The consequences of lymphedema
In the absence of treatment, lymphedema can have many late effects. The skin develops blisters and eczema, which heal worse and worse over time. In the stage of elephantiasis the skin becomes leathery and grey.
The pressure can also damage vessels and muscles. The storage of the lymph can make the body many kilograms heavier and in the long run damage the joints.The tissue changes and in extreme cases can also produce malignant tumors. At the beginning, no damage is visible on the skin.
From the second stage onwards, blisters and rashes form, which in some cases can be inflamed. Later on, wound healing disorders occur and even small injuries cause large eczema. If not treated, the skin can reach the stage of elephantiasis.
Elephantiasis describes a clinical picture characterized by massive swelling of body parts due to lymph congestion. At this stage, healing of the skin is no longer possible. If detected early, skin care should be performed regularly and wounds should be checked regularly. You can find more information about wound healing disorders here.
The treatment
The treatment depends on the location of the edema, its cause and stage. The primary therapy is a decongestion. Manual lymphatic drainage moves the lymphatic fluid into areas that are not congested and can thus be transported further in a natural way.
This is possible because there are small connections, so-called anastomoses, between the various lymph vessels and the complete pathway is not blocked. The next step is to prevent renewed congestion by applying compression stockings or compression bandages to the affected limbs. In order to keep the joints mobile, physiotherapy and exercise can be helpful.
The actual cause of lymphedema cannot be treated. In later stages, the edema can often not be completely removed. Besides the therapy of the edema itself, treatment and care of the skin is necessary.
Anti-inflammatory ointments and moisturizers can be used for this purpose. However, these should be fragrance-free, as the already damaged skin often does not tolerate this well. The exact therapy should be discussed with the treating physician and checked by him regularly.
After the lymph has been removed by manual or mechanical lymph drainage, the aim is to continue to prevent the edema. Compression stockings, for example, are suitable for this, as they reduce lymph accumulation. Compression stockings are a medical product and should not be used without consulting a doctor.
There are different thicknesses and lengths of stockings and depending on the type of edema, different stockings are recommended. It is also necessary to change the stockings regularly, as the thickness may decrease. You can find more information about compression stockings here.
In most cases, drug therapy is only used to support the skin. There are various ointments for the skin, which support healing and fight bacteria. A causal treatment is not possible.
So-called water tablets do not help with lymphedema and can even be harmful as they increase the protein content in the tissue and worsen the lymph transport. These water tablets are useful in cases of heart-related oedema. Lymphedema is a serious disease which should always be clarified and treated by conventional medicine.
Without adequate treatment, lymphedema develops into so-called elephantiasis (a massive swelling of body parts due to lymph congestion). Homeopaths recommend Lycopodium clavatum and Gingko Biloba. This can be taken supportively.
Pure homeopathic therapy is not recommended. With some movement exercises and physiotherapy, the lymph drainage in the body can be supported. Helpful sports are gymnastics, swimming and cycling.
Except when swimming, the prescribed compression stockings should be worn for these sports. When swimming, the even water pressure from the outside supports lymph transport. In resting phases, the affected body regions should be elevated.
A classical massage of the body areas is not recommended, as this promotes the production of lymph. Certain movements can specifically support the removal, but other exercises can also have a harmful effect, which is why the exercises should be learned in the context of physiotherapy. Basically, walking is better than standing and long periods of sitting should also be avoided.
Gymnastic exercises also promote blood circulation and muscle building. Healthy muscles can increase the transport of lymph and venous blood, which is why it is also called muscle pump. Cross-country skiing or endurance running with overloading of the legs should be avoided.This does not mean, however, that these sports have to be completely eliminated.
A conservative therapy of lymphedema can be very stressful for the person affected and usually has to be continued for life. An alternative may be surgery. There are various approaches to restore lymph drainage.
Two procedures aim to create new pathways for lymphatic fluid by transplanting lymphatic tissue from healthy areas of the body. The transplanted tissue forms fresh lymph vessels at the new location. This system is called lympholymphatic anastomosis.
Another procedure leads the lymph fluid directly into the veins, which is called lympho-venous anastomosis. Another possibility, which however only works when the lymph vessels are constricted by radiation and surgery, is the removal of the disturbing scar tissue. The last surgical option is the removal of tissue.
This is not a curative therapy, but only a relief, because in less tissue there is less room for liquid. This resection allows compression therapies to work better again. An operation is always associated with risks and should therefore be the last option.
