Lymphedema

Lymphedema refers to swelling that generally occurs in one of your arms or legs. Although lymphedema tends to affect just one arm or leg, sometimes both arms or both legs may be swollen.

Lymphedema is caused by a blockage in your lymphatic system, an important part of your immune and circulatory systems. The blockage prevents lymph fluid from draining well, and as the fluid builds up, the swelling continues. Lymphedema is most commonly caused by the removal of or damage to your lymph nodes as a part of cancer treatment, but can occur for a variety of reasons including surgery, after injury, after infection, or because of congenital or spontaneous issues.

There’s no cure for lymphedema, but it can be controlled. Controlling lymphedema involves care of your affected limb.

Lymphedema symptoms include:

  1. Swelling of part of your arm or leg or your entire arm or leg, usually including your fingers or toes
  2. A feeling of heaviness or tightness in your arm or leg
  3. Restricted range of motion in your arm or leg
  4. Aching or discomfort in your arm or leg
  5. Recurring infections in your affected limb
  6. Hardening and thickening of the skin on your arm or leg

The swelling caused by lymphedema ranges from mild, hardly noticeable changes in the size of your arm or leg to extreme swelling that can make it impossible to use the affected limb. If your lymphedema is caused by cancer treatment, you may not notice any swelling until months or years after treatment.

When to see a doctor

Make an appointment with your doctor if you notice any persistent swelling in your arm or leg. 

Lymphedema in your arm or leg can lead to serious complications, such as:

  1. Infections. Lymphedema makes your affected arm or leg particularly vulnerable to infections. Possible infections include cellulitis — a serious bacterial infection of the skin — and lymphangitis — an infection of the lymph vessels. Any small  injury to your arm or leg can be an entry point for an infection.
  2. Lymphangiosarcoma. This rare form of soft tissue cancer can result from the most-severe cases of untreated lymphedema. Possible signs of lymphangiosarcoma include blue-red or purple marks on the skin.

Your doctor may try to rule out other causes of swelling when diagnosing lymphedema. Swelling can have many causes, including a blood clot or an infection that doesn’t involve your lymph nodes.

If you’re at risk of lymphedema — for instance, if you’ve recently had cancer surgery involving your lymph nodes — your surgeon may diagnose lymphedema based on your signs and symptoms.

Typical testing involved starts with vascular and soft tissue ultrasound imaging, which is painless and non-invasive, but if the cause is not clear, other testing may include MRI, CT scanning, and lymph scanning.

Treatment options for lymphedema start with non-surgical options such as compression garments, therapeutic massage and physical therapy. If disease remains unmanageable with these options, surgical options include a variety of techniques from lymph fluid rerouting by microsurgery and lymph node tranposition to therapeutic liposuction to remove some of the bulky tissue involved. Because our offices offer the most cutting edge diagnostic imaging as well as the full spectrum of surgical options, we can tailor the plan to each patients needs.