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This article was co-written by Chris M. Matsko, MD. Dr. Matsko is a retired physician with offices in Pittsburgh, Pennsylvania. He was awarded the University of Pittsburgh Cornell’s Distinguished Leadership Award. He received his PhD from Temple University School of Medicine in 2007. He holds a Research Diploma from AMWA in 2016 and a Medical Content Writing & Editorial Certificate from the University of Chicago in 2017.
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Lymphedema is the accumulation of fluid in the body’s soft tissues due to the blockage or removal of lymph nodes. Lymphedema is usually caused by lymph node removal following cancer treatment but can also be due to environmental or genetic factors. Most lymphedema develops within 3 years of surgery. Lymphedema can also be caused by abnormal development of the lymphatic system at birth, and symptoms may appear later. Recognizing symptoms and getting treatment early is the best way to prevent lymphedema.
Steps
Prevention of lymphedema
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Talk to your doctor as soon as you notice signs of lymphedema. Signs of lymphedema include swelling in the arms, legs, hands, fingers, neck, or chest. If you notice swelling or other signs (listed below), you should see your doctor immediately. [1] X Research Source
- Recognizing the early signs is the best way to prevent the disease from getting worse.
- There is no cure for lymphedema, but early treatment can help relieve symptoms and prevent other symptoms.
- Lymphedema can appear days, weeks, months, or even years after cancer treatment.
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Avoid drawing blood from an arm at risk for lymphedema. Lymphedema usually occurs at the site of the body where surgery is performed. You should avoid injections or intravenous infusions in hands that are at risk for lymphedema [2] X Research Source
- When measuring blood pressure, you should measure it on the arm that is less likely to develop lymphedema.
- Consider purchasing a medical alert bracelet to warn others not to draw blood, give it intravenously, or inject it into an arm at risk of lymphedema.
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Do not take a hot bath for too long. Do not expose hands or feet that are likely to have lymphedema to come into contact with hot water, steam, or places with high temperatures. If you want to take a hot tub, you should avoid submerging your hands in the water. [3] X Trusted Source BreastCancer.org Go to Source
- Do not use hot packs or other heat treatments.
- Do not over-massage areas at risk of lymphedema.
- High heat and massage will push the body’s fluids to the sensitive area, thereby stimulating lymphedema.
- Limit exposure to the sun if possible.
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Do not carry heavy objects or carry heavy bags on your shoulders. To recover from surgery or cancer treatment, you should avoid using the affected part of your body to lift heavy objects. Care should be taken to avoid putting too much pressure on the arm due to heavy objects at risk of lymphedema. [4] X Trusted Source BreastCancer.org Go to Source
- When carrying heavy objects, you should raise your arms above your hips.
- As you get better, you can slowly lift heavy objects.
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Do not wear clothes or jewelry that are too tight. If your watch, ring, bracelet or other piece of jewelry is too tight, you should loosen it or stop wearing it. In addition, it is recommended to wear loose clothing that does not impede movement. [5] X Trusted Source BreastCancer.org Go to Source
- Avoid wearing tight collars if there is a risk of lymphedema in the head or neck area.
- Wrapping or tightening too tightly around the neck, arms, legs, wrists, and other parts of the body can cause fluid accumulation in that area.
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Raise arms/legs high. If you’re at risk for lymphedema, you should elevate your arm/leg that’s at risk if possible. This helps prevent fluid from accumulating in the hands/feet to prevent swelling. [6] X Research Sources
- This precaution is most effective in preventing lymphedema from developing in the arms, hands, or fingers.
- If you sleep on your back, keep your feet higher than your heart. For example, you can place a pillow under your knees or feet.
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Change posture. Do not sit or stand in one place for too long. Instead, you should change positions often. Do not cross your legs when sitting and should sit with your back on the bed. [7] X Research Sources
- Sitting upright while in bed improves lymphatic drainage in the body.
- You can set an alarm in your phone or set a clock to remind yourself to move around often. Also, use natural objects/events to prompt yourself to move. For example, when watching TV, you should change your position every time you come to the commercial.
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Wear protective clothing. Cuts, sunburn, burns, insect bites, and cat scratches can all cause fluid to pool in the affected area, increasing the risk of lymphedema. Wearing long, loose clothing can help protect the skin from these injuries. [8] X Trusted Source BreastCancer.org Go to Source
- Wear loose-fitting clothes, not too tight.
- Do not wear protective sleeves (usually for athletes) because the sleeves will squeeze the arm.
