IS LYMPHEDEMA 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 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.

The unpleasant sensory symptoms of lymphedema are associated with real tissue and organic damage, which results in chronic 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 the best treatment for 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. 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:

• Symptom Frequency, Intensity, And Distress In Patients With Lower Limb Lymphedema
• Is Lymphedema Painful?
• Can Lymphedema Be Fatal?

SCIENTIFIC SOCIETIES

• GERMAN SCIENTIFIC SOCIETY GUIDELINE: Diagnostics and Therapy of Lymphoedema.
• THE INTERNATIONAL SOCIETY OF LYMPHOLOGY: Consensus Document.

DIAGNOSE AND TREATMENT

• LYMPHATIC MEDICINE: Paradoxically and Unnecessarily Ignored
• CHRONIC OEDEMA/LYMPHEDEMA: Under-recognized and Under-treated
• LYMPHEDEMA: From Diagnose to Treatment
• TREATMENT: Lymphedema Limbs
• LOWER EXTREMITY LYMPHEDEMA UPDATE: Diagnose and Treatment Guidelines
• BEFORE THE PROBLEM BECOMES ELEPHANTIASIS: How to Solve Lymphatic Congestion
• LYMPHATIC MANAGEMENT: An International Interest between Developed and Developing Countries, Similarities, differences, and Challenges.
• THE RISK OF GENITAL EDEMA after External Pump Compression for Lower Limb Lymphedema
• WHAT IS THE ROLE OF EXCISIONAL SURGERY IN THE TREATMENT OF LYMPHEDEMA

INFECTIONS

• INFECTIOUS COMPLICATIONS OF LYMPHEDEMA
• ACUTE INFLAMMATORY EXACERBATIONS IN LYMPHEDEMA
• LYMPHEDEMATOUS AREAS: Privileged sites for Tumors, Infections, and Immune Disorders
• MALIGNANT TUMORS: As Complications of Lymphedema

PEDIATRIC AND PRIMARY LYMPHEDEMA

• NORD: Rare Disease Database. Lymphedema
• AN APPROACH TO FAMILIAL LYMPHOEDEMA
• PRIMARY LYMPHEDEMA
• PEDIATRIC CHILDREN LYMPHEDEMA: A Retrospective Chart Review of 86 Cases
• LYMPHATIC FILARIASIS: An Infection of Childhood

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• WHICH COUNTRY PROVIDES THE BEST LYMPHOEDEMA TREATMENT COVERAGE 

• WHAT IS THE BEST TREATMENT OPTION FOR PAEDIATRIC AND PRIMARY LYMPHOEDEMA

• SPANISH LYMPHEDEMA ASSOCIATIONS – SPANISH NATIONAL FEDERATION OF LYMPHEDEMA ASSOCIATIONS

LYMPHEDEMA INCIDENCE 
AND PREVALENCE
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