A lymphatic obstruction is a blockage in the lymphatic system. The lymphatic system is made up of lymph nodes and vessels that drain fluids from your body’s tissues. The fluids carry toxins and other waste products to your lymph nodes before your body eliminates them.
Lymph nodes are small, bean-like glands located in various parts of the body, such as your neck, groin, and armpits. These glands are important to your body’s immune system. They produce blood cells that help your body fight infections.
A blockage in the lymphatic system causes tissues to become swollen with lymphatic fluid. This is called lymphedema. It results in swelling in your arms or legs.
You can be born with a lymphatic blockage that causes lymphedema (called primary lymphedema) or you can develop lymphedema as a secondary condition. Primary lymphedema is often the result of a genetic disorder, while secondary lymphedema is usually a complication of cancer treatment.
Lymphatic obstruction is a chronic condition for most people. This means you’ll probably need to treat the swelling throughout your life.
There are several different causes of primary and secondary lymphatic obstruction.
It’s largely hereditary, meaning you’re born with it. This is less common than secondary lymphedema. You’re more likely to have primary lymphedema if a family member is also affected. Two rare genetic conditions, Milroy’s disease and Meige’s disease, cause the structures that make up your lymphatic system to form incorrectly.
A mastectomy is one of the most common causes of secondary lymphedema. Surgeons often remove lymph tissue from under the arm when they’re removing a cancerous breast. Fluids draining from the arm must pass through the armpit. If lymph nodes are removed from this area, lymphatic obstruction and swelling in the arm can occur.
Cancer and radiation therapy can also cause lymphedema to develop. Tumors and scar tissue from radiation and surgery can cause blockage.
The primary sign of lymphatic obstruction is lymphedema. Lymphedema causes swelling in your arms or legs. Your fingers or toes may also retain fluid and swell. The swelling can limit your range of motion. You may experience heaviness or a dull ache in the affected limb.
People with congenital lymphatic obstruction may show symptoms in early childhood or at the onset of puberty.
Symptoms of secondary lymphedema can appear any time after surgery. Most symptoms will appear within two to three years of surgery. However, some people don’t experience swelling until months or years after their treatment.
Infections may occur along with the swelling of lymphatic obstruction. Cellulitis is a type of skin infection. Lymphangitis is a bacterial infection of the lymph vessels. Symptoms of infection include a streaky, red rash or blotchy patch on the affected limb. Fever, itching, and chills can accompany the edema (swelling) and rash.
Your doctor will perform a physical exam and ask you about your medical history.
Your doctor may order imaging tests if they suspect lymphatic obstruction. A lymphangiogram is a type of X-ray scan that uses contrast dye to make your lymph nodes and vessels stand out more clearly. Your doctor will inject the dye into a vein between your toes. The X-ray images can reveal blockages in your lymphatic drainage system.
How Is Lymphedema Classified?
The severity of lymphedema is classified into stages:
- Stage 1: This is the mildest form. Your limb is usually normal size in the morning, but swells during the day. Tissue will hold an indentation when you press on it.
- Stage 2: This stage is moderate. It’s characterized by an irreversible form of swelling in which your limb tissue feels spongy to the touch.
- Stage 3: This is the most severe stage. It involves an irreversible form of edema in which your affected limb hardens and becomes very large.
The goals of treatment are to reduce swelling as much as possible and to retain range of motion in the affected limb. Lymphedema that is caused by infection will be treated first with antibiotics in an effort to control pain and swelling, and to prevent the infection from spreading.
Compression is a common form of treatment for lymphedema. Compressing the affected limb encourages the lymphatic fluids to move toward your torso in a more normal pattern of circulation. Wrapping your arm or leg tightly with an elastic bandage or wearing a compression garment keeps continuous pressure on the swollen area.
Compression garments are socks, stockings, or sleeves that fit tightly over the swollen limb. Your doctor may suggest buying compression garments of a certain grade or level of compression according to the severity of your condition. Compression garments are available at most pharmacies and drugstores.
Another form of compression therapy is called pneumatic compression. Pneumatic compression involves vests or sleeves that inflate and stimulate the proper flow of lymphatic fluid.
Exercise can help manage lymphatic obstruction. Your muscles contract during exercise. These contractions put pressure on your lymph vessels. This helps fluid move through the vessels and reduces swelling.
Simple range of motion exercises such as knee bends or wrist rotations are designed to maintain flexibility and mobility. Light exercises can also stop fluid from pooling in your arms or legs. Try walking, doing yoga or low-impact aerobics, and swimming. Exercise for 20 to 30 minutes most days of the week. Speak with your doctor before starting an exercise routine.
You may require manual lymph drainage if compression therapy isn’t enough. Manual lymph drainage is a type of massage therapy performed by a qualified professional. Manipulating tissues allows the lymph fluids to drain more freely. You should not undergo manual drainage if you have cellulitis or other types of skin infections.
The outlook for lymphatic obstruction varies for each person. In most cases, you’ll deal with some level of swelling on a regular basis. You may notice less swelling over time, but most people have permanent edema.