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Protect limbs from injury. Any cut, open wound, scrape, or burn in the area of the arm or leg with lymphedema can cause an infection. The infection will prevent the lymph fluid from filtering out bacteria and viruses. Signs of infection include: swelling, pain, redness, feeling warm, and fever. If you have these signs, you need to go to the nearest hospital right away for treatment and infection control. [9] X Trusted Source BreastCancer.org Go to Source
- Do not allow sharp objects to penetrate the skin.
- Always use a dike when sewing, wear thick gloves when gardening, and apply insect repellent when outdoors.
- Moisturize your skin by applying a gentle moisturizer to prevent dry and chapped skin.
- Extra care should be taken when shaving if using a regular razor.
- If you have a manicure, you must not cut or pull the cuticle. You should go to a nail salon where a technician knows your health condition for special attention. If the manicurist is a novice, you should carefully inquire about their health status. Do not do your nails in a place that has poor hygiene ratings or where a client has had a fungal, bacterial or viral infection.
- Wear gloves when doing housework or gardening to avoid injuring your hands, fingers, or nails.
- Wear comfortable, closed-toe shoes to reduce the risk of foot and toe injury.
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Eat a balanced and low-salt diet. Each meal should have 2-3 servings of fruit and 3-5 servings of vegetables. Eat foods rich in fiber, including whole-grain breads, cereals, pastas, rice, and fresh fruits and vegetables. It is best to avoid alcohol consumption (up to 1 serving per day). [10] X Trusted Source American Cancer Society Go to Source
- Avoid consuming fast food or junk food that is high in calories, not nutritious. Not only are these foods high in calories and low in nutrients, but these foods are also very high in salt.
- Limit your consumption of red meat and processed meat products such as hot dogs or smoked meats.
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Maintain a healthy weight. Being overweight or obese both contributes to an increased risk of lymphedema. Excess weight puts extra pressure on already swollen areas of the body, which in turn affects lymphatic drainage. [11] X Research Source
- A balanced diet, exercise, and discipline are key to maintaining an ideal weight.
- If you need help, you can consult your doctor. Your doctor can make recommendations based on your medical condition.
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Maintain a healthy lifestyle. Achieving and maintaining a healthy weight helps prevent lymphedema from developing. You should stick to healthy eating habits and exercise regularly for a healthy lifestyle. [12] X Trusted Source American Cancer Society Go to Source
- Getting enough sleep helps maintain a healthy immune system and reduces the risk of lymphedema.
- Work with your doctor to create a healthy exercise program. Vigorous exercise is not recommended. You should try to exercise every day.
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No smoking. Smoking narrows capillaries and small blood vessels, making it difficult for fluids to circulate freely in the body. Smoking also takes away oxygen and other nutrients needed for smooth fluid circulation. Skin elasticity is also damaged by smoking. [13] X Trusted Source BreastCancer.org Go to Source
- If you need help quitting smoking, you can consult your doctor about how to quit. There are many resources available to help you quit smoking.
- Quitting smoking also reduces the risk of cancer and other health problems.
Know the symptoms of illness
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Note a bump in an arm, leg, breast, or hand. Soft tissue swelling of the arms or legs is one of the most common signs of lymphedema. In the early stages, the skin is still tender and the swollen area will concave when pressed down. [14] X Research Source
- Your doctor may use a tape measure to measure the swelling and monitor where the swelling is.
- In the later stages of lymphedema, the swollen area will become firm and hard. When pressing on the swollen area, it will not be indented.
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Pay attention to the feeling of heaviness in your arms or legs. Next to the bump or before you see it, you may feel fluid build up, making it heavy and difficult to move your arm or leg. If you are at risk for lymphoma, this could be an early sign of the disease. [15] X Research Source
- If you’ve had surgery, radiation therapy, or lymph node removal surgery, you should look in the mirror to detect swelling (if any).
- Compare the two sides of the body to find the difference.
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Note if you have difficulty moving the joint. A feeling of stiffness in your fingers, toes, knees, elbows, and other joints can be a sign of increased fluid buildup due to lymphedema. Although there are many causes of stiffness, pressure in the joints from a buildup of body fluids can be a sign of lymphedema. [16] X Trusted Source National Cancer Institute Go to Source
- Symptoms of lymphedema may come on gradually or come on all at once.
- Know yourself to recognize abnormal signs.
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Take note if your toes or feet feel itchy or burning. It could be a sign of cellulitis – a bacterial and non-infectious skin infection. Because lymphedema affects the immune system, it’s important to see your doctor as soon as you notice symptoms of cellulitis. [17] X Research Source
- Cellulitis can be caused by an insect bite or scratch.
- Your doctor will treat the infection with antibiotics. Do not be subjective when there are signs of infection because an infection can quickly become life-threatening.
