Lymphedema

Lymphedema is a common cause of leg and arm swelling due to the collection of too much lymph fluid caused by damage to the delicate vessels that hold the lymph fluid, called lymphatics.

Lymph fluid accumulates in the tissues of the arm or leg and causes swelling when the lymphatics system is damaged.

Common causes of lymphatic damage include:

  • Surgery or radiation to treat cancer
  • Infection
  • Injury
  • Post-surgery onset
  • Obesity

When the lymphedema is due to one of these causes, it is called secondary lymphedema.

In some cases, lymphedema may develop without any external injury to the lymphatics. This is called primary lymphedema. One form of primary lymphedema is an inherited condition, which begins during childhood or puberty.

Lymphedema presents as swelling of one or both of the legs or arms. Following surgery or radiation for cancer, it presents on the same side the cancer was treated. 

In more advanced cases, the swelling may become quite severe and disfiguring, interfering with daily activities and causing emotional distress. The swelling usually involves the feet and legs, or (in the case of arm edema) the hands and arms.
           
Occasionally, patients with lymphedema may develop skin infections called cellulitis and lymphangitis. The skin will be red, painful, and warm, and fever may be present. It is essential to see a physician for appropriate antibiotics and prescribed skincare if a skin infection develops.

Your doctor will usually be able to diagnose lymphedema with an appropriate history and physical exam. It is important to differentiate lymphedema from other causes of swelling, such as deep vein thrombosis, congestive heart failure, or kidney disease. You may undergo one or more tests, such as a duplex ultrasound, CT scan, or blood tests during the diagnostic process.
 

The most essential and effective lymphedema treatment is compressive therapy, which typically includes a prescription-strength compression stocking or glove.

In addition, a type of specialized massage called manual lymphatic drainage can be an important part of treatment. This is usually performed on an outpatient basis for two to three weeks, followed by long-term stocking (or glove) use. Because lymphedema can predispose to skin infection, personal hygiene and skincare are very important.

Lymphedema Therapy: Treatment Locations

Certified lymphedema therapists provide treatment at numerous Inova locations, including:

Inova Hospital-based Rehab Locations

Outpatient Physical Therapy Centers