Lymphedema

What is lymphedema?
Although many people have never heard of this condition, lymphedema is a common cause of leg or arm swelling due to the collection of too much lymph fluid in a part of the body. Nearly one million Americans are affected by this condition, and the number of people worldwide with it may soon approach 100 million. The swelling produced by lymphedema is usually not painful, but it may limit a person's ability to use his or her arms or legs, increase the risk of certain infections, or cause emotional distress.

What causes lymphedema? Most of the human body is made up of water and other fluids. Sometimes too much fluid will collect within a certain part of the body, such as an arm or leg. When this occurs, the extra fluid normally drains back into the blood through long, thin tubes called lymph vessels. If these tubes become plugged or broken, the extra fluid builds up and causes the undrained body part to swell. Many things can damage the lymph vessels and cause lymphedema, including cancer, infections, surgery, certain injuries, radiation therapy, insect bites, birth defects, and others. In some cases, an injury that seems minor may produce severe swelling.

Can lymphedema be treated? It is rarely possible to "cure" lymphedema, but it can usually be treated with success. Elevating the swollen limb whenever possible will help the excess fluid to drain back into the blood. When necessary, other methods, including tight wraps, pumps that squeeze the swollen body part, and massage, may be used to push fluid out of the swollen areas. After the swelling has been decreased as much as possible, the patient wears a tight-fitting elastic stocking or sleeve to prevent fluid from building up again.

How do I know if I have lymphedema? Your doctor can usually tell if you have lymphedema by asking you questions about your swelling and by examining you. If necessary, there are tests that can detect blockages in the lymph vessels. The usual test requires a small amount of radioactive material to be injected through a small needle into the swollen area. Except for the minor skin injection, this test is not otherwise dangerous or painful.

Conclusions: Lymphedema is a chronic common cause of swelling that can affect anyone. It can be easily diagnosed and effectively treated with simple measures. It is unusual to completely cure lymphedema, but most people who receive proper treatment for it can lead normal, active lives.

About the Author: Thom W. Rooke, MD is the Krehbiel Professor of Vascular Medicine and Section Head of Vascular Medicine at the Mayo Clinic, Rochester, MN. He has published many articles and books and is a popular lecturer. Dr. Rooke specializes in peripheral vascular medicine, sclerotherapy for varicose veins, lumphedema, and erythromelalgia.