What is lymphoedema?
The lymphatic system collects excess fluid from the tissues and returns it to the circulation. When this system is underdeveloped from birth or damaged later, fluid builds up and a persistent swelling develops.
Lymphoedema caused by an inherited weakness is called primary; when it follows surgery, radiotherapy, infection or injury it is called secondary.
Symptoms
- Swelling that often starts on one side
- Swelling that may include the top of the foot and the toes
- Tightness and heaviness in the tissue
- Thickening of the skin in later stages
- Recurrent skin infections
Causes and risk factors
- Inherited weakness of the lymphatic system
- Surgery involving removal of lymph nodes
- Radiotherapy
- Recurrent infections
- Long-standing venous insufficiency
How is it diagnosed?
History and examination are central. Colour Doppler ultrasound may be used to rule out vein-related causes; further tests of the lymphatic system are planned when needed.
Treatment approach
Treatment is based on compression, skin care, movement and, when needed, manual lymphatic drainage. Accompanying venous insufficiency is assessed separately. Long-term follow-up may be required.
When to see a doctor
An assessment is advised for swelling that does not go away or keeps increasing, or for redness and warmth of the skin. Sudden swelling and pain in the leg should be assessed without delay.
Related treatments
Frequently asked questions
Does lymphoedema go away completely?
Lymphoedema is usually long-term; with suitable treatment and regular care, swelling and symptoms can be controlled.
What do compression stockings do?
They help reduce fluid build-up and stop the swelling from increasing. Pressure and size should be chosen on medical advice.
Is every leg swelling lymphoedema?
No. Swelling can also be caused by venous insufficiency, heart or kidney problems or medication. An examination is needed to find the cause.
Which doctor treats lymphoedema?
The cause of leg swelling is investigated at a cardiovascular surgery examination, with colour Doppler ultrasound if needed. When lymphoedema is diagnosed, treatment with compression, manual lymphatic drainage and exercise is planned together with the relevant specialties.
