Lymphedema is a condition that causes swelling in the arms or legs due to a buildup of lymph fluid. This swelling occurs when the lymphatic system is damaged or blocked. The lymphatic system is a network of tissues and organs that help rid the body of toxins, waste and other unwanted materials. Lymphedema can develop when lymph vessels are missing, impaired, damaged or removed. This interference with the normal lymphatic flow causes swelling because the lymph fluid accumulates in the soft tissues under the skin. Lymphedema most commonly affects the arms or legs, but it can also occur in other parts of the body, such as the trunk, head and neck, or genitals. While lymphedema itself is not curable, it can be managed with early diagnosis and diligent care of your affected limb. However, there are certain things that can worsen lymphedema symptoms. Being aware of these risk factors is important in order to avoid flare-ups.
Infection
One of the biggest causes of lymphedema worsening is infection, especially cellulitis. Cellulitis is a bacterial skin infection that causes redness, warmth, swelling, and tenderness. It most often develops in areas of broken skin or where the immune system is compromised. People with lymphedema are at a higher risk of developing cellulitis due to potential breakdowns in the lymphatic system. If bacteria enter through a cut or crack in the skin, they can become trapped due to impaired lymph drainage and multiply rapidly. This causes inflammation, swelling, and further damage to the lymphatic vessels. Recurring cellulitis infections can lead to worsening of lymphedema over time. Preventing and promptly treating infections is crucial for lymphedema management.
Prevention Tips
– Maintain meticulous skin care and hygiene
– Moisturize daily and avoid dry, cracked skin
– Treat small cuts and abrasions right away
– Avoid punctures, insect bites, sunburns
– Get manicures/pedicures from licensed professionals
– Wear gloves for gardening and household chores
Signs of Infection
– Increased swelling, tightness, pain
– Redness, warmth in the affected area
– Chills, fever, flu-like symptoms
– Red streaks or pus from a wound
See your doctor immediately at the first signs of infection for prompt treatment with antibiotics. Untreated cellulitis can rapidly worsen lymphedema.
Injury and Trauma
Injury or trauma to the affected limb can worsen lymphedema by causing additional damage to the lymphatic system. Cuts, burns, fractures, bruises or other wounds provide an entry point for bacteria that can lead to infection. They also create inflammation that stresses the already impaired lymph vessels. Exercise extra caution to avoid injuring your limb and skin.
Prevention Tips
– Wear protective clothing, gloves, pads, helmets for activities
– Handle your limb gently during daily tasks
– Avoid extreme temperatures that can burn skin
– Use caution with pets or children to prevent scratches
– Pad and stabilize furniture/fixtures to avoid bruising
If Injury Occurs
– Clean the wound gently with soap and water
– Apply antibiotic ointment and cover with a clean bandage
– Elevate the injured limb to reduce swelling
– Use ice packs to ease pain and inflammation
– See your doctor if signs of infection develop
Getting prompt treatment for injuries can help prevent complications. Notify your doctor about any trauma to your affected limb.
Compression Garments
Compression garments like sleeves, wraps or stockings are commonly used to help manage lymphedema. However, improper use and care of compression garments can aggravate the condition. Compression garments work by applying gentle pressure to the skin to move fluid through the tissues and improve lymph drainage. They need to fit well and be replaced every 3-6 months to maintain optimal compression levels. Issues like inadequate compression, poor fit, and low quality garments can all cause problems.
Compression Problems
– Garment slips, pinches or chafes, causing irritation
– Too loose to provide sufficient compression
– Overly tight, restricting blood flow
– Worn-out elastic providing little compression
– Seams/closures creating pressure points
Tips for Proper Use
– Ensure proper fit by a certified lymphedema therapist
– Follow wear times & schedules from your therapist
– Hand wash daily and air dry; check for damage
– Replace every 3-6 months as elasticity declines
– Contact doctor if garment causes discomfort/pain
Improper compression can make lymphedema worse. Work with your therapist to ensure your garments fit well and are replaced regularly. Notify your doctor about any compression issues.
Overusing the Affected Limb
While exercise and movement are important for managing lymphedema, overdoing activity with your affected limb can worsen swelling. Lifting heavy objects, repetitive motions, and overexertion can overwork the damaged lymphatic system. This leads to fluid buildup faster than the lymph vessels can drain it. It’s important to maintain a balance between rest and activity.
