Conditions Basics

What is lymphedema?

Lymphedema is a collection of fluid that causes swelling (edema) in the arms and legs. Normally, lymph nodes filter fluid as it flows through them. If the lymph system isn't working as it should, fluid can build up in the affected arm or leg, and lymphedema can occur.

What causes it?

One cause of lymphedema is surgery to remove lymph nodes, usually during cancer treatment. Medicines such as tamoxifen (Nolvadex), radiation therapy, and injury to the lymph nodes can also cause it. This type is called secondary lymphedema.

Lymphedema can be present at birth or develop during puberty or adulthood. This type is called primary lymphedema. The cause isn't known.

What are the symptoms?

Symptoms of lymphedema include feeling as though your clothes, rings, wristwatches, or bracelets are too tight. You may have a feeling of fullness in your arms or legs and less flexibility in your wrists, hands, and ankles.

How is lymphedema treated?

Treatment focuses on draining lymph fluid, reducing swelling, and protecting your affected limb and skin from injury. For example, propping up your affected arm or leg can help ease the drainage of lymph fluid. Gentle exercise and wearing compression stockings or sleeves can help reduce swelling. And using sunscreen can help protect your skin.

How can you care for yourself?

Lymphedema may develop if you have lymph nodes removed or have radiation therapy as part of cancer treatment. The following tips may help you avoid lymphedema or keep it under control.

• Prop up the affected limb.

  Whenever you can, rest a swollen arm or leg on a comfortable surface, above the level of your heart. Propping up the affected arm or leg can help ease the drainage of lymph fluid.

  • Don't put pressure on your armpit or groin area.
  • Don't hold a limb up without support for very long. It can increase swelling.
• Protect the area below the surgery from injury, even many years after surgery.

  If you've had lymph nodes removed from under your arm:

  • Don't have blood drawn from the arm on the side of the lymph node surgery.
  • Don't allow a blood pressure cuff to be placed on that arm. If you're in the hospital, make sure you notify your nurse and other hospital staff of your condition.
  • Wear gloves when you garden or do other activities that can lead to cuts on your fingers or hands.
  • Use an electric shaver for your underarms.

  If you've had lymph nodes removed from your groin:

  • Bathe your feet daily in lukewarm, not hot, water. Use a mild soap, preferably one that has moisturizers. Or use a moisturizer separately.
  • Wear comfortable shoes that fit properly and support your feet.
  • Wear the correct size of pantyhose and tights. Avoid tight garters or knee-high or thigh-high stockings.
• Do gentle exercise.

  Using muscles during exercise naturally helps lymph fluid to circulate, which can reduce swelling. But it also increases blood flow to the muscles being used. This can increase the amount of lymph fluid. It's important to properly bandage an affected limb before you exercise. Ask your doctor how to use a bandage for this purpose. And ask what exercises are right for you.

• See a physiotherapist who specializes in lymphedema.

  Ask your doctor to refer you. Your provincial health plan may not pay for physiotherapy without a doctor's referral.

• Protect your skin.

  Use sunscreen and insect repellent when outdoors. Ask your doctor how to handle any cuts, scratches, insect bites, or other injuries.

• Wear a lymphedema alert bracelet.

  The bracelets help people avoid treatments to their affected limbs that could make their condition worse. These include blood pressure readings, injections, or blood draws.

• Use compression garments, such as stockings or sleeves, when you travel by air.

  Changes in cabin pressure during flight can cause swelling or make it worse. A compression garment that doesn't fit right can also make swelling worse. So be sure your garment fits correctly.