it develops from childhood. Some conditions associated with primary lymphoedema are:

• Milroy disease
• Meige disease
• Lymphedema tarda
• Lymphedema praecox

Secondary lymphoedema:

Secondary lymphoedema is caused by some acquired condition that causes an obstruction or disturbance in the normal lymphatic flow. Examples of different conditions causing secondary lymphoedema are:

• Lymphatic filariasis
• Surgery for cancer 
• Radiation therapy for cancer 
• Tumor causing lymphatic obstruction
• Trauma to the lymphatic system

Mechanism of lymphedema:

As the functioning of the lymphatic system has been briefly described earlier, we learn that the lymphatic system collects fluid and returns it to the bloodstream. When there is any problem with the lymphatic system, such as obstruction, the fluid cannot go to the bloodstream and tends to accumulate in the lymphatic vessels. Fluid accumulation causes swelling (edema) of the affected part of the body, which we refer to as lymphoedema.

Symptoms of lymphoedema:

• Swelling of a part of the whole limb
• A heavy feeling of the limb
• Aching of the limb
• Difficulty moving the limb
• Infections of the affected part
• Elephantiasis (elephant-like appearance of the limb due to excessive swelling and thickening of the skin)

Diagnosis of lymphoedema:

The diagnosis of lymphoedema is mostly clinical. By history and physical exam, your doctor can diagnose lymphoedema. For further evaluation and detecting areas of obstruction, a CT scan or an MRI may be suggested. A test for filariasis may also be suggested.

Treatment of lymphoedema:

There is no cure for lymphoedema. However, with proper treatment, the condition can be managed. The treatment is primarily focused on resolving the symptoms. The edema can be managed by the following strategies:

• Manual lymphatic drainage
• Exercises for limb
• Elevating the limb
• Pressure bandages
• Massage

Other than this, surgical reconstruction for primary lymphoedema may be considered. For secondary lymphoedema, the treatment also involves treating the underlying cause of lymphoedema.

Conclusion

Lymphoedema is a condition in which swelling of a limb occurs. The condition could be due to numerous causes. With appropriate treatment, the condition can be managed and the quality of life can be returned to normal. If you notice any signs and symptoms of lymphoedema, it is advisable to see your doctor.