Legs

Lymphedema - causes, symptoms, treatment


What is lymphedema?

Lymphedema is a condition that can result from an impaired lymphatic system. Tissue fluid collects in the spaces between the cells, which can no longer drain away sufficiently. As a result, the affected part of the body swells up. In the worst case, there are veritable deformities that considerably restrict the freedom of movement and the quality of life of those affected and increase the risk of secondary diseases. The chances of healing or the chances of relief are high with suitable therapies. The healing process can be supported by naturopathy.

Lymphedema - a brief overview

First of all the most important things in brief:

  • definition: Lymphedema is an accumulation of fluid in the spaces between cells due to a malfunction of the lymphatic system.
  • Occurrence: The legs are often affected. But it can also appear on the face, arms, neck, trunk, or genitals.
  • Symptoms: The accumulation of fluid leads to progressive swelling of the affected part of the body. If left untreated, there is a risk of elephantiasis, in which the part of the body swells up to complete deformity and the skin tends to blisters, fistulas, eczema and poorly healing wounds.
  • diagnosis: The so-called Stemmer's sign, in which certain skin folds can no longer be raised, is a sign of lymphedema. A more precise assessment can be made using ultrasound examinations or lymphography.
  • Stadiums: Depending on the severity, the disease is divided into different stages from zero to three. From the second stage, the disease is considered irreversible. Stage three is called elephantiasis.
  • therapy: The most common therapies include manual and mechanical lymphatic drainage, special skin care and compression treatments, which use bandages or stockings as well as targeted movement exercises.

Lymphedema symptoms

Typically, lymphedema first manifests itself in one-sided swelling in one arm or leg. Lymphedema can also occur in other parts of the body. In the initial phase, these swellings are barely noticeable and not painful, but they increase continuously over time. Often, those affected only become aware when clothing such as trousers and shoes or jewelry suddenly no longer fits or is tight.

First warning signs

If you press the swelling and a dent forms, which persists for a while after the pressure is removed, this is a possible first sign of lymphedema.

Firm skin and rapid signs of fatigue

As the process progresses, the skin feels increasingly firmer, tighter and tighter at the affected area. Often an extremity (arm or leg) is affected, which quickly fatigues during physical exertion.

Advanced symptoms

In the advanced stage, widened skin folds and furrows can occur. The skin can no longer be lifted and the affected part of the body can assume irregular proportions. The skin can also be affected. Discoloration, hardening, inflammation, eczema and poorly healing or open wounds can occur.

Late effects

Lymphedema should definitely be treated by a doctor. If this does not happen, there are long-term consequences such as:

  • Skin infections,
  • open wounds,
  • Restricted movement,
  • crooked posture,
  • Blistering and fistula formation.

Stages of disease

Lymphedema is divided into four stages depending on the severity:

  • Stage 0: At this stage the edema is subliminal. The disease mechanisms have already started, but no symptoms are yet appearing.
  • Stage 1: First swellings appear, which have a pasty and soft consistency. The skin can be pressed in with the finger and there is occasionally a dent in the pressure point.
  • Stage 2: The swelling is pronounced and feels hard. The skin cannot be pressed in or only with great difficulty.
  • Stage 3: The swelling has deformed the affected part of the body and the skin is prone to inflammation, eczema, discoloration, fistulas, blisters and open wounds.

Causes of lymphedema

Our lymphatic system consists of the lymphatic vessels, lymph nodes, the lymphatic fluid, the spleen and the thymus. A restricted function of one or more of these components can manifest itself in a lymph congestion (lymphostasis), which can be seen and felt from the outside. At this point, lymphedema can be distinguished from lymph node swelling.

Accumulation of lymphatic fluid

The restricted function leads to a fluid build-up in the lymphatic system, which increases the pressure at the damaged area. This leads to leakage or reduced absorption of the lymphatic fluid, which then results in increasing swelling.

Primary form

Basically, lymphedema is classified into primary and secondary forms. The primary form is a rare form in which the lymphatic vessels or lymph nodes are not properly formed or malformed from birth. Entire extremities or even body regions can be affected. This form of edema includes clinical pictures such as Milroy disease, Meige disease, Parkes-Weber syndrome and Klippel-Trénaunay syndrome.

Secondary form

This much more common form is not genetically determined, but can arise in the course of life. The causes of this form include:

  • Breast cancer surgery: Many edema develop in a chronologically traceable context after breast cancer surgery or after armpit lymph nodes have been removed.
  • Cervical or cervical cancer: Surgery, in which many lymph nodes in the abdomen have to be removed, can lead to leg lymphedema.
  • Overweight: Obesity can increase the emergence in connection with operations.
  • Radiation treatment: Radiation therapy against certain types of cancer can lead to subsequent malfunctions of the lymphatic system, which can lead to lymphedema.
  • Malignant diseases: Certain malignant lymph node diseases such as Hodgkin's disease or leukemia can also trigger edema.
  • Lymphangitis: Inflammation of the lymphatic vessels and lymph nodes can cause the edema.
  • Other causes: Other possible triggers include injuries, scarring and parasite infestation.

