For Immediate Release

A Swelling Problem

Suzie Ehmann, certified lymphedema therapist

Philadelphia, PA, Wednesday, October 22, 2008 —Swelling is an increase in the size or change in the shape of an area of the body. Swelling is also a primary symptom of lympehdema, an often misdiagnosed problem. Lymphedema refers to an abnormal swelling that occurs most often in your arms or legs. Lymphedema affects men and women and with proper treatment can be controlled to limit discomfort and swelling. 

The lymphatic system is crucial to keeping healthy. It circulates protein-rich lymph fluid throughout the body, collecting bacteria, viruses and waste products. The lymphatic system carries these through the lymph vessels, which lead to lymph nodes. The wastes are then filtered out by lymphocytes — infection-fighting cells that live in the lymph nodes — and ultimately flushed from the body. Lymphedema occurs when there is a blockage or impairment in the lymphatic system that prevents the lymph fluid in the arm or leg from draining adequately. As the fluid accumulates, the swelling continues.

Lymphedema can be either primary or secondary. This means it can occur on its own (primary lymphedema) or it can be caused by another disease or condition (secondary lymphedema). Primary lymphedema is an inherited condition caused by problems with the development of lymph vessels in the body. Primary lymphedema occurs more commonly in women and usually affects the legs, rather than the arms. 

Forms of secondary lymphedema can occur following any condition or procedure that damages the lymph nodes or lymph vessels.  Some of the most common causes of secondary lymphedema include surgery and treatment for cancer including breast, colon, ovarian, prostate and testicular. Surgery can cause lymphedema to develop if the lymph nodes and lymph vessels are removed or severed. For instance, surgery for breast cancer may include the removal of one or more lymph nodes in the armpit. If the remaining lymph nodes and lymph vessels can't compensate for those that have been removed, lymphedema may result in the arm, chest or trunk area. Radiation can cause scarring and inflammation of the lymph nodes or lymph vessels, further restricting the flow of the lymph.

Other causes include an injury that damages the lymph nodes or lymph vessels.  This may be the result of chronic infections, chronic non-healing wounds, deep vein thrombosis, chronic venous hypertension, varicose veins, and obesity to just name a few.

  Symptoms of lymphedema may include swelling of a part of the arm or the entire arm or leg, including fingers or toes; a feeling of heaviness or tightness in the arm or leg; restricted range of motion in your arm or leg; an aching or discomfort in the arm, leg or trunk; recurring infections in the affected limb; and hardening and thickening of the skin on the arm or leg.

If you are experiencing these symptoms, make an appointment with a doctor as there are many different cause of swelling including a blood clot or an infection that doesn’t involve your lymph nodes. A doctor may perform tests to identify the cause of your symptoms.

There is no cure for lymphedema, however, lymphedema can be treated. The earlier the treatment is initiated, the better the outcome, although benefits can be seen even with long standing lymphedema with regards to the reduction of size of the limb, reducing pain and discomfort and increased functional use. Treatment should be provided by a certified lymphatic therapist. Treatment focuses on minimizing the swelling and controlling the pain and often include exercise, compression wrap, massage and compression garment.   

Chestnut Hill Hospital is now able to provide treatment for those individuals with lymphedema.   Suzie Ehmann, PT, DPT/CWS/CLT - LANA, has more than 300 hours of lymphedema training. She is accredited by the Lymphedema Association of North America. In addition, Ms. Ehmann is a certified wound care specialist. Appointments can be scheduled with a physician referral by calling the physical therapy department at Chestnut Hill Hospital, 215-248-8559.