Lymphedema

Diagnosis

If you're at risk of lymphedema — for instance, if you've recently had cancer surgery involving your lymph nodes — your doctor may diagnose lymphedema based on your signs and symptoms.

If the cause of your lymphedema isn't as obvious, your doctor may order imaging tests to get a look at your lymph system. Tests may include:

• MRI scan. Using a magnetic field and radio waves, an MRI produces 3D, high-resolution images of the involved tissue.
• CT scan. This X-ray technique produces detailed, cross-sectional images of the body's structures. CT scans can reveal blockages in the lymphatic system.
• Ultrasound. This test uses sound waves to produce images of internal structures. It can help find obstructions within the lymphatic system and vascular system.
• Lymphoscintigraphy. During this test, the person is injected with a radioactive dye and then scanned by a machine. The resulting images show the dye moving through the lymph vessels, highlighting blockages.

Treatment

There's no cure for lymphedema. Treatment focuses on reducing the swelling and preventing complications.

Medications

Lymphedema greatly increases the risk of skin infections (cellulitis). Your doctor may prescribe antibiotics for you to keep on hand so that you can start taking them immediately once symptoms appear.

Therapy

Specialized lymphedema therapists can teach you about techniques and equipment that can help reduce lymphedema swelling. Examples include:

• Exercises. Gentle contraction of the muscles in the arm or leg can help move the excess fluid out of the swollen limb.
• Manual lymph drainage. Therapists trained in this massage-like technique use very light pressure to move the trapped fluid in the swollen limb toward an area with working lymph vessels. People should avoid manual lymph drainage if they have a skin infection, blood clots or active cancer in the affected limb.
• Compression bandages. Using low-stretch bandages to wrap the entire limb encourages lymph fluid to flow back toward the trunk of the body.
• Compression garments. Close-fitting elastic sleeves or stockings can compress the arm or leg to encourage lymph fluid drainage. These garments often require a prescription to ensure that the proper amount of compression is used. You may need to be measured by a professional to ensure proper fit.
• Sequential pneumatic compression. A sleeve worn over the affected arm or leg connects to a pump that intermittently inflates the sleeve, putting pressure on the limb and moving lymph fluid away from the fingers or toes.

Surgical and other procedures

Surgical treatment for lymphedema may include:

• Lymph node transplant. Lymph nodes are taken from a different area of the body and then attached to the network of lymph vessels in the affected limb. Many people with early-stage lymphedema see good results from this surgery and can decrease the amount of compression needed.
• New drainage paths. Another option for early-stage lymphedema, this procedure creates new connections between the lymph network and blood vessels. The excess lymph fluid is then removed from the limb via blood vessels.
• Removal of fibrous tissue. In severe lymphedema, the soft tissues in the limb become fibrous and hardened. Removing some of this hardened tissue, often through liposuction, can improve the limb's function. In very severe cases, hardened tissue and skin may be removed with a scalpel.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

To reduce the risk of complications from lymphedema, avoid injuring the affected limb. Cuts, scrapes and burns can invite infection. Protect yourself from sharp objects. For example, shave with an electric razor, wear gloves when you garden or cook, and use a thimble when you sew.

Coping and support

It can be frustrating to know there's no cure for lymphedema. However, you can control some aspects of lymphedema. To help you cope, try to:

• Find out all you can about lymphedema. Knowing what lymphedema is and what causes it can help communication with the doctor or physical therapist.
• Take care of the affected limb. Clean your skin daily, looking over every inch of the affected limb for signs of trouble, such as cracks and cuts. Apply lotion to prevent dry skin.
• Take care of your whole body. Eat a diet rich in fruits and vegetables. Exercise daily, if you can. Reduce stress. Try to get enough sleep. Taking care of your body gives you more energy and encourages healing.
• Get support from others with lymphedema. Whether you attend support group meetings in your community or participate in online message boards, it helps to talk to people facing similar difficulties.

Preparing for your appointment

Here's some information to help you get ready for the appointment with your doctor.

What you can do

List the following:

• Your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment
• Key personal information, including major illnesses or trauma, cancer treatments or recent life changes
• Medications, vitamins and supplements you take
• Questions to ask the doctor

For lymphedema, some basic questions to ask the doctor include:

• What's the likeliest cause of this swelling?
• Could there be another cause?
• What tests do I need? Do these tests require special preparation?
• Is the swelling temporary or long lasting?
• What's the treatment for lymphedema?
• Are there alternatives to the approach you're suggesting?
• Are there medications to ease the swelling?
• I have other health conditions. How can I best manage them together?
• Do I need to restrict my diet or activities?
• Do you have brochures or other printed material that I can take? What websites do you recommend?

Don't hesitate to ask other questions, as well.

What to expect from the doctor

Your doctor is likely to ask you a number of questions, such as:

• When did the swelling begin?
• Did anything precede the swelling, such as surgery, trauma, radiation therapy or new medications?
• Do you have other signs or symptoms?
• Has the swelling been continuous or occasional?
• Does anything seem to make the swelling better?
• Does anything seem to worsen the symptoms?
• What have you tried to treat the edema, and how did it work?

What you can do in the meantime

Keep the swollen limb elevated as much as possible and protect your skin from injury. The swelling from lymphedema might dull pain from an injury or burn, so don't use heating pads on the affected limb. Moisturize your skin daily.