Lymphedema: Overview, Symptoms, Stages, and Treatment

Lymphedema is a chronic disorder which can only diagnosed by a lymphedema specialist by first ruling out other disorders. It can be caused by an operation, radiation, injuries, and infections and, in some cases, it can be hereditary. Learn more about the four stages of Lymphedema and the steps you can take to reduce lymphedema symptoms. Lymphedema is swelling caused by damage to the lymphatic system. Our body is covered with lymphatic vessels. These vessels are responsible for the transport, collection, and filtration of protein and the metabolic waste of inflammatory products in bodily fluids. If the lymphatic system is damaged, it can no longer process sufficient fluid, causing visible swelling in your arms, legs, feet, chest, abdomen, or genitals. Click one of the topics below to jump straight to that section or keep reading to learn more about Lymphedema forms, stages, symptoms, and treatments.

1. The Two Forms of Lymphedema
2. Common Symptoms of Lymphedema
3. The Four Stages of Lymphedema
4. Treating Lymphedema
5. Lymphedema Overview Infographic

The Two Forms of Lymphedema

There are two forms of lymphedema, one which is hereditary, and another caused by damage to the lymphatic system.

• Primary: Primary lymphedema is rare and results from abnormal development of the lymphatic system. Symptoms can occur beginning at birth or later in life.
• Secondary: Secondary lymphedema is more common. This form is caused by damage to the lymphatic system from cancer, radiation therapy, surgery, lymph-node removal, scar tissue, or parasites (rare).

Common Symptoms of Lymphedema

• Swelling of the arms or legs
• Reduced flexibility in the hands, wrists, or ankles
• Stiffness or tingling of the skin
• Hardening or thickening of the skin

The Four Stages of Lymphedema

See your doctor if you’re experiencing any of the symptoms above or if you’ve been diagnosed with lymphedema and your symptoms worsen. If you haven’t been previously diagnosed, your doctor may perform a manual exam of the area(s) along with tests to determine if the lymph nodes are blocked and why. From there, they will identify which of the four stages of lymphedema best match your symptoms and prescribe a treatment.

• Stage 1: Damage to the lymphatic vessels, no visible form of lymphedema.
• Stage 2: Soft edema occurring in the evening, disappearing or minimizing with leg elevation.
• Stage 3: Thickened skin with persistent edema. Does not minimize with elevation.
• Stage 4: Large, complicated swelling with pronounced skin changes. Wart-like growths, small blisters, or fistulas containing lymph fluid may discharge.

Treatments for Lymphedema

While lymphedema is a chronic disease, there are many treatment options available. Your doctor will recommend one that is right for your lifestyle and the stage you’re diagnosed with.

Some severe cases of lymphedema require surgical treatment, but many mild and moderate cases can be managed with Complete Decongestive Therapy (CPD), a series of measures which help drain lymphatic fluid, restructure hardened connective tissues, and strengthen muscle as well as the lymphatic system. CPD is divided into two phases, an active and maintenance phase.

1. Active Phase: Ongoing for several weeks to start moving fluid and decrease swelling. Includes skin and hygiene treatment, manual lymph drainage sessions multiple times per week, compression bandage therapy, and special exercises.
2. Maintenance Phase: Ongoing for several months or years to keep swelling down and improve muscle and lymphatic system strength. Includes skin and hygiene treatment, manual lymph drainage, compression stocking therapy, and special exercises while wearing compression stockings.

In addition to specialized exercises and proper skin care, two of the most important elements of CPD are compression therapy and elevation.

• Compression Therapy: Compression wraps and bandaging help exert pressure on the affected muscle and tissue to promote proper lymph drainage and can prevent lymph from flowing back into the affected area. During the active phase, the affected limbs are bandaged using special graduated compression wraps. During the maintenance phase, graduated compression socks and stockings are used to support the proper flow of lymph fluid.
• Leg Elevation: When the lymphatic system becomes blocked, the area swells because fluid has accumulated in the soft tissue. Leg elevation helps relieve the aches associated with fluid retention while promoting fluid drain and swelling reduction. Leg wedge pillows are a popular option to provide comfortable and stable elevation.

Lymphedema Overview Infographic

Click here to see the full infographic.

Managing Your Lymphedema

As always, we recommend you speak with your doctor first if you have questions about your condition or ongoing treatment. If you need clarification about any of our compression or leg wedge products, call our certified experts at 877-525-7224 and we’ll be happy to assist you.

Sources

• Mayo Clinic. “Lymphedema” https://www.mayoclinic.org/diseases-conditions/lymphedema/symptoms-causes/syc-20374682
• Johns Hopkins Medicine. “Treating Lymphedema” https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/treating-lymphedema
• Physiopedia. “Complete Decongestive Therapy (CDT)” https://www.physio-pedia.com/Complete_Decongestive_Therapy_(CDT)

About the Author

Kaki Zell - Vice President of Sales, Marketing, eCommerce at Legs-4-Life LLC

Kaki holds a Bachelor of Science degree in Business Administration and Management from Virginia Polytechnic Institute and State University. She’s been working in the medical device industry over 11 years and currently serves on the Board of Directors for the Greensboro Science Center.

Written July 2018 | Page last updated December 2022