Signs of Overuse
– Muscle fatigue, achiness, soreness
– Heaviness, tightness, or pain in the limb
– Increased swelling during or after activity
– Stiffness, decreased flexibility or range of motion
Tips to Prevent Overuse
– Start slow and increase activity gradually
– Take regular rest breaks during exercise or tasks
– Avoid repetitive motions for prolonged periods
– Use healthy body mechanics and proper form
– Ask for help lifting heavy objects; use assistive devices
– Balance activity with rest periods to allow lymph drainage
Pacing yourself and allowing rest days can help prevent overexertion that can worsen lymphedema. Consult your doctor or therapist for guidance on safe activity levels.
Weight Gain
Gaining a significant amount of weight can worsen lymphedema by increasing fluid accumulation and straining the lymphatic system. Excess fatty tissue impedes lymph drainage and flow through the body. When lymph fluid cannot efficiently drain, it pools in the limbs and causes swelling. Lymphedema may gradually get worse if weight continues increasing. For some people, losing weight helps reduce lymphedema swelling. However, crash dieting is not recommended as it can exacerbate the condition. Gradual weight loss with a healthy diet and exercise plan is best for lymphedema management.
Tips for Losing Weight with Lymphedema
– Consult your doctor/therapist about safe weight loss strategies
– Set small, incremental weight loss goals (1-2 lbs per week)
– Focus on portion control and choosing low sodium, high protein foods
– Increase activity slowly, listen to your body, and rest as needed
– Wear compression garments during activity to control swelling
– Get support from others managing lymphedema and weight issues
Pregnancy
For women with lymphedema, pregnancy poses a risk as weight gain and fluid retention can aggravate swelling. Hormonal changes during pregnancy also increase lymph production. In addition, an expanding uterus puts pressure on lymphatic vessels in the pelvis and legs later in pregnancy. Lymphedema can be managed with careful monitoring and use of compression garments during pregnancy. However, swelling may still increase. It’s important to be under the care of both a lymphedema therapist and obstetrician when pregnant to prevent worsening. After pregnancy, as weight decreases, lymphedema often improves to baseline for many women.
Tips for Pregnancy with Lymphedema
– Monitor swelling frequently and report significant increases promptly
– Wear a well-fitted compression garment daily; update measurements as needed
– Drink plenty of water to stay hydrated; limit sodium intake
– Follow doctor’s advice on safe exercise during and after pregnancy
– Elevate legs frequently when possible
– Get regular complete decongestive therapy as recommended
– Ask for help with lifting/chores that strain affected limb
With diligent self-care and monitoring, many women do not experience permanent worsening of lymphedema during pregnancy. Still, the risk exists and must be managed carefully. Communicate regularly with your treatment team during this time.
Blood Clots
Blood clots in the veins of an affected limb (known as deep vein thrombosis or DVT) are a possible complication of lymphedema that can make swelling much worse. When a clot forms, it further obstructs lymph drainage and causes fluid buildup, pain and inflammation. Seek emergency care for redness, sudden increase in swelling or tenderness, and warmth in the limb as these may indicate a DVT. Prompt treatment is needed to dissolve clots and prevent permanent damage that can worsen lymphedema. Your doctor may prescribe blood thinners and recommend elevating your limb to relieve swelling. People with lymphedema may need to take preventive measures to reduce DVT risk.
DVT Prevention Tips
– Stay hydrated and avoid prolonged immobility
– Wear properly fitted compression stockings
– Do leg exercises to keep blood circulating
– Maintain a healthy weight
– Avoid smoking and eat a low-sodium diet
Seeking treatment at the first signs of DVT can prevent complications like post-thrombotic syndrome which can further obstruct lymph drainage. Alert your doctor about leg swelling, tenderness, warmth or redness.
Avoiding Follow-Up Care
While lymphedema is a lifelong condition, keeping up with treatment and self-care helps control swelling and prevent progression. Failing to follow recommendations from your lymphedema therapist can lead to worsening over time. Complete decongestive therapy is usually prescribed, which includes:
– Manual lymphatic drainage (specialized massage to improve lymph flow)
– Compression bandaging and garments
– Exercise
– Skin care
– Education on self-care techniques
Continuing self-care at home is key to maintaining results long-term. But over time, without follow-up therapy, swelling may recur and increase due to stagnant lymph fluid. Getting repeat evaluations ensures compression garments still fit properly. Exercise programs can also be progressed to continue improving lymph circulation. Don’t skip appointments with your lymphedema therapist or doctor when scheduled. Consistently attending therapy helps manage the condition.
