Causes and risk factors
Lymphedema is caused when lymphatic vessels are unable to drain lymph fluid usually from arm or leg. Lymphatic obstruction causes rise in protein content of extravascular tissue with retention of water and swelling of soft tissue. Damage to the lymph nodes or lymphatic vessels leads to development of lymphoedema. The cause can be primary or secondary. Primary causes include inherited disease, Milroy’s disease, and Meige’s disease. Secondary causes involve infection, injury to the lymphatic vessel due to surgery, radiation treatment, side effect of drug tamoxifen, filariasis, cellulitis, Turner’s syndrome.
Clinical presentation
The affected limb will have symptoms such as swelling due to fluid retention, pitting oedema, dull ache, heaviness, limited range of motion, and presence of skin changes like discoloration, thickening of skin, cracks and scales, leakage of fluid through skin, warty growths, and recurring bacterial infections.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Investigations include measuring limb volume, bioimpedance testing, Lymphoscintigraph, Doppler ultrasound of the limb, CT scan and MRI scan.
Treatment
Treatment depends upon the underlying cause. Decongestive lymphatic therapy [DLT] which includes compression treatment like using compression garment like stockings, tights or manual lymph drainage, massage to improve circulation of the lymphatic channels, exercise to improve range of motion, flexibility and mobility . Medications like Antibiotics for underlying infection may be helpful. Surgery to drain excess fluid when conservative measures fail. Supportive care is given to prevent further infection.
Other Modes of treatment
The other modes of treatment can also be effective in treating Lymphedema. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating Lymphedema.
