Swelling of the lower extremities is a very common occurrence. A swelling that appears after a hard day and disappears in the morning should alert the person. Such a symptom may be an early manifestation of varicose veins or thrombophlebitis. If puffiness only grows every day, you need to see a doctor as soon as possible in order to exclude lymphostasis of the lower extremities. This disease occurs in 10% of the world's inhabitants.
Features of the lymphatic system
The lymphatic system is part of the circulatory system and actively interacts with the cardiac apparatus. Vessels play the role of a transport artery to promote lymph throughout the body. It itself serves as a mechanism for plasma purification. The fluid first enters the intercellular space, and then, together with the proteins, is redirected to the capillaries. From there, it passes into the lymph nodes, where the blood passes the final purification and is distributed throughout the body.
The lymphatic system performs several important functions:
- the formation of antibodies;
- participation in the formation of white blood cells;
- transportation of fat from the large intestine to the blood system;
- fluid filtration and removal of toxins and foreign substances from it.
Any malfunction of the lymphatic system causes a poor outflow of fluid from the soft tissues. They occur, as a rule, due to clogging of vessels or their overgrowth. This contributes to the occurrence of edema, which are the first signs of lymphostasis of the lower extremities.
Description of the disease and its causes
Lymphostasis is a chronic disease characterized by impaired lymphatic drainage. Most often, it affects the region of the lower extremities. With this pathology, the lymph ceases to fully circulate throughout the body and begins to accumulate in the tissues. Therefore, the legs swell strongly, and the skin becomes very dense over time. The people know this phenomenon under the term "elephantiasis" because of the external similarity with the limbs of the animal.
The disease has 2 forms of flow: primary and secondary. They differ among themselves in the mechanism of occurrence and pathogenesis. Primary lymphostasis develops against a background of congenital pathology. Usually it is diagnosed in babies, and among the reasons, doctors identify several factors at once:
- genetic abnormalities;
- heart valve failure;
- underdevelopment of organs.
Secondary lymphostasis of the lower extremities is not congenital in nature. It affects men and women over 30 years old. People leading a sedentary lifestyle also fall into the risk group. The development of the disease is due to acquired disorders that interfere with the normal outflow of lymph. These are the following violations:
- overweight;
- previous thrombophlebitis;
- body irradiation;
- neoplasms in the lymphatic system;
- heart failure;
- kidney pathology;
- parasitic infections;
- skin burns.
The causes of lower limb lymphostasis may not have a direct connection with the lymphatic system, but indirectly have a pathological effect on adjacent organs.
Clinical picture
In its development, the disease goes through 3 stages of development. Each of them has a specific clinical picture.
The initial stage, or lymphodema, is characterized by reversible processes. Swelling appears only in the ankle and at the base of the toes. This symptom is especially noticeable after exercise, as well as in the evening. After resting, it usually disappears without a trace. At this stage, the disease lends itself well to conservative treatment methods.
The second stage, or fibrodema, is characterized by a more pronounced clinical picture. Puffiness becomes permanent. She rises to the level of the ankle. In this area, the skin visibly tightens, acquires a bluish tint. Possible deformation of the leg, an increase in its size in diameter. Some patients have cramps in the calves and joints of the foot.
Elephantism is the final stage of development of lymphostasis of the lower extremities. In the photo below you can consider its characteristic features. Due to puffiness, the leg enlarges excessively in diameter. The difference between a healthy and affected limb is about 50 cm. The skin is very rough and thickens. In the soft tissues, cystic-fibrous changes are manifested. The foot gradually loses the functions assigned to it by nature.
Diagnostic Methods
The treatment of lymphostasis of the lower extremities is carried out by a lymphologist. In the absence of a specialized specialist in a medical institution, you need to contact a phlebologist or an angiosurgeon for help.
After a physical examination of the patient, the study of his complaints, the doctor prescribes an additional examination. It includes the following activities:
- Dopplerography of blood vessels (allows to detect edema in the veins).
