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The lymphatic system is a drainage system of the body. It contains both thin vessels and nodes that are responsible for the transportation and cleansing of the fluid known as lymph. The lymphatic system is also a critical part of the immune system. Lymphatic nodes contain cells (lymphocytes) that destroy bacteria and viruses.

Lymphedema occurs from a blockage of the lymphatic pathways which can result in chronic swelling of an arm or a leg. This may occur as a result of trauma, general surgery, or cancer treatments such as radiation therapy or removal of lymph nodes. This is called secondary lymphedema. Lymphedema can also develop on its own from incomplete formation of the lymphatic system during gestation. This is called primary lymphedema.

The circulatory system contains the veins, arteries and the lymphatic vessels. The heart pumps blood out to all the tissues of the body through the arteries. Water, nutrients and some protein from the blood spill out into the tissue space. The veins take back most of the water and the wastes, but some fluid and protein (about 10 percent) remain in the tissues. The lymphatic system drains and cleanses the tissue space thus removing water and the potentially harmful protein. The veins take blood back to the heart, while the lymphatics move fluids through vessels and lymph nodes to veins in the neck; here the lymph is reintroduced into the blood stream.

If there is damage to the lymphatic vessels or nodes, the fluid and protein becomes trapped in the tissues. The lymph is unable to drain; and like a river that is blocked by a dam, the fluid increases and causes that part of the body to swell. This is lymphedema. The swelling sensation has been described as a feeling of heaviness, tightness, pressure or a bursting feeling in the arm or leg. This can be painful and is often unsightly. The most severe cases are known as elephantitis.

Lymphedema can be managed by lymphatic massage, compression therapy, exercises and education on how to avoid situations that may cause the fluid to increase. Lymphatic massage – manually moving the fluid and protein from a blocked area to properly functioning pathways – is relaxing and decreases the pain and pressure felt in the limb. This condition if left untreated may cause tissues to become hardened and there is also an increase in the risk of infection. Infection may occur because the fluid does not drain and therefore is not cleansed by the lymphocytes. Lymphedema may take weeks, months or even years to develop as the stress over time causes failure of the vessels to drain the area.

Low stretch compression bandaging helps reduce the size of the swelling and compression garments help maintain a smaller size of the limb once the minimum size is achieved. The client will be taught self massage and exercises, and educated on safety and precautions. Early intervention is recommended for optimal management.


Lymphedema Presentation