miércoles, 1 de abril de 2020

IS LYMPHEDEMA PAINFULL - Does Lymphoedema Ache - Pain in Lymphoedema - Lymphoedema Symptoms - Pediatric and Primary Lymphoedema - Secondary Lymphoedema - Lymphatic Filariasis and Podiconiosis - Lymphostatic Elephantiasis

For many decades and possibly even centuries, lymphedema has been underestimated from a medical 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. Read more about the signs, symptoms, and complications of the disease HERE.


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 long been a neglected sequela and overlooked problem.



The unpleasant sensory symptoms of lymphedema are associated with real tissue and organic damage, which may result in chronic discomfort and somatic pain of varying intensity. Without treatment or under-treatment, both physical and reduced mobility components increase, measurably reducing the quality of life and limiting labor access and socialization, all of which can also induce anxiety and depression. Read more about disability and lymphedema HERE.



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 (Organic Impairment). 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), can lead to distension, inflammation, and fibrosis).
  • 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: This is the swelling of soft tissues as a result of excess fluid accumulation. It can be a general or isolated body site, but mostly affects 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, where 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. Studies have reported that discomfort and pain are common symptoms of lymphedema. 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: This 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 chronic 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 perform 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 (Organic Disability), which may also produce a consequent physical and functional limitation (Physical Disability) due to the edema. 




IMPORTANT NOTICE 

Lymphedema is a serious chronic and progressive disease due to an organic dysfunction (Organic Lymphatic Vascular Disease). The clinical treatment of lymphedema is neither a cosmetic nor an aesthetic treatment. The treatment of lymphedema is to control its progression and alleviate the symptoms related to dysfunction of the lymphatic circulatory system. 

To prevent and avoid serious complications associated with treatment, such as the possible displacement of edema to previously unaffected areas when compression therapy is applied for volume reduction, patients should use highly specialized and experienced therapists. 

Professional qualification and instruction delivered remotely online are not the same as live hands-on practical instruction in the clinical training and certification of lymphedema therapists, similar to all other rehabilitation, medical, and surgical training programs, and especially for developing the necessary manual skills to treat a disease as complex as lymphedema. 

Patients should also take special care when choosing a Multidisciplinary Expert Center of Reference for Lymphedema, as not all countries and centers provide the same treatment options. The best choice is a center of reference that provides Complete Decongestive Therapy (CDT), which is recognized as the “Gold Standard” treatment for lymphedema.

  • Read more about what is the best treatment option for Lymphedema HERE.
  • Read about what are the principal functions of Manual Lymphatic Drainage HERE.
  • Read about what are the main differences between the two principal lymphedema treatment protocols HERE. 
  • Read about what are the strategies for the implementation of low-cost treatment options for Lymphedema HERE.

REFERENCES

(Click on the texts to read the research articles)

SCIENTIFIC SOCIETIES

PATHOPHYSIOLOGY

CUTANEOUS COMPLICATIONS
INFECTIOUS COMPLICATIONS
CELLULITIS / DERMATOLYMPHANGIOADENITIS
TUMOURS

TREATMENT

COMPRESSION GARMENTS

DISABILITY

DISFIGUREMENT

PSYCHOSOCIAL IMPACT

PEDIATRIC LYMPHEDEMA

LYMPHATIC FILARIASIS / PODOCONIOSIS











  • WHAT KIND OF DOCTOR TREATS LYMPHEDEMA/LYMPHOEDEMA - WHICH MEDICAL SPECIALITIES ARE RELATED TO LYMPHEDEMA












LYMPHEDEMA INCIDENCE 
AND PREVALENCE
(click on the texts) 






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