The lymph system helps your body fight illness. Lymph fluid travels throughout the body in lymph nodes and vessels. The fluid builds up if these nodes or vessels are blocked, damaged, or missing. Fluid build-up in the arms or legs is called lymphedema. There are two types of lymphedema:

  • Primary lymphedema is uncommon and occurs because people are either born without lymph nodes and vessels or they do not work properly.
  • Secondary lymphedema occurs when there is injury to the lymph nodes or vessels or there is blockage by infection or tumors.

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Lymphedema can be caused by a variety of factors:

  • Primary lymphedema
    • Being born without lymph vessels and nodes or with poorly functioning ones
    • Milroy’s disease
    • Meige disease
    • Late-onset lymphedema
  • Secondary lymphedema
    • Surgery for cancer
    • Radiation treatment for cancer
    • Burns
    • Liposuction
    • Surgery on blood vessels
    • Infection
    • Trauma

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These factors increase your chance of developing lymphedema. Tell your doctor if you have any of these risk factors:

  • Surgery that removed lymph nodes such as breast cancer surgery
  • Radiation treatment
  • Cancer
  • Infection
  • Parasites — tropical/subtropical regions
  • Overweight
  • Poor diet
  • Older age

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Symptoms of lymphedema include:

  • Swelling in arms, legs, fingers, or toes
  • Loss of range of motion
  • Infection
  • Aching, pain, or discomfort
  • Heaviness or tightness of the skin
  • Clothes, shoes, or jewelry that feel too tight
  • Hardening of the skin
  • Redness of the skin

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Cases of lymphedema can vary from mild to severe. Your doctor will ask about your symptoms and medical history. A physical exam will be done. Images may need to be taken of your body structures. This can be done with:

  • MRI scan
  • CT scan
  • Duplex ultrasound or Doppler ultrasound

Other tests may include:

  • Measurement of your arms and/or legs—to assess the severity of fluid build-up
  • Lymphoscintigraphy—a test that uses dye to trace the travel of fluid through your lymph system

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Talk with your doctor about the best plan for you. Physical therapy treatment may include the following:


A physical therapist can provide manual lymph drainage to encourage the lymph nodes and vessels to move the excess fluid  into the correct drainage area.


Compression stockings, sleeves, or bandages are often used to direct fluid away from your affected arm or leg. A physical therapist can provide the proper gradient pressure to the involved limb.

Therapeutic Exercise

Therapeutic exercise is needed for joint flexibility and muscle contraction necessary for optimal lymphatic flow.

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If you are at risk for developing lymphedema, there are measures you can take to help reduce your chance of having the condition. You can prevent swelling and fluid if you:

  • Do not allow anyone to take blood or blood pressure on your affected arm or leg.
  • Wear a medical bracelet warning of your risk for developing lymphedema.
  • Avoid crossing your legs or carrying items on your shoulder if either area is at risk.
  • Maintain a healthy weight and eat properly.
  • Avoid ice packs or heating pads to the affected area.
  • If you had lymph nodes in your armpit removed during breast cancer surgery, participating in a physical therapy program may help to prevent lymphedema.

You can prevent side effects if you:

  • Keep your affected arm or leg clean.
  • Keep hands and feet protected by wearing gloves and shoes.
  • Use an electric razor to shave.
  • Use sunscreen when outdoors.

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  • National Cancer Institute

  • National Lymphedema Network

  • Canadian Cancer Society

  • Lymphedema Association of Quebec

  • Lymphedema. National Cancer Institute website. Available at: Updated March 6, 2013. Accessed May 16, 2013.
  • Lymphedema. Society for Vascular Surgery website. Available at: Updated December 2011. Accessed May 16, 2013.
  • What is lymphedema? The National Lymphedema Network website. Available at: Accessed May 16, 2013.
  • 1/22/2010 DynaMed’s Systematic Literature Surveillance Torres Lacomba M, Yuste Sánchez MJ, Zapico Goñi A, et al. Effectiveness of early physiotherapy to prevent lymphoedema after surgery for breast cancer: randomised, single blinded, clinical trial. BMJ. 2010;340:b5396.


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