Lymphedema (also lymphostasis) is swelling or swelling of one limb (arms or legs). In rare cases, the disease affects both upper or lower limbs.
Most often, lymphedema occurs due to the removal or injury of lymph nodes in the course of cancer treatment. The immediate cause is blockage in the lymphatic system, which is part of the immune system. Blockage leads to accumulation of lymph, and therefore to swelling.
Unfortunately, it is impossible to defeat lymphostasis. Medical treatment, like other methods of dealing with lymphedema, is aimed only at reducing edema and pain. The success of therapy depends on the timely diagnosis and the provision of good care for the affected limb.
Symptoms
Symptoms and signs of lymphostasis appear in the arm or leg and include the following conditions:
- Full or partial swelling of the arm or leg, including fingers.
- A feeling of heaviness or tension.
- Limited range of motion.
- Pain or discomfort.
- Recurrent infections.
- Thickening and hardening of the skin (fibrosis).
Edema caused by lymphedema can be almost imperceptible, or, conversely, so severe that it becomes very difficult to use an arm or leg. If the cause of the disease was the treatment of cancer, limbostasis of the extremities can occur several months or even years after the end of therapy.
If you notice that leg or arm swelling does not go away, be sure to make an appointment with your doctor.
Causes
The lymphatic system is invaluable in maintaining the health of the whole body. She is responsible for the circulation of protein-rich lymph through the body, for the collection of bacteria, viruses and waste. The system passes lymph with these harmful substances through the vessels leading to the lymph nodes. Bacteria and toxins are then filtered by lymphocytes - cells that live in the lymph nodes and are designed to fight infections, and are ultimately eliminated from the body.
Lymphostasis of the arm or leg occurs when the vessels are unable to promptly remove lymph. This condition is primary and secondary, that is, develop independently (primary lymphedema) or as a result of another disease (secondary lymphedema). The latter type is much more common.
Causes of Secondary Lymphedema
Any disease or procedure that damages the lymph nodes or blood vessels can cause lymphostasis. Reasons include the following:
- Surgery. Removal or damage to lymph nodes and blood vessels (for example, when checking the degree of spread of breast cancer or during surgery involving the blood vessel system) most often leads to lymphedema.
- Cancer radiotherapy. Exposure to radiation can cause scarring and inflammation of the lymph nodes or blood vessels.
- Cancer. A common cause of lymphedema is blockage of the lymphatic vessels by cancer cells. For example, a tumor growing in the immediate vicinity of the lymph node can grow so much that the lymph flow is blocked.
- Infection. Infection of the lymph nodes prevents the normal outflow of lymph. Infectious disease-related lymphedema is most common in the tropics and subtropics, as well as in developing countries.
Causes of Primary Lymphedema
Primary lymphostasis is a very rare hereditary disease that occurs as a result of disorders in the development of lymphatic vessels. Specific causes include:
- Milroy's disease (primary congenital elephantiasis) - develops during the first months of life and causes abnormal development of the lymphatic vessels.
- Mayge's disease (primary juvenile elephantiasis) - occurs in the puberty or during pregnancy.
- Primary late lymphedema is a rare case of the disease. It appears in patients older than 35 years.
Risk factors
Circumstances that may increase the risk of developing a disease after cancer treatment and other secondary causes include:
- Elderly age.
- Overweight or obesity.
- Rheumatoid or psoriatic arthritis.
Complications
Lymphostasis is a serious disease that can lead to the following complications:
- Infections Due to lymphedema, a severe bacterial infection of the skin (inflammation of the subcutaneous tissue) or infection of the lymphatic vessels (lymphangitis) often occurs. The slightest damage to an arm or leg can turn into a place where bacteria or viruses enter the body.
- Lymphangiosarcoma. This rare form of soft tissue cancer develops in cases of severely advanced lymphostasis. Possible symptoms of cancer are blue-red and purple spots on the skin.
What should be discussed with a doctor?
Before you visit a specialist, make a few lists. You will need the following information:
- Your symptoms, including those that seem unrelated to the reason for visiting the doctor.
