What is Lymphedema? Well, Lymphedema’s most predominant symptom is swelling in the arms and legs. The condition occurs when lymphatic fluid gradually accumulates in these regions – and fortunately lymphedema treatment in St Louis – like vein therapy – can help.
Before starting on lymphedema treatment however, most patients will likely ask their doctor for more details. Why does fluid retention occur, you may ask? Is it based on genes or environmental factors?
The buildup is likely to be caused by damaged or absent blood vessels. When lymphatic fluid isn’t properly circulated in the blood stream through the lymph nodes and vessels, this is when retention transpires. The disease can also be caused by injuries, genetics, or underlying medical conditions.
Lymphatic fluid is transparent and composed of fat, water and proteins.
With Lymphedema, you may notice one or more of the following symptoms:
Lymphedema can progress beyond mild to moderate swelling of the arms and legs. Some risks of leaving the condition untreated include a greater risk of infection, which can occur when something as simple as cuts or insect bites take place. These infections can progress to lymphangitis and cellulitis which further injures the lymphatics and further complicates your ability to fight infection, leading to a vicious cycle of more infections and worsening condition.
Without proper treatment, even without complicating infections, lymphedema can lead to fibrosis or hardening and scarring of the skin and subcutaneous fat. The fibrosis can grow, which then can further impede the circulation of lymph fluid. This also can lead to increased lipid accumulation in the effected limb/s causing more difficulty with movement.
Fibrosis presents its own set of symptoms including impaired mobility and limited range of motion in the joints of the effected limb/s. Finally, the fibrosis can impair vein circulation which further complicates swelling in the limb/s. Increased pressure in the venous system increases the flow of fluid into the lymphatic vessels and when the lymphatic circulation is injured, as with lymphedema, the increased flow of fluid in the lymphatics leads to worsening swelling.
So Lymphedema is much more than swelling in the limbs. Untreated lymphedema can progress to a disabling condition that can dramatically affect a person’s quality of life.
Lymphedema can be an inherited medical condition and is known by three types. Congenital Lymphedema, when the symptoms develop in early childhood, Lymphedema Praecox when the symptoms develop in adolescences, and Lymphedema Tarda, when symptoms develop later in life. More often lymphedema is secondary to an injury to the lymphatics. The most common injury to the lymphatics in the United States of America is the result of cancer treatment, either from removal of lymph nodes with cancer surgery or from radiation treatment for cancer. The next most common causes of lymphedema are infection and physical trauma.
Lymphedema is primarily diagnosed by a history and physical exam performed by a physician experienced with lymphatic disease. Before it is diagnosed it may be important to rule out other causes of swelling in the legs or arms such as heart, kidney, or liver disease. A venous Doppler ultrasound is usually performed to assess whether there is venous insufficiency, which can cause or worsen swelling. When there is unusual presentation of lymphedema, or for research protocols, additional tests to assess lymphatics may be done. These additional tests include the following.
There is no cure for lymphedema, but the condition, complications, and progression of the disease can be managed effectively with a combination of treatments.
The foundation of good lymphedema management is compression. Compression stockings and compression sleeves are still one of the mainstays for the management of lymphedema. There are also many new and improved compression devices like the CircAid® Velcro compression leggings and gauntlets that are much easier to put on and wear.
Lymphatic fluid is transparent and composed of fat, water, and proteins. Manual lymphatic drainage, also known as lymphatic massage, is an important aid to the management of lymphedema. Lymphatic massage works by moving the lymph in a central to distal direction thus massaging the lymph out of a congested area. It is often combined with compression bandages, with the whole treatment being called Combined or Complete Decongestive Therapy. Exercises of the affected limb and diaphragmatic breathing exercises are essential to ensure the fluid that is drained from the limb is returned all the way back to the venous circulation.
Depending on the severity of the lymphedema, additional treatments can be used, such as intermittent compression pump therapy. Some of the newer compression pumps can help manage even complicated lymphedema by moving the trapped lymphatic fluid through the entire lymphatic circulation.
Finally, it is important extreme care is taken to prevent additional infections, with precautions and prompt treatment of infections when they occur.
At-home care tips include:
There are some supplements and natural treatments for lymphedema. In addition, antibiotics may be prescribed for prevention in some cases where recurrent cellulitis is responsible for worsening of Lymphedema.
Lymphedema’s most predominant symptom is swelling in the arms and legs. Underlying venous insufficiency leads to increased pressure in the veins that in turn causes more fluid to be shifted into the lymphatics, which by itself worsen the swelling. So it is important to treat underlying venous insufficiency which will improve limb swelling and simplify the Lymphedema management. Vein treatment can add significant improvement to the control of Lymphedema when combined with comprehensive lymphatic care.
To learn more about our lymphedema treatment in St. Louis, call Dr. Wright’s office today to schedule a consultation, or use the form on the right.