Lymphedema
- Why Are My Limbs Swollen?
by Denise Johnson, PT

Lymphedema is a type of swelling where an excess of fluid accumulates in the tissues of the body. Lymphedema usually affects the arms or legs, but can affect the head, neck, face, trunk or any of the body's organs. Swelling occurs when the amount of lymph fluid in the tissues is greater than the ability of the system to remove it.

The role of the lymphatic system is to remove impurities from the tissues of the body. The system is composed of many vessels (lymphatics) which carry waste products and excess water (or lymph fluid) from the tissues of the arms and legs to the trunk.

All lymph fluid passes through lymph nodes located throughout the body where it is filtered and concentrated. From the nodes, the fluid is carried into the venous blood system where it is eventually removed from the body.

Lymphedema sometimes occurs when a person is born with abnormal lymphatics (Primary Lymphedema). The other type, Secondary Lymphedema, occurs in people who have had lymph nodes or lymph vessels damaged or removed. This may be a result of surgical removal of cancer tissue, radiation therapy of lymph nodes/vessels, or traumatic damage to large lymph vessels or nodes following an accident.

These factors will lead to a less efficient lymph system. The onset of swelling is usually associated with an infection, inflammation or muscle strain of the limb. Because of the decreased capacity of the lymph system, the system becomes "overloaded" by the increased lymph fluid level. The fluid backs up, resulting in lymphedema.

Lymphedema can also occur together with other diseases. Chronic venous diseases almost always involve the lymphatics after a period of time, and this makes the venous disease worse.

The early onset of swelling may progress quickly or slowly, and may be associated with a specific incident (e.g. muscle strain, infection, overheating.) Episodes can recur often if precautions are not followed.

It can recur from something as simple as papercuts or torn hangnails - any small opening in the skin where bacteria can enter the limb and start an inflammatory process. The swelling may resolve initially with elevation of the limb, however, if it does not resolve additional treatment is needed.

With the presence of lymphedema, the removal of waste products from the tissues and the process of wound healing are severely limited. The stagnant fluid in the tissues also provides an ideal environment for bacterial growth and resulting infection.

Recurrent secondary acute infections (cellulitis) may occur. Left untreated, the swollen limb can lose function, motion, and strength and can become extremely painful.

Thankfully, there is treatment available for lymphedema, in the form of decongestive massages, wrapping, exercise programs, and skin care. Consult a specially trained Physical Therapist for more information on controlling your lymphedema.

NovaCare Rehabilitation have therapists that specialize in the treatment of Lymphedema - Call 216-292-6363 ext. 225 for more information.