LYMPHEDEMA - CAUSE AND TREATMENT

Do you know someone with swollen legs or feet? Sometimes individuals have swollen legs and feet and the underlying cause may be a problem with the lymphatic system, known as lymphedema. The lymphatic system serves all body tissues except cartilage, bone and epithelial tissues and it returns lymph through lymph channels. Lymph comprises of plasma proteins and other particles. Lymph is usually filtered in nodes before returning to blood circulation.

Lymphedema occurs due to a defective lymphatic system which causes an accumulation of proteins in the interstitial compartment. Lymphedema is categorized into: primary lymphedema and secondary lymphedema.

Primary lymphedema is a disorder of the lymphatic vascular system and may be genetically based. There are three types of primary lymphedema: congenital, lymphedema praecox and lymphedema tarda. In the congenital case, Milroy’s disease is the most common type of congenital lymphedema in which there is aplasia of the lymphatic system. Another case is megalymphatics in which there are dilated lymphatic system which causes unilateral limb swelling due to the absence of lymphatic valves. Lymphedema praecox occurs before 35 years of age and is often unilateral. Lymphedema tarda occurs after the age of 35 and is typically uncommon.

Secondary lymphedema is acquired due to a disruption of the lymphatic system. Secondary lymphedema can occur due to: trauma, post inflammation/infection, post surgical, radiotherapy (radiation), venous disease and immobility. Worldwide, the most common cause of secondary lymphedema is caused by a filarial worm via mosquito where the worm travels to the lymph nodes and lodges in there causing an allergic response which leads to severe lymphatic destruction, this is known as: filariasis.  

Management of an individual with lymphedema includes: limb elevation, massage, compression stockings, and exercise. If you or a loved one might be experiencing symptoms of a swollen foot or leg it is important to seek medical advice in order to get proper treatment.

Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.