- Lymphoscintigraphy (necessary to assess the state of the lymphatic system). This diagnostic method involves the introduction under the patient’s skin of a substance that enters the lymphatic flow and takes several pictures using a gamma camera.
- Lymphography (a special case of x-rays, with which you can determine the number of vessels and the permeability of their walls). During the procedure, the doctor introduces a dye between the first toes. Then he makes a small incision in the bones of the midfoot. Through it, blue-colored vessels subsequently appear.
- Urinalysis (helps evaluate kidney function).
- Ultrasound examination of the lymphatic flow (recommended for determining the functioning of the lymphatic system).
- Blood tests (necessary to detect inflammation in the body).
- ECG of the heart (allows you to establish the relationship between the work of the heart and the underlying disease).
Based on the results of a patient examination, a specialist tells how to treat lower limb lymphostasis. Therapy can be either conservative or operational. The main course is well complemented by massage and physiotherapy. For some patients, prescriptions for folk doctors help. Each treatment option used in modern medical practice is described in more detail below.
Nutrition recommendations
Treatment of lymphostasis of the lower extremities at home should be comprehensive and should consist of drug and compression therapy, special massage, exercise therapy. Dietary adjustment has a positive effect on the development of the disease. The diet should be low-calorie and practically salt-free. Condiment so beloved by many retains fluid in the body and only contributes to the occurrence of edema. It is recommended to choose foods rich in plant and animal proteins, fatty acids.
Doctors recommend sharply limiting the consumption of pastries and sweets, pasta. But the presence in the diet of fresh vegetables and fruits, dairy products is only welcome. Do not forget about the drinking regimen. It is recommended to consume up to 2 liters of pure water per day. It is better to replace coffee and tea with fruit drinks or compote without sugar, herbal infusions.
Drug use
Drug treatment of lymphostasis of the lower extremities implies the use of drugs to normalize lymph flow, increase vascular elasticity. Usually prescribed drugs from the following groups:
- Enzymes (Wobenzym, Flogenzim). They stop swelling, stimulate the immune system and have an anti-inflammatory effect.
- Diuretics. These drugs help to remove excess fluid from the body, but you need to take them under the constant supervision of a doctor.
- Antiplatelet agents (Trental, Curantil). Medicines from this group dilute blood well.
- Angioprotectors. Medicines are designed to normalize the tone of the lymphatic vessels and reduce the permeability of their walls.
- Benzopyrons ("Coumarin"). The course application of such drugs helps to reduce edema.
Given the general clinical picture and the causes of lymphostasis of the lower extremities, antihistamines and antibiotics are additionally prescribed. The former are recommended for relapses of erysipelas, and the latter in the case of trophic changes in the skin.
The benefits of massage
Massage with lymphostasis of the lower extremities is an important component of the course of treatment. Equally effective is the hardware and manual effects on the affected areas. Trying to independently carry out this procedure is not worth it. The study of stagnation begins with the groin area, which is physically difficult for the patient to perform himself. Therefore, with severe puffiness, it is recommended to undergo a massage course with a specialist.
After the first session, many patients note that the affected limb has significantly decreased in size. If there is a slight tingling sensation and “goose bumps” in the body, then the stagnation of fluid and lymph in the soft tissues subsides.
Massage is not for everyone. Among the contraindications to this procedure, doctors note the presence of varicose veins, trophic ulcers and other violations of the integrity of the skin. If during the session discomfort appears, it is immediately stopped.
Compression underwear
Judging by the reviews, with lymphostasis of the lower extremities, medical knitwear is a real salvation for patients. Patients claim that special compression underwear has several advantages:
- Functionality. Stockings and socks delicately compress the affected limbs, and also provide support for them.
- Convenience. Few have the skills of bandaging or lymphatic drainage massage. And compression knitwear can be worn by everyone.
- Beauty. The treatment of even such an unpleasant disease can be fashionable. Today, knitwear is available in various colors, with an unusual design. It can be worn under clothes and instead of the usual clothes.
