The swelling of lymphoedema often quietly affects people before they realise there is a problem. The degree of lymphoedema severity will vary from person to person, yet the underlying problem is always the same.

This lymphoedema introduction gives a brief outline of why this happens and what options are available for treatment control. (Lipoedema information is at bottom of page)

The good news is; lymphoedema is treatable and controllable even if at this stage there is no known cure

What causes lymphoedema?

Lymphoedema swelling is caused when localised plasma proteins leaked from arterial blood capillary walls remain trapped in the body’s soft tissues long term due to irreversible dysfunctional lymphatic drainage and consequential macrophage overload. These systems are the only two natural methods of protein removal from the soft tissues of your body.

All lymphoedemas have this common problem regardless of what caused the dysfunctional lymphatic condition to occur.

Why do trapped proteins in the tissues cause such a problem?

Proteins can be likened to a magnet and its magnetic field, for just as a magnet will draw iron filings around itself within its magnetic field; similarly (plasma) proteins will draw body fluids to themselves, not by a magnetic field, but by the action of osmosis. 

Too greater a concentration of proteins (than that of approximately 2% of extra cellular body fluids in the body tissues) in any one area will cause too much fluid retention and consequential oedema, or lymphoedma, if the entrapment of excess protein is permanent.

Therefore it could be said:
Lymphoedema is directly caused by;  ‘The protein deposit into tissues from arterial blood capillary walls being greater than protein transport out of tissues by the lymphatic drainage system, over a prolonged period of time’.

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Lymphoedema classification

The causes of lymphoedema may be termed Primary or Secondary.

With primary lymphoedema in many cases there are too few lymphatics in other cases there are many, but they are very dilated and unable to pump properly. Sometimes a combination of both the aforementioned is the cause of primary lymphoedema. When protein removal from the tissues is compromised due to lymphatic dysfunction there is a resultant lymphoedema as above described.

Primary lymphoedema often becomes apparent at puberty and is termed ‘lymphoedema praecox’, other times of appearance may appear at birth (connatal lymphoedema) or later in life, for example from 30-40 onwards (lymphoedema tarda) 

Secondary lymphoedema has many causes, many reasons are shown below:

1. The lymphatic drainage is cut or blocked from surgery,

2. Radiotherapy has been administered,

3. Accidental trauma occurs resulting in lymphatic vessels becoming torn which then do not rejoin when the blood vessels do,

4. Parasites enter the lymphatics (i.e.; filarial worms injected from mosquito bites which happen only in endemic countries where the disease is clearly present),

5. A limb becomes paralysed which prevents the lymphatic uptake,

6. Chronic venous insufficiency causes malformation to lymphatics running alongside distended and twisted veins, thus causing lymphatic insufficiency, which causes lymphatic dysfunction.

7. When lipoedema ( a condition like cellulite gone wild) is present lymphatic function becomes compromised causing lymphoedema superimposed over the lipoedema.

Lymphoedema diagnosis information is at 
 http://www.lymph.com.au/webcontent5.htm  

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The symptoms of lymphoedema are:

1. Feelings of tightness and heaviness in the limb,

2. 'Bursting' pains where the affected limb feels like it may explode,

3. Aching buttocks (leg lymphoedema) or back of the shoulder (arm lymphoedema).

4. Pins and needles in the limb.

5. 'Shooting' pains up the limb.

6. A feeling of 'tightness' and tenderness in the elbow or back of the knee.

7. Pain in joints (e.g. elbow, knee and ankle), similar to arthritis.

8. Tenderness in the groin of an affected leg.

9. 'Blown up' abdomen if a leg is affected or in 'lymphoedema-all-over'.

10. The limb or affected areas are warmer than other parts - but not red, which suggests infection as well.

In some primary lymphoedemas there can be a very gradual increase in size, but no particular pain - just a feeling of heaviness in the limb. Joints, in particular the knee can also become swollen with lymphoedema. this also is often diagnosed as 'arthritis' - which in a way it is. 

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Lymphoedema control

Lymphoedema treatment reduces oedema; increases mobility plus provides you with a personalised lymphoedema control strategy. The website sponsor employs the method of Complex Physical (Lymphatic) Therapy - (Casley-Smith Method) which includes;

lymphatic drainage massage

compression bandaging and garments

skin hygiene

exercise program 

dietary control

Additionally to assist result incorporated into treatment is: 

Low Level Laser Therapy (LLLT)

Polarized light therapy

Pulsed low level laser laser combined with pulsed magnetic therapy

A few good things to be aware of;

Lymphoedema is normally controllable with a little perseverance, a little self massage or special exercise, compression garments, dietary supplementation, regular home based skin care and regular clinic CPT lymphoedema massage. 

The new diet book available at  www.lymph.com.au contains details of the specialised diet required for lymphoedema and lipoedema. Go straight to the Diet Page for more information.

Lymphoedema will react unfavourably to;

• too much exercise:
  sunburn, or too much sun exposure:
  carrying heavy loads in affected arms: 
  blood pressure readings on affected arms: 
  injections, bites, stings or scratches on affected arms (or legs): 
  saunas: 
  hot baths: 
  tight fitted clothing or accessories; 
  tight fitting underwear:
  long periods of inactivity. 

All of these things are best avoided.

Lipoedema

Lipoedema is caused by excessive amounts of lipid (fat) being stored in the legs and buttocks. It normally starts at the ankles and finishes at the waist. In early stages feet remain normal, however, over time the lymphatic system often becomes clogged and lymphoedema swelling will affect the feet to become superimposed in the legs.

Arms also may be affected with lipoedema. In many cases the arms are affected starting at the wrist and progressing up the arms. Initially hands are not affected and only swell when the condition affects the lymphatic system. Lipoedema is a bi lateral condition affecting either both legs and/or both arms. Lipoedema may concurrently affect arms and legs, so is not limited to just arms or just legs.

Diet changes combined with a little regular exercise, wearing of compression garments and having CPT clearance massage/treatment as prescribed for lymphoedema will most often help lipoedema conditions and provide a satisfactory result.

Lipoedema reductions are slow and require perseverance, however, it is controllable and can be managed with a little persistence. In clinic practice, most all the CPT treatments used for lymphoedema will also help control lipoedema.  

The new diet book available at  www.lymph.com.au contains details of the specialised diet required for lipoedema. Go straight to the Diet Page for more information.

Last edited 16th Sept 2009

Information at this website is presented by:

Poppy Lane Skin Care & Lymphoedema Clinic
139 Hollywood Drive Lansvale NSW 2166 Australia

www.lymph.com.au
 (02) 9723 5402

                     e-mail julietgeorge at lymph.com.au