Symptoms of Lymphedema: More Than Just Swelling

by Dr. Ashok BC, HOD - Department of Plastic Reconstructive and Aesthetic surgery & Chief of Medical Services, Aster Whitefield Hospital, Bengaluru

The pain begins to get worse the longer you sit or stand, if you have been saying this too often, chances are you might be suffering from lymphedema. Lymphedema is swelling due to accumulation of fluids in the system and lymph comes from the lymphatic system. It is basically fluid that builds in the tissues and limbs. But you are not alone; Lymphedema, is a chronic condition affecting millions globally. In the below article, we will get into the nuances of lymphedema, its identification to management, uncovering the complexities of this often-misunderstood condition.

Identifying the symptoms: More than just swelling 

There can be variety of reasons for the swelling but in case it is accompanied by heaviness, tightness, limited mobility, joint stiffness, skin changes; it points to elephantiasis or in medical terms lymphedema. It also increases your susceptibility to infections. 

Diagnosis Dilemmas: Unravelling the Mysteries

The identification requires one to have a keen eye and a thorough medical examination. It can often be confused with lipoedema; build-up of fluids due to excess of fatty tissue in arms and legs, lymphedema requires a precise diagnosis. Your healthcare provider may use methods like physical examination, medical history analysis to make initial assessments. While Blood, urine and tissue studies are not the primary markers, they might be used to check for underlying causes in case the origin is not known. Further advanced imaging techniques are used to differentiate and gauge its severity.

Primary vs. Secondary Lymphedema:  There are two of them.

The disease can either present as an inherited condition due to genetics, called Primary Lymphedema or due to post medical procedures or due to injury, infection, or any other obstruction such as surgery, to the lymphatic system, called the secondary lymphedema. 

The primary lymphedema is almost like a time bomb with different length of fuse; and might show up at birth or within two years of birth, at puberty or within a decade of puberty or post 35 years of age. 

The secondary lymphedema happens most commonly due to infections or surgical excision of the lymph nodes, radiation therapy or other medical procedure. Breast cancer is the most common cancer associated with secondary lymphedema.

Facing the Reality: The Consequences of Ignoring Lymphedema

The consequences can escalate from simple swelling to recurring infections, skin alterations and diminished mobility. While the exact progression is difficult, left untreated it can lead to swelling of hands and legs, skin becoming scaly and thick, small blisters developing on the skin to lymphatic fluids leaking out of the skin.

 Proactive Measures: Managing Lymphedema for a Quality Life

 Still, not all is lost as the disease can be effectively managed. Maintaining a healthy weight, doing gentle exercise, adopting a balanced diet and a proper skin care routine are key elements. Lifestyle modification, avoiding tight clothing and staying hydrated and having regular medical check-ups can play pivotal role in preventing or managing lymphedema.  

Home Remedies and Beyond: Empowering Self-Care

Beyond conventional methods, individuals can explore home remedies. Manual lymphatic drainage techniques, cold packs for swelling reduction, and specific exercises under healthcare guidance offer additional avenues for relief.

Advancement in treatment

Recent advancements in lymphedema treatment include innovative surgical techniques such as lymphaticovenous anastomosis where connection is done between lymphatics and veins bypassing the blockage, vascularised lymph node transfers or Robotic assisted lymphatic surgery and ICG guided MLD.  

Seeking Professional Guidance: A Crucial Step 

Ignoring lymphedema is not an option. Living with lymphedema may present challenges, both physical and mental. Integrating medical advice into daily life is a crucial step in managing this condition. Understanding, managing with lymphedema involves a holistic approach.