Lymphedema treatment

Therapy offers a variety of good treatment options, which on the one hand relieve pain and on the other hand increase mobility and quality of life. The so-called complex physical decongestive therapy (KPE) is often used. This takes place in two phases, the decongestion and the maintenance phase.

In the decongesting phase, the focus is on draining the jammed liquid. Manual lymphatic drainage and compression bandages are used for this. In the maintenance phase, targeted therapeutic exercises and wearing compression stockings are intended to support the therapeutic success from the first phase. In severe cases, therapy can also take place in a clinic. If the applications are unsuccessful, surgery may also be required.

Own measures for reduction

In addition to the therapies, the symptoms of lymphedema can be reduced through several everyday behaviors, or the success of treatment can be maintained for longer. These include:

  • Wear comfortable and loose fitting clothes,
  • Skin care with pH-neutral agents,
  • Avoid overweight or reduce weight,
  • adequate exercise (e.g. gymnastics),
  • take no unnecessary risk of injury,
  • Avoid and reduce stress (e.g. breathing exercises, yoga),
  • Lymphatic drainage helps, but avoid kneading massages,
  • wear compression stockings during sports.

Naturopathic treatment

There are two different approaches to naturopathic treatment. Some of the possible treatments relate to symptom relief, others focus on the cause.

Symptom-oriented and soothing procedures

Naturopathic treatments without a malignant background aim to stimulate and drain the lymph flow to relieve the symptoms. Edema that arises after surgery in particular responds well to treatment with leeches, as does the use of high-dose enzymes when used in good time. A diet is often recommended that largely avoids animal proteins. In addition, a lot of movement, breathing exercises and light brush massages are prescribed. Phytotherapeutically, plants with a lymphatic and blood cleansing effect are prescribed - as tea, tincture or in homeopathic preparation. Lymphatic drainage, osteopathy, foot reflex zone therapy and compression treatments are mainly used manually.

In-depth causal therapy

In-depth therapy is intended to restore the body's natural ability to regulate by recognizing and treating causal disorders. Naturopathic diagnosticians use constitution-oriented methods such as iris diagnosis, use dark field microscopy to get an idea of ​​the (microbial) milieu exposure or detect blockages through energetic measurements (e.g. EAV, bioresonance, vegan testing), which can have a negative impact on a wide variety of functional processes in the body - although from a conventional point of view there is no direct causal connection. This is followed by individual therapy, which, depending on the therapist's method of working, can be medicinal, manual, traditionally draining, physical, nutritional and orderly therapeutic, or subtle-energetic. (tf, jvs, vb)

Swell

  • Internet presence of the Lymphzentrum Nordwest with further information
  • German Cancer Research Center (dkfz)
  • Guideline diagnosis and therapy of lymphedema
  • University Hospital Düsseldorf: Lymphedema - causes, diagnosis, therapy
  • As well as articles linked in the text.

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Graduate editor (FH) Volker Blasek, Barbara Schindewolf-Lensch

Swell:

  • German Society for Angiology - Society for Vascular Medicine: Lymphedema (accessed: July 24, 2019), dga-gefaessmedizin.de
  • Lulay, Gerd R .: Secondary lymphedema: diagnosis and therapy still unsatisfactory, Dtsch Arztebl, 2017, aerzteblatt.de
  • German Society for Lymphology: Lymphedema (accessed: July 24, 2019), dglymph.de
  • Cancer information service of the German Cancer Research Center: Lymphedema in cancer patients (accessed: July 24, 2019), krebsinformationsdienst.de
  • Institute for Quality and Efficiency in Health Care (IQWiG): Breast cancer: Treatment of lymphedema (available on July 24, 2019), gesundheitsinformation.de
  • Mayo Clinic: Lymphedema (accessed: July 24, 2019), mayoclinic.org
  • National Cancer Institute: General Information About Lymphedema (accessed: July 24, 2019), cancer.gov
  • Cleveland Clinic: Lymphedema (accessed: July 24, 2019), my.clevelandclinic.org
  • Public health portal of Austria: diseases of the lymphatic vessels (accessed: 24.07.2019), gesundheit.gv.at

ICD codes for this disease: I89ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.


Video: Lymph oedema clinical cases, Part 1 (November 2021).