miércoles, 1 de abril de 2020

IS LYMPHOEDEMA PAINFULL - Does lymphoedema ache - Pain in lymphoedema - Lymphoedema Symptoms - Pediatric and Primary Lymphoedema - Secondary Lymphoedema - Lymphatic Filariasis and Podiconiosis - Lymphostatic Elephantiasis - Rare Disease

For many decades and possibly even centuries, lymphedema has been underestimated from a medical and social point of view, as generally a painless and non severe illness. This assumption couldn't be further from the truth, and 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 also the question about the severeness and graveness of lymphedema, this is something now recognized too, specially concerning it's life threatening infections and malignant complications. Symptoms related to lymphatic dysfunction, have for long been a neglected sequela and overlooked problem.

The unpleasant sensory symptoms of lymphedema is associated with real tissue and organic damage, which results in chronic somatic pain of varying intensity. Without treatment or with under-treatment, both physical and reduced mobility components increase, measurably reducing the quality of life and limiting labour access and socialization, all of which can also induce anxiety and depression. Readmore about the best treatment for lymphedema here.

To analyse pain related to oedema due to lymphatic dysfunction, the definition of the term lymphedema can give a greater understanding and focus on it's physical and sensory implications. 

Lymphedema is a slow-progressing chronic disease which 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 a lymphostatic edema is a progressive life-long swelling, inflammation and build up of fluid in the body's tissues. There are symptoms and complications associated to lymphedema, some of which are potentially debilitating, physically and functionally impairing, and even life threatening

The following list of terms appear related to the definition of lymphedema. Amongst are vocables that define physical sensory symptoms that are present in lymphedema, and which can be severe in some patients:
  • DISEASE: Is an illness or sickness characterizd by specific signs and symptoms.
  • SYMPTOM: Is the subjective evidence of a disease or physical disturbance. 
  • INFLAMMATION: Is 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: 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: Is 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 as DLA (Infectious Cellulitis). Read more about Infectious Cellulitis and lymphedema here.
  • SWELLING: Is an abnormal bodily or localized volume enlargement. Swelling may cause pain and limit how well the affected area moves. Swelling in Lymphedma is caused by lymph fluid build-up in arms and legs, but can also happen in other parts or whole body as well. 
  • FLUID BUILD-UP AND RETENTION: Is seen as 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 a symptom, not a disease. It is the swelling of soft tissues as a result of excess fluid accumulation. It can be a general or isolated body site, but most affects arms and legs, and is called peripheral oedema. Common signs include a sensation of tautness and pain in the surrounding area. Oedema 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 reclined position, but this is not the case regarding chronic lymphedema, the swelling normally persists even after extended periods of bed rest.
  • PAIN: Is an unpleasant sensation that can range from mild and diffused area, to localized discomfort and agony. Pain has both physical and emotional components. The physical part of pain results from nerve fibber stimulation that carry 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 usually dull persistent continuous pain, as opposed to sharp pangs or twinges. An ache can be either dull and constant. In lymphedema, symptoms include discomfort or aching in the affected limb. DULL PAIN is a deep ache felt in an area, but typically doesn't stop you from daily activities / Dull pain is usually a bearable but long-term pain.
  • PHYSICAL AND FUNCTIONAL IMPAIRMENTS: Is the 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 consequence of an organic impairment, that also produces a consequent physical and functional limitation due to the oedema. Read more about disability and lymphedema here.


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