For
many decades and possibly
even centuries,
lymphedema has been underestimated from a medical and social point of view,
as a painless and non-severe illness. Nowadays specialist physicians
have begun to recognize pain as a symptom that affects a large
percentage of patients with lymphedema, as well as other physical
manifestations, which
can also reach significant degrees of physical and psychological
suffering.
Regarding
the severeness and graveness of lymphedema, this
is something now recognized too, especially concerning its life-threatening infections and malignant complications. Symptoms
related to lymphatic dysfunction, have for long been a neglected
sequela and overlooked problem.
To
analyze pain related to edema due to lymphatic dysfunction, the
definition of lymphedema can give a greater understanding
and focus on its
physical
and sensory
implications.
DEFINITION
OF LYMPHEDEMA: Lymphedema
is a chronic slow-progressing disease of the skin, that can lead to severe stages.
It is an incurable but treatable medical condition, which is caused
by injury, trauma, or congenital defects causing a permanent failure
in the Lymphatic Circulatory System. The characteristic of lymphatic edema
is a progressive life-long swelling, inflammation, and build-up of
fluid in the body's tissues. There are symptoms and
complications associated with lymphedema, some of which are potentially
debilitating, physically and functionally
impairing,
and even life-threatening.
The
following list of terms appears related to the definition of
lymphedema.
Amongst are vocables
that
define physical and sensory symptoms that are present in lymphedema, and
which can be severe in some patients:
- INFLAMMATION: A localized reaction that produces redness, warmth, swelling, and pain as a result of infection, irritation, or injury. The accumulation of protein-rich interstitial fluid in the tissues in lymphatic dysfunction (Lymphedema), leads to distension, inflammation, and fibrosis.
- CHRONIC INFLAMMATION: This is when response lingers, and over time may have a negative impact on tissues and organs. Clinical studies have implicated inflammation as a critical component in the pathophysiology of lymphedema.
- INFECTION: The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites that are not normally present within the body. Due to impairment of bacterial elimination via lymphatics, chronic lymphedema is predisposed to infections such as DLA (Infectious Cellulitis). Read more about Infectious Cellulitis and lymphedema here.
- SWELLING: An abnormal bodily or localized volume enlargement. Swelling may cause pain and limit how well the affected area moves. Swelling in Lymphedema is caused by lymph fluid build-up in arms and legs, but can also happen in other parts, or the whole body as well.
- FLUID BUILD-UP AND RETENTION: A swelling in one or more parts of the body where fluid gets trapped. Symptoms of fluid build-up include aching limbs or joints.
- OEDEMA: Is the swelling of soft tissues as a result of excess fluid accumulation. It can be a general or isolated body site, but mostly affect arms and legs, and is called peripheral edema. Common signs include a sensation of tautness and pain in the surrounding area. Edema is often most prominent at the end of the day because fluid pools while people maintain an upright position. In blood venous disease the swelling usually goes down when in a reclined position, but this is not the case with chronic lymphedema, the swelling normally persists even after extended periods of bed rest.
- PAIN: This is an unpleasant sensation that can range from mild and diffused areas to localized discomfort and agony. Pain has both physical and emotional components. The physical part of pain results from nerve fibber stimulation that carries impulses to the brain. In lymphedema, studies have reported pain as a common symptom. Theories suggest that the stimulation of sensory nerves resulting from the increased lymph pressure due to the congestion, may cause pain and that the congestion may also produce pain due to the tension forces upon the subcutaneous tissue.
- ACHE / ACHENESS: Is to suffer a dull persistent continuous pain, as opposed to sharp pangs or twinges. An ache can be either dull or constant. In lymphedema, symptoms include discomfort or aching in the affected limb.
- PHYSICAL AND FUNCTIONAL IMPAIRMENTS: This is a disability that limits a person's capacity to move, coordinate actions, or performs activities. In lymphedema, chronic progressive swelling leads to limb heaviness, pain, and recurrent infections, significantly decreasing quality of life and limiting how well the affected area moves. Lymphedema in the context of disability is the consequence of an organic impairment, that also produces a consequent physical and functional limitation due to the edema. Read more about disability and lymphedema here.
Referencias:
SCIENTIFIC SOCIETIES
DIAGNOSE AND TREATMENT
INFECTIONS
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