What Is Lymphedema?
Lymphedema, also known as elephantiasis, is the accumulation of lymphatic fluid in the intercellular tissue, typically leading to swelling in the arms, hands, legs, or feet. Unlike blood circulation, lymphatic fluid moves slowly through the body and mixes with the bloodstream via lymph vessels and lymph nodes. When these vessels or nodes are damaged or congenitally defective, lymph fluid builds up in certain areas of the body, causing lymphedema. This condition is usually progressive and can become permanent if not treated in time.
What Causes Lymphedema?
In many cases, the exact cause of lymphedema is unknown. However, in some patients, it develops due to:
- Breast surgery
- Radiotherapy
- Infection
- Trauma
Surgical removal of lymph nodes—especially during breast cancer treatment—significantly increases the risk of lymphedema. If radiotherapy is also applied after lymph node removal, the risk becomes even higher. Additionally, orthopedic or other surgical interventions involving the legs can also lead to the development of lymphedema.
Stages of Lymphedema
Lymphedema is classified into three stages:
Stage 1: Reversible Lymphedema
- Temporary swelling
- Edema increases throughout the day but disappears with rest at night
Stage 2: Chronic, Irreversible Lymphedema
- Persistent swelling
- Reduced sensation, pain, burning, and limited mobility
Stage 3: Lymphostatic Elephantiasis
- Progressive limb deformity
- Severe movement and functional limitations
- Intense pain
Symptoms of Lymphedema
- Unilateral swelling that leaves an indentation when pressed
- Asymmetry in arms or legs
- A painless, heavy, tense, and full feeling in the affected limb
- Skin folding, thickening, and discoloration
- Swelling that begins in the hand or foot and moves upward
- Reduced joint mobility over time
- Increased risk of frequent infections
Treatment for Lymphedema
The delay in proper treatment is often due to lack of awareness, misinformation, or difficulty in accessing appropriate care. This can cause the condition to worsen. The most effective approach is Complex Decongestive Physiotherapy (CDP).
This method includes:
- Manual Lymphatic Drainage (MLD): A special massage performed entirely by hand, applying very light pressure to encourage lymph flow, enhance vessel contraction and relaxation, and relieve fluid buildup.
- Compression Therapy: After massage, special bandaging techniques are applied using specific bandages. These maintain pressure, reduce limb volume, and stimulate lymphatic circulation.
- Compression Garments: Once therapy is complete, the patient is provided with customized pressure garments to help maintain results.
The key principle of bandaging is to apply higher pressure during muscle activity and lower pressure at rest, preventing the re-accumulation of fluid in the affected limb. These treatments are supported by customized exercise programs prescribed by physiotherapists.
Duration and Outcomes
Lymphedema treatment typically lasts 3 to 5 weeks, with daily sessions. As a result of therapy:
- Many patients experience full recovery
- Others see significant improvement or disease stabilization
However, untreated cases—commonly referred to as elephantiasis—can lead to irreversible complications.