By Kelly Gray, PT
The lymphatic system is a major part of your body’s immune system, helping to fight infection and keep you healthy.
On occasion, you might experience swollen lymph nodes when your system is combatting illness, but otherwise you likely don’t even know that your lymphatic system is working.
However, when the system is interrupted or damaged, a type of swelling called lymphedema can occur. It can cause uncomfortable symptoms and put you at risk for other serious health complications.
The certified lymphedema therapists in the Lymphedema Management Program at Princeton Rehabilitation, a program of Penn Medicine Princeton Medical Center, offer one-on-one treatment for individuals dealing with the condition.
Understanding the Lymphatic System
First, what is lymph?
Lymph is a clear-to-white fluid made of:
• White blood cells, especially lymphocytes, that attack bacteria in the blood.
• Fluid from the intestines called chyle, which contains proteins and fats.
Your lymph system is a network of organs, lymph nodes, lymph ducts, and lymph vessels that make and move lymph from tissues to the bloodstream.
Lymph nodes are soft, small, round, or bean-shaped structures that normally cannot be seen or easily felt. There are hundreds of lymph nodes throughout your body, including in your neck, armpit, chest, abdomen and groin.
As part of your lymph system, these nodes make immune cells that help the body ward off infection. They also serve as filters, removing foreign material such as bacteria and cancer cells, from the lymph fluid.
When your lymph nodes detect bacteria in the lymph fluid, they produce more infection-fighting white blood cells, causing the nodes to swell. The swollen nodes may be felt in the neck, under the arms and groin. When the infection clears, the nodes return to their normal size.
Causes, Complications of Lymphedema
When the lymphatic system is damaged or blocked, lymph can build up in your body’s soft tissues and lead to lymphedema — or swelling — usually in the arms, legs, groin or neck.
While a variety of conditions can hurt the lymphatic system, including infection, cancer or genetics, the most common cause of lymphedema is the removal of or damage to your lymph nodes during cancer treatment.
For example, lymph nodes in your armpit may be removed to check for the spread of breast cancer. Or radiation may cause scarring and inflammation of your lymph nodes or lymph vessels.
However, it is important to note, that not everyone who has had lymph nodes removed as part of cancer treatment will develop lymphedema.
Symptoms of lymphedema can include:
• Swelling in your arm, leg, or other part of your body. The swelling may be barely noticeable at first, but worsens over time.
• Tightness in the skin in the affected area. A tingling sensation may also occur.
• Heavy feeling in the affected arm or leg.
• Clothing and jewelry feel tight.
• Skin appears thick or leathery.
These symptoms may occur shortly after cancer surgery or may develop a year or more after cancer treatment.
If you experience signs of lymphedema, talk to your doctor about what is causing it and how it can be treated.
Left unmanaged, lymphedema can cause serious complications, including:
• Increased risk of infection in the swollen area because the cells that prevent infection can’t reach that part of your body.
• Slower wound healing in the affected area.
• Stiffness or soreness in the area.
Additionally, lymphedema may cause people to feel embarrassed, depressed, or even angry because of how the condition makes them look and feel.
Managing Lymphedema
Though there is no cure for lymphedema, the condition can often be treated and managed to keep the swelling down and relieve symptoms. Treatment may include:
• Light exercises aimed at helping the lymph fluid drain, which reduces swelling.
• Manual lymph drainage massage to help push the fluid out of the swollen area.
• Compression bandaging to encourage the lymph fluid to move back toward your torso.
• Compression garments such as sleeves or stockings can help keep the fluid moving.
At Princeton Rehabilitation, certified lymphedema therapists offer patients treatment and education tailored to meet their specific needs.
Living With Lymphedema
Millions of people across the United States are affected by lymphedema each year, and as the Centers for Disease Control and Prevention (CDC) advises, the key to managing the condition is to prevent infections and allow fluids to flow through the swollen area.
In addition to seeking treatment, the following tips can help patients living with lymphedema.
• Keep your skin clean, use lotion to keep it moist and protect it from the sun.
• If you get a small cut, clean it right away and apply antibacterial ointment and a bandage.
• Avoid wearing tight clothing or jewelry. Tight bracelets, watches, and even rings can interrupt lymph flow.
• If your arm or leg is swollen, elevate it above your heart whenever possible.
• Wear compression garments as prescribed.
• Maintain a healthy weight to optimize lymphatic drainage.
• Maintain overall good health. Eating a healthy diet, exercising, and getting enough sleep will help support your lymphatic system and encourage lymph flow.
For more information about Princeton Rehabilitation or to find a certified lymphedema therapist call 609-853-7840 or visit www.princetonhcs.org.
Kelly Gray, PT, is a physical therapist and certified lymphedema therapist. She is a rehabilitation manager with Princeton Rehabilitation, a program of Penn Medicine Princeton Medical Center.