Not differentiating between normal oedema and lymphoedema is a very common mistake that is made amongst healthcare professionals. We learn the differences.
What is oedema?
Oedema is swelling caused by excess fluid trapped in your body’s tissues. Although oedema can affect any part of your body, you may notice it more in your hands, arms, feet, ankles and lower legs first.
What is lymphoedema?
Any form of chronic oedema that has been present for more than six weeks is called lymphoedema, regardless of the cause, and can be managed by Complete Decongestive Therapy.
Lymphoedema is a high-protein oedema that causes pitting (displacement of the fluid underneath the skin, causing an indentation, when you are depressing the skin with your finger) or tissue thickening that may lead to an increase in size and circumference of a limb.
The lymphatic system forms part of the body’s circulatory system that transports waste products back to the thoracic duct and subclavian vein. The human body produces two to four litres of lymphatic fluid in 24 hours. When the lymphatic system is not functioning at its optimum, the fluid starts to collect in the interstitial space.
Primary lymphoedema is caused by a congenital malformation in the lymphatic system.
Secondary lymphoedema is caused by trauma to the lymphatic system, such as:
- When a mastectomy with sentinel lymph node biopsy/lymph node dissection is done
- After radiation over areas where lymph nodes are present
- A tumour blocking the flow of the lymphatic fluid
- A degloving injury (type of severe injury that happens when the top layers of your skin and tissue are ripped from the underlying muscle, connective tissue, or bone) destroying the superficial lymphatic vessels.
- Post-surgical oedema that doesn’t subside
- Chronic Venous insufficiency could also lead to chronic oedema
Whatever the cause of the oedema, it can be managed by doing manual lymph drainage and using short stretch compression bandages (Comprilan) in a multi-layered compression system. Together with exercise, diet control and some lifestyle changes when needed.
When the oedema has stabilised the correct compression garment must be fitted for long-term management.
MEET OUR EXPERT – Erika van der Mescht
Erika van der Mescht is a Physiotherapist (BPhysT) and certified Lymphoedema Therapist. She co-presents courses with the International Lymphoedema and Wound Care Institute and does various awareness talks about lymphoedema for BSN Medical.