Models are best selected according to individual standards. In the free sale, you can also pick up suitable linen.
About the importance of exercise therapy
Treatment of lymphostasis of the lower extremities at home is not complete without exercise. A set of exercises should be selected by a specialist. The first classes are held under his control, but after 2 weeks you can begin to work independently. They require little time - only 15 minutes twice a day. At the same time, a compression bandage must be present on the affected leg.
What exercises can be included in the exercise therapy complex?
- "Bicycle" with a sore foot.
- Bending and alternating toes.
- Drawing by the feet of the G8.
- The rotation of the feet in different directions, but alternately.
The listed exercises are quite easy, but it is important to repeat them daily.
Help traditional medicine
Treatment of lymphostasis of the lower extremities with folk remedies is permissible only as an addition to the main course of therapy. Before this, consult your doctor. Due to the inability to present all the recipes recommended against the disease, we consider only the most popular.
- Apple vinegar. This tool helps to strengthen the walls of blood vessels, well stops swelling. For grinding, vinegar should be diluted with a liquid in a ratio of 1: 2. After the procedure, the skin should be washed under running water and lubricated with a moisturizer.
- Compress based on pharmaceutical tar. For its preparation, the onion must be baked in the oven and knead with a fork. Add 2-3 tablespoons of tar to the mixture, put it on gauze or soft tissue. The bandage must be fixed with a bandage.
- Medicinal decoctions can be used as night applications. To prepare a compress, you will need to take St. John's wort, yarrow and plantain in equal proportions. In a decoction of these herbs, you need to add an aspirin tablet and 25 ml of medical alcohol. The composition can soak gauze and attach to the affected area of the leg, securely fixed with a bandage.
During the treatment of lymphostasis of the lower extremities, one should not forget about other recommendations of doctors. For example, during the entire course of therapy and for some time after it, you will have to refuse to visit the bath, sauna and solarium. You should also review the wardrobe. Cloths that are tight and rubbing the skin should be put aside, replacing them with more comfortable options made from natural materials. Unfortunately, high-heeled shoes will have to be abandoned.
The need for surgery
When conservative methods of treating lymphostasis of the lower extremities are ineffective, and irreversible destructive processes in the soft tissues are actively progressing, surgery is recommended for the patient. In uncomplicated cases, doctors resort to shunting. This is a microsurgical intervention during which the doctor creates anastomosis between the lymphatic vessels and veins. As a result, there is a discharge of lymph into the venous bed, which prevents stagnation of the fluid.
More complex operations are prescribed for irreversible fibrous processes in the soft tissues. They are also addressed in case of loss of contractile function of the lymph nodes. Such interventions include various skin plastic surgery. During their conduct, excessively overgrown fiber is excised, and the wound is sutured carefully. Such an operation does not guarantee a complete cure, but it greatly facilitates the life of the patient. It should be remembered that in such patients, due to metabolic disturbances in the affected limb, wounds heal slowly. Therefore, the risk of joining a secondary infection of bacterial etiology is quite high. This fact once again confirms that the treatment of lower limb lymphostasis should be resorted to immediately after confirming the diagnosis.
Prognosis for recovery
The disease itself does not pose a threat to the life of the patient. However, its course is often accompanied by complications that lead to irreversible consequences.
For example, severe edema can limit the patient's movement, causing pain. With untimely treatment, a person loses the opportunity to self-service himself, which negatively affects his quality of life. Developing lymphostasis sometimes provokes functional disorders in the tissues. As a result, multiple seals and trophic ulcers form on the affected limb. This condition is complicated by a decrease in local immunity and the inability to fully resist various infections. A neglected disease leads to erysipelas and sepsis, which often leads to death.
If the patient does not neglect the advice of the doctor and immediately proceeds to the prescribed treatment, the listed complications are easily avoided. In general, specialists give a favorable prognosis for recovery.