• Is a swelling of a body part, most often an extremity caused by the abnormal accumulation of lymph fluid.
  • Can be described as the accumulation of protein-rich fluid in the interstitial spaces as a result of lymph system dysfunction.
  • Can be recognized by signs and symptoms of infection – redness, heat, pain, (indications of viral and/or bacterial infection combined with fluid retention).
  • Can be recognized by a deep ache, loss of limb function and a visible increase in size of limb as a result of swelling.
  • Can be indicated by pitting oedema – the oedematous tissue will pit if pressed with a thumb. However, it gradually becomes larger and harder and will no longer pit.
  • May cause oedematous tissue to feel cool to the touch if it is cut off from the circulatory or lymphatic system.
  • If longstanding, can lead to fibrosclerotic changes in interstitial spaces of the superficial fascia causing hardening of the skin.
  • Due to congenital malformations in the lymphatic system such as defective valves or vessels is referred to as primary lymphoedema.
  • That is considered secondary or acquired lymphoedema may result from:
  • Surgery – particularly when lymph nodes are removed after treatment for cancer: breast, prostate, gynaecological, head or neck, sarcoma or melanoma.
  • Radiotherapy – this kills cancer/tumour cells but it can also cause scar tissue that interrupts the normal flow of lymph in the lymphatic system.
  • Accidental trauma/injury or infection that may damage the lymph vessels and therefore, reduces drainage of lymph.
  • Reduced mobility/paralysis – muscle contractions (during activity/exercise) are important to help the lymph to move.
  • Problems with veins not working very well (varicose veins/after deep vein thrombosis) – often known as venous insufficiency. This results in the lymph system becoming overloaded and unable to function effectively.
  • Cancer itself may also result in a blockage of the lymphatic system.
  • May cause embarrassment, can lead to depression and causes a general worsening of the patient’s life and health. (If the lymphoedema is severe especially if more than one limb is involved, the patient is excessively heavy)
  • May be caused by a type of parasitic infestation known as filariasis in developing countries.
  • Can affect any part of the body but is most commonly seen in an arm or a leg.
  • May develop rapidly (e.g. after an operation) and will cause great pain as the tissues are torn apart.
  • May cause adjacent areas, which are receiving excess lymph diverted from the blocked region, also often ache (e.g. the shoulder adjacent to a lymphoedematous arm).
  • May be painless when developing slowly, except during bouts of infection.

REFERENCES:

Hardy, D & Mortimer, P.S. Prof., http://www.lymphoedema.org/lsn/lsn010.htm#TOP

The Lymphoedema Association of http://www.lymphoedema.org.au/lymphoed.html

Premkumar, K. 1999. Pathology A to Z — A handbook for massage therapists. 2nd Ed. Calgary: VanPub Books.

Werner, R. 2005. A massage therapists guide to pathology. Philidelphia: Lippincott Williams & Wilkins.