Lymphoedema is a long term condition which causes swelling in any part of the body with the legs and arms most commonly affected.
A failure in the lymphatic system, the bodies drainage system which helps regulate fluid as well as forming part of the immune system, sees a build up in protein rich fluid beneath the skin which leads to enlarged and swollen limbs. It is thought to affect around 240,000 people in the UK of any age and gender. Lymphoedema should not be confused with swelling caused from heart failure or leaky or obstructed veins (veinous insufficiency).
To understand Lymphoedma you first have to understand how the Lymphatic system works. As part of the immune system, the lymphatics help to deal with infection but more importantly they help to regulate and maintain the balance of fluid in the body. Like a waste disposal system the lymphatics drain fluid, bacteria, protein and waste products away from the tissue around skin, fat, muscle and bone. The fluid from the tissue, known as 'lymph' then makes its way through a network of lymphatic vessels which become larger and deeper.
The movement of lymph is dependent on muscle movement through exercise and the movement of the vessels themselves. During its journey the lymph will pass through a lymph gland or node which are found in clusters at the back of the neck, groin and armpits. Here, acting as a filter and defence system the body removes waste matter, harmful cells and bacteria from the lymph before draining back into the large veins behind the collar bone. From here it is finally excreted as urine through the kidneys.
Lymphoedema occurs when there has been a failure in the lymphatic system causing the fluid in the tissues to build up resulting in swollen and often enlarged limbs or appendages. As well as discomfort due to the swelling it also makes the area more susceptible to breaks in the skin and infection as bacteria is not being cleared from the site. A severe infection in the skin, cellulitis is common among those with Lymphoedema. Healing in the area is also compromised as oxygen and nutrients essential for repair are unable to get to the area often leading to further complications.
There are two types of Lymphoedema, Primary and Secondary. Primary Lymphoedema is due to a condition from birth, Secondary occurs when there is damage to the Lymphatic system most commonly due to surgery, trauma, radiation or infection.
How does Lymphoedema affect the feet?
As well as reduced mobility, swelling makes the fitting of footwear difficult often causing pressure and friction. These can lead to corns and callous and in more severe cases breaks in the skin. As the feet are in and out of footwear and on floors they are generally full of bacteria which can lead to infections in any cuts and grazes. Lack of oxygen and nutrients also affects the quality of the skin often causing dry and devitalised skin.
How to prevent problems arising in the feet:
• Ensure footwear is well fitting, Velcro or laces allow you to loosen or tighten depending on the swelling each day reducing pressure.
• Check feet every day for any cuts, grazes or areas of pressure.
• Ensure skin is kept in good condition with use of emollients.
• Regular foot care to maintain foot health and prevent areas of pressure.
• Compression therapy can help to reduce the overall swelling, improves shape and helps prevent
further build-up of fluid. Initially, this may be done by applying a specialised form of bandaging, but
more often will mean wearing prescribed elastic graduated compression garments
• Exercise is essential to maximise lymph drainage, keep the body supple and weight within normal
For more information visit Lymphoedema Support.