Lymphoedema: the condition
Lymphoedema is a condition where an accumulation of lymphatic fluid (lymph) in the body’s tissues causes chronic swelling (oedema).
Normally, lymphatic fluid constantly bathes the tissues of the body to nourish and cleanse them. The fluid then is channelled through the lymphatic system’s small vessels back to the bloodstream, passing through the lymph nodes, which act as filters to remove foreign particles, such as cancer cells or bacteria. The lymph nodes are really small ‘filters’ and ‘warehouses’ within the lymphatic tree for dealing with foreign substances or infective agents found in the lymphatic fluid. So, the lymphatic system is part of the body’s defence system against infection.
In lymphoedema there is a breakdown or blockage in the lymphatic system, which leads to the lymphatic fluid stagnating in the body’s tissues and not being re-absorbed by the lymph glands and returned to the bloodstream. This causes swelling in the tissues, usually of the arms or legs.
If the swelling is not treated the lymph fluid will become thicker and difficult to move. The affected body part becomes hard and fibrous.
Who has lymphoedema?
About 300,000 Australians suffer from lymphoedema — men, women and children. One in every 6000 people is born with the condition and others acquire it from surgery or accidents that affect their lymph nodes.
The cause
Primary lymphoedema
is present from birth, although it may not be diagnosed until later. It is caused by an underdeveloped lymphatic system which does not have enough vessels to handle all the lymphatic fluid. It is unusual for the swelling to be obvious at birth — usually the system can cope with the small amount of lymph that a baby produces. However, by puberty or later, the lymphatic system becomes overwhelmed as the amount of lymph being produced increases and swelling occurs.
Secondary or acquired lymphoedema
is the name given to lymphoedema that is related to damage or blockage of the lymph system. This is the more common form of lymphoedema. It can occur as a result of surgery or radiation therapy for cancer in which the lymph nodes are removed or damaged.
The lymph nodes can also be affected by injury or burns. In the tropics, repeated infection by the parasiteFilaria may cause lymphoedema which can progress to the severe form known as elephantiasis, where the enlargement and thickening of the tissues cause the skin to resemble that of an elephant.
Signs and symptoms
Lymphoedema usually starts as a painless slow swelling of an arm or leg. As the swelling increases, the limb may become heavy and uncomfortable and more difficult to move. Sometimes infection can occur. With further swelling the limb may become painful and hard and it may be resistant to pressure when pressed.
Treatment
Unfortunately, there is no cure for lymphoedema. The condition can usually be managed by a combination of techniques which are:- compression bandaging to reduce the swelling;
- specialised lymphatic massage;
- compression garments;
- an exercise routine; and
- skin care.
The outlook
In the long term, management of lymphoedema depends upon understanding the condition and learning how to adapt your lifestyle. Information and help, both physical and emotional, should be available from self-help groups and your doctor.
Last Reviewed: 14 March 2002