- Key personal data, including serious illnesses, cancer treatment or important changes in life, as well as facts directly related to the disease: did you cleanse your lymph with folk remedies, was the effect noticeable.
- Used drugs, vitamins and nutritional supplements.
- Questions to ask a specialist.
In this case, the list of basic questions for the doctor can be made according to the template:
- What is the most likely cause of swelling?
- Could other circumstances cause swelling?
- What research needs to be done? Do I need to prepare for them?
- Perhaps the swelling will subside soon? If not, is it possible to make a forecast?
- How is lower limb lymphedema treated?
- Are there alternatives to the methods you have proposed?
- Are there medications that can reduce swelling?
- I have other diseases. Is it possible to treat them in combination with lymphedema?
- Do I need to follow a certain diet or limit physical activity? How will this affect lymphostasis of the arm or leg?
- Do you have brochures or printed materials that you can take with you? What sites do you recommend?
Feel free to ask other questions.
What will the doctor say?
The specialist is likely to be interested in the following:
- When did the swelling begin?
- Are there any other signs or symptoms?
- Does edema persist for a long time or does it appear periodically?
- Does anything affect the nature of swelling and symptoms? Positive or negative?
While you are waiting for the appointed date for a consultation or diagnosis, you can independently take some measures to improve your condition. As often as possible, keep the swollen arm or leg raised, protect the skin on it from damage. Lymphedema of the lower extremities is able to reduce pain during an injury or burn, so you can not put heating pads on the swollen area of the body. Remember to moisturize your skin every day.
Diagnostics
If you are at risk (for example, due to a recent surgery, including manipulation of the lymph nodes), the doctor will be able to diagnose lymphedema based on signs and symptoms.
If the cause of the disease is not so obvious, a specialist will schedule imaging tests to assess the condition of your lymphatic system. Diagnosis may include methods for determining the ailment, such as:
- Magnetic resonance imaging. Using a magnetic field and radio waves, MRI produces high-resolution 3D images.
- CT scan. This X-ray technique allows you to create detailed images of various structures of the human body in a section. Based on CT, it is possible to identify the fact of clogging of blood vessels and violations of the basic function of the lymphatic system.
- Doppler ultrasonography. This variation of traditional ultrasound focuses on blood flow and pressure by using high-frequency sound waves (ultrasound) on red blood cells. Ultrasound helps detect problems with lymph outflow.
- Scintigraphy of the lymphatic system. During this study, the patient is injected with a radioactive dye and then the movement of the substance through the body is monitored using special equipment. The final pictures show the movement of the dye through the vessels, especially highlighting the place of clogging.
Treatment
Lymphostasis is an incurable disease. The medical effect is aimed only at reducing edema and reducing the intensity of the pain syndrome. For these purposes, appoint:
- Physical exercise. Light charging, including for the affected limb, can slightly improve the outflow of fluid and enable the patient to perform simple everyday duties, for example, carry purchases from the store. Exercise should not strain or cause fatigue - on the contrary, you should focus on careful muscle contraction in the arm or leg. Such activities are a natural cleansing of lymph and a way to cheer yourself up.
- Wearing bandages on the affected limb. A bandage along the entire length of the arm or leg helps to facilitate the outflow of lymph towards the center of the body. The stiffest layers of a medical bandage are placed on the fingers, and then gradually weaken the tension of the matter as it moves up the limb.
- Massage. Special massage techniques can facilitate the outflow of fluid from an arm or leg, but you must contact a truly competent and responsible specialist. This method of treating the disease is not suitable for everyone. Massage is contraindicated if you have been diagnosed with a skin infection, a growing cancerous tumor, blood clots, or chronic heart failure.
- Compression underwear. Long sleeves or stockings with therapeutic effect allow fluid to escape from the affected limb. Such underwear is especially useful to wear during exercise. It may need to be made to order.
In severe lymphostasis, the doctor may prescribe a surgical operation to remove excess tissue in the arm or leg in order to reduce swelling.