About Lymphedema
Lymphedema Staging
The progression of lymphedema can be divided into 4 stages.
Stage 0
Latency stage. The lymphatic system does not function optimally, but this may be unnoticeable due to the body’s compensatory mechanisms.
Stage 1
Spontaneously reversible stage. The swelling is now noticeable when using a finger to press down on the tissue, which leaves an imprint. However, the swelling can reduce when the limb is elevated.
Stage 2
Spontaneously irreversible stage. The swelling worsens and becomes permanent.
Stage 3
Irreversible stage. Massive swelling and fibrosis are present. There is tissue hardening and mobility is affected due to heaviness of the limb.
What is the lymphatic system?
The lymphatic system comprises tissue and organs that make up part of your immune system. It helps to transport lymphatic fluid (containing white blood cells) around the body to help fight off infection.
What is lymphedema?
Lymphedema is the swelling of limbs caused by impaired lymphatic transport causing lymph to build up in the tissue underneath the skin. As your lymphedema progresses, you may experience symptoms such as fat accumulation and skin hardening. This is due to the excess lymph in your tissues causing inflammation and tissue transformation.
What causes lymphedema?
Primary lymphedema may arise from genetic abnormalities and usually becomes apparent during childhood and adolescence. Occasionally, primary lymphedema develops in adulthood and is known as lymphedema tarda. Secondary lymphedema may be caused by trauma, cancer surgery (which includes the removal of lymph nodes), radiotherapy or infectious diseases.
What are the signs and symptoms?
• Swelling of one or more of the limbs
• Feeling of tightness or heaviness in the limb
• Restricted range of motion in the limb
• Recurring inflammation presenting with redness of the limb and fever
• Fat accumulation in the affected limb
• Skin hardening in the affected limb
How is lymphedema diagnosed?
Lymphedema is diagnosed by clinical examination. The progression of your swelling can be charted by repeated measurements of limb volume and girth. Imaging modalities such as lymphoscintigraphy, indocyanine green scanning (ICG) and magnetic resonance imaging (MRI) may also be used. Lymphoscintigraphy and ICG are useful in determining the function of your lymphatic channels and the severity of lymph stasis. MRI is useful to determine if there is a build up of fluid or fat underneath the skin.
Is there a cure for lymphedema?
There is currently no cure for lymphedema yet, however, conservative and surgical treatments exist to relieve your symptoms. You can read more about this under Treatment Options.
What should I take note of if I have been diagnosed with lymphedema?
• Prevent dry skin by using adequate moisturising cream
• Be careful when cutting finger and toenails to prevent ingrown nails
• Avoid wearing tight bras and clothes with tight sleeves and pants
• Refrain from carrying heavy loads for prolonged periods of time
• Pace your household chores and other activities to avoid over-straining of affected limbs
• Avoid acupuncture and injections in the affected limb
• Elevate the affected limb as much as possible
• Wear a compression sleeve/glove/stocking when taking a flight or during upper limb exercise