Air Travel
The decreased air pressure and confined spaces during flight can exacerbate lymphedema for some people. Sitting still for prolonged periods leads to fluid pooling in the limbs. Flying also poses DVT risk due to immobility. In-flight exercise is important to promote circulation. Compression garments should be worn to help prevent swelling. Upon arrival, elevate your legs and perform self-massage to stimulate lymph drainage. Seek prompt medical attention if you experience significant limb swelling after air travel. Preventive precautions make air travel safer for lymphedema patients.
Air Travel Tips
– Walk, stretch, and do leg exercises in your seat often
– Wear well-fitted compression garments
– Use pillows/supports to elevate limbs when possible
– Stay hydrated; avoid alcohol which causes fluid loss
– Apply lotion frequently; use moist wipes to refresh
– Report discomfort, swelling, or pain to flight staff
– Schedule complete decongestive therapy upon arrival
Extreme Temperatures
Exposure to very hot or cold conditions can worsen lymphedema. Heat causes expansion of the lymph fluid, resulting in increased swelling and heaviness. Staying hydrated helps counteract this. Cold restricts blood vessels, decreasing circulation needed to drain lymph fluid. Low temperatures can also dry the skin and lead to cracks that raise infection risk. Take care to protect your skin in extreme weather.
Tips for Hot Weather
– Stay in air conditioning when possible
– Wear loose, breathable clothing
– Apply sunscreen and moisturize skin
– Drink plenty of water; avoid alcohol
– Take breaks in shade; cool limbs with fans/ice packs
– Schedule therapy if increased swelling occurs
Tips for Cold Weather
– Layer clothing to conserve body heat
– Wear breathable moisture-wicking fabrics
– Cover skin to avoid damage from wind/cold
– Limit time outdoors; avoid getting chilled
– Warm up swollen limbs after exposure to cold
– Moisturize skin to combat dryness
With common-sense precautions, people with lymphedema can enjoy hot and cold weather while avoiding exacerbations. Listen to your body and get out of the elements if swelling worsens. Therapists can suggest adjustments to your treatment regimen during times of temperature extremes.
Lack of Exercise
While overdoing activity is problematic, not exercising the affected limb enough can also worsen lymphedema over time. Regular movement and muscle contraction help pump lymph fluid through vessels and tissues. Completely avoiding activity allows fluid to pool and stagnate. However, it’s crucial to start exercise slowly and gradually increase duration and intensity under your therapist’s guidance. Stop if you feel pain or fatigue. Aim for a level of activity that is tolerable and doesn’t exacerbate swelling. Customized exercise programs improve lymph drainage while preventing harm.
Tips for Safe Exercise
– Consult your therapist on appropriate activities
– Start with simple range-of-motion and progress slowly
– Avoid repetitive motion or lifting heavy weights
– Do each movement smoothly and controlled
– Allow plenty of rest between exercise sessions
– Wear compression garments during activity
– Monitor for signs of overexertion; stop if limb feels tired
Regular, moderate exercise tailored to your needs helps manage lymphedema. But check with your doctor before starting any new workout program.
Stress and Anxiety
Studies suggest that high levels of psychological stress may worsen lymphedema. Stress stimulates the sympathetic nervous system, causing constriction of lymph vessels which hinders drainage. Stress also increases inflammatory chemicals that contribute to swelling. While more research is needed, many report lymphedema worsening during stressful life events. Managing stress through therapy, medication, meditation, social support, or other relaxation techniques may help improve lymphedema symptoms.
Tips for Coping with Stress
– Attend support groups to gain insight from others with lymphedema
– Set realistic expectations; change what is within your control
– Separate minor issues from true priorities; avoid perfectionism
– Make time for hobbies, interests or social activities you enjoy
– Use calming techniques like deep breathing, yoga, or music
– Get counseling to work through difficult emotions
– Communicate your needs clearly to family, friends, healthcare providers
Learning healthy stress management provides physical and emotional benefits that may ease lymphedema. Make self-care a priority and don’t be afraid to ask for help.
Summary
In summary, while lymphedema is a progressive condition, being aware of factors that can worsen it gives you the power to control swelling and prevent permanent damage. Stop infections promptly, use compression garments properly, pace activity, and maintain diligent self-care under your therapist’s guidance. With an understanding of the risks that come with lymphedema, as well as ways to minimize their impact, you can keep your symptoms stable over the long-term. Consistency and vigilance are key in safeguarding your affected limb.