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Check for signs of thickening (hyperkeratosis). Fluid buildup can cause the skin to thicken. If you notice thicker skin on your arms, hands, legs, or feet, or other skin changes like blisters or warts, it could be a sign of lymphedema. [18] X Trusted Source Mayo Clinic Go to Source
- Keeping the skin clean is an important step for people with hyperkeratosis.
- Use a healing moisturizer every day and avoid lotions containing lanpin or lotions with fragrance.
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Pay attention when you see clothes or jewelry that do not fit you. People with lymphedema often feel uncomfortable wearing a bra, even without gaining weight. In addition, wearing a ring that does not fit your hand, and uncomfortable when wearing a watch and bracelet can also be a sign of lymphedema. [19] X Trusted Source American Cancer Society Go to Source
- You may have trouble fitting one arm into your sleeve.
- Because lymphedema symptoms can develop slowly, you won’t feel any swelling in your shoulder or arm until you have trouble putting on a shirt. If you find your clothes are tight on one side or it is difficult to fit a t-shirt or jacket, you should pay attention to detect signs of lymphedema.
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Watch for signs of tight, shiny, warm, or red skin. The skin may be “shiny” or “stretch”. That could be a sign of cellulitis. If the color or texture of your skin changes, you should see a doctor immediately. [20] X Research Source
- Affected skin may spread rapidly on observation.
- Other (uncommon) symptoms include fatigue, fever, aches, or cold-like symptoms.
Identify the markings on the head/neck
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Note any swelling around the eyes, face, lips, neck, or under the chin. Signs of head and neck lymphedema usually appear 2-6 months after cancer treatment in the head area. Sometimes lymphedema develops in the larynx and pharynx (mouth and throat). The disease can also develop beyond the neck and face or both, depending on whether the lymphatic channel is blocked. [21] X Research Source
- See your doctor if you have any signs of lymphedema of the head or neck.
- Uncontrolled swelling can lead to inflammation and quickly become out of control.
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Feel for tightness or swelling in the affected body area. Because swelling in the head and neck can be difficult to see, the first symptom of lymphedema in the head and neck is often felt. You should pay attention if you see any signs of tension in the head and neck area. [22] X Research Source
- You may find it difficult to move your head, neck, or face. The skin may also feel stiff or uncomfortable, even though no visible swelling is visible.
- Your doctor may perform additional tests to check for lymphedema, including radionuclide imaging of the lymphatic system or another imaging technique that relies on the injection of a contrast dye to show Abnormalities of lymphatic circulation.
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Be alert if eye swelling affects vision. Blurred vision, excessive or uncontrollable tears, red eyes, and orbital pain can all be signs of double eyelash-lymphedema syndrome. This disease is inherited at birth, but it may not be until puberty that signs of the disease appear. [23] X Research Sources
- Extra eyelash growth along the inner lining of the eyelids is also a sign of double eyelash-lymphedema syndrome.
- Other vision problems caused by the disease include abnormally curved corneas and corneal scarring.
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Observe if you have difficulty swallowing, speaking or breathing. In more severe cases of lymphedema, swollen tissue in the neck and throat interferes with normal functions. You may experience drooling or drop food from your mouth. [24] X Research Source
- The swelling can lead to a stuffy nose or pain in the ears. Swelling can affect the sinus glands and sinus cavities.
- To confirm lymphedema in the neck and head, your doctor may perform an ultrasound or magnetic resonance imaging (MRI). These tests show the location of the lymphatic fluid in the head.
Advice
- Even if you’re at risk for lymphedema, you should see your doctor to rule out other causes of your lymphedema symptoms.
Warning
- See your doctor right away if you have signs of an infection such as a fever above 38°C, sweating, persistent chills, a skin rash, or other skin abnormalities such as pain, redness, or swelling.
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This article was co-written by Chris M. Matsko, MD. Dr. Matsko is a retired physician with offices in Pittsburgh, Pennsylvania. He was awarded the University of Pittsburgh Cornell’s Distinguished Leadership Award. He received his PhD from Temple University School of Medicine in 2007. He holds a Research Diploma from AMWA in 2016 and a Medical Content Writing & Editorial Certificate from the University of Chicago in 2017.
There are 13 references cited in this article that you can view at the bottom of the page.
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Lymphedema is the accumulation of fluid in the body’s soft tissues due to the blockage or removal of lymph nodes. Lymphedema is usually caused by lymph node removal following cancer treatment but can also be due to environmental or genetic factors. Most lymphedema develops within 3 years of surgery. Lymphedema can also be caused by abnormal development of the lymphatic system at birth, and symptoms may appear later. Recognizing symptoms and getting treatment early is the best way to prevent lymphedema.
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