What is lymphedema?
Lymphedema is long-lasting swelling that happens when the body’s lymph fluid cannot drain properly and builds up in the tissues, usually in an arm or leg. Your lymph system is a network of thin vessels and nodes that carries fluid, waste, and infection-fighting cells. When parts of it is missing, damaged, or overloaded, fluid backs up and the limb swells.
It is a chronic (lifelong) condition. There is no cure, but with the right care most people control the swelling well and stay active.
Why does a vein clinic treat Lymphedema?
The vein system and the lymph system work as partners. When leg veins do not empty properly, a common problem called chronic venous insufficiency (CVI) develops due to poorly working vein valves. Extra fluid from CVI leaks into the tissues and overloads the lymph system. Over time this can lead to a mixed “vein-and-lymph” swelling sometimes called phlebolymphedema. In fact, about half of people with leg lymphedema also have a vein problem. That is why a vein ultrasound is often done as part of your evaluation, and why treating the veins can be an important part of controlling the swelling.
What causes Lymphedema?
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Primary lymphedema: you are born with a lymph system that didn’t form normally. Swelling may show up in childhood, at puberty, or in adulthood.
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Secondary lymphedema (more common): the lymph system is damaged later in life by cancer surgery (especially lymph node removal), radiation, injury, infection, obesity, or long-standing vein disease. Worldwide, a parasite infection (filariasis) is the most common cause.
What does Lymphedema feel and look like?
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Swelling of an arm or leg (or sometimes the trunk, face, or genitals)
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A feeling of heaviness, tightness, or fullness
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Aching or discomfort
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Skin that gradually becomes thicker or firmer
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Rings, shoes, or sleeves that feel tight
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Trouble bending or moving the swollen area
Early on, the swelling may go down when you raise the limb. As it advances, elevation helps less and the skin becomes firmer.
How is Lymphedema diagnosed?
Lymphedema is usually diagnosed by an exam and your history — no special test is needed. Your clinician will look at where the swelling is, feel the skin, and often check a sign at the base of the toes or fingers (whether the skin can be pinched up). A vein ultrasound is commonly done to check the veins. If the diagnosis is unclear, a special imaging test of the lymph system (lymphoscintigraphy) can confirm it.
How is Lymphedema treated?
The foundation of treatment is non-surgical care, often called complete decongestive therapy. Started early, treatment works better, so tell your care team promptly about new or worsening swelling. The main parts are:
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Compression: fitted compression garments, wraps, or bandages are the cornerstone. They squeeze the limb to move fluid out and keep it from building up again. A pump (pneumatic compression) can help at home.
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Skin care: keeping skin clean and moisturized lowers the risk of infection.
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Exercise and movement: muscle activity helps pump fluid. Gradual, supervised exercise — including resistance/strength training — is safe and helpful and does not cause or worsen lymphedema.
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Manual lymphatic drainage: a gentle, specialized massage that helps move fluid, usually combined with compression.
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Treating the veins: if a vein problem is contributing, treating it can reduce the swelling.
A certified lymphedema therapist is the ideal person to fit compression and guide this care.
When swelling is severe or does not improve with these measures, surgery may be an option. This includes procedures that reroute or rebuild lymph channels or remove excess tissue, and is decided together with a specialist.
Preventing Lymphedema flare-ups and infection
People with lymphedema are more prone to skin infections (cellulitis) in the swollen limb. Call your care team right away if you notice redness, warmth, increasing pain, red streaking, or fever — infections may need prompt antibiotics.
Other everyday steps:
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Wear your compression as directed — this is the single most important habit.
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Protect the skin from cuts, burns, and insect bites; treat any breaks in the skin.
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Keep a healthy weight; excess weight makes swelling harder to control.
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Stay active.
Living with lymphedema
Lymphedema can affect how you feel about your body, your comfort, and your daily activities, and the day-to-day self-care can feel like a lot. These feelings are common and valid. Support from your care team, counseling, and connecting with others who have lymphedema can help. With consistent care, most people keep their swelling under control and lead full, active lives.
Ask your care team about the plan that is right for you.
