Lymphedema: Causes, Symptoms, and Treatment

Lymphedema is a chronic pathological condition that affects the lymphatic system, compromising its ability to adequately drain fluids from the tissues. This dysfunction leads to the abnormal accumulation of lymph, causing swelling and other debilitating symptoms that can significantly impact a patient’s quality of life. Among the available therapeutic options, the use of specific compression stockings has proven particularly effective in managing this condition.

How the Lymphatic System Works and the Pathogenesis of Lymphedema

To fully understand lymphedema, it is essential to know how the lymphatic system functions. This complex network of vessels and tissues plays a crucial role in maintaining fluid balance in the body, supporting immune defense, and transporting nutrients.

Under normal conditions, the lymphatic system drains excess interstitial fluid, proteins, and other molecules from tissues and returns them to the bloodstream. When this process is impaired, lymph accumulates in the tissues, resulting in lymphedema.

Lymphedema can be classified into two main types:

• Primary lymphedema: caused by congenital malformations of the lymphatic system, usually appearing during childhood or adolescence

• Secondary lymphedema: more common, resulting from damage to the lymphatic system due to surgery (often cancer-related), radiation therapy, trauma, or infections

Symptoms and Impact on Quality of Life

Lymphedema typically presents with the following symptoms:

• Progressive and persistent swelling, most often in the limbs

• A feeling of heaviness and tightness in the affected area

• Skin changes, with the skin becoming tight, thickened, and sometimes dimpled (like orange peel)

• Reduced mobility of the affected limb

• Increased susceptibility to skin infections

These symptoms can significantly affect daily life, limiting physical activities, causing aesthetic and psychological discomfort, and increasing the risk of complications.

Multidisciplinary Therapeutic Approach

The treatment of lymphedema requires a personalized and multidisciplinary approach aimed at reducing swelling, relieving symptoms, and preventing complications. Key strategies include:

Complete Decongestive Therapy (CDT): considered the gold standard, and includes:

• Manual lymphatic drainage: a massage technique that stimulates lymph flow

• Compression bandaging: to reduce swelling and improve circulation

• Therapeutic exercises: specific movements to support lymphatic drainage

• Skin care: to prevent infections and complications

Compression therapy: the use of elastic compression garments (stockings and sleeves) during the day and night is essential for long-term management of lymphedema.

Patient education: patients must be taught hygiene practices, weight control, self-monitoring, and how to properly use compression garments.

Surgery: options such as liposuction or lymphatic bypass surgery may be considered in selected cases.

Compression Stockings: A Cornerstone of Lymphedema Treatment

Compression stockings specifically designed for lymphedema are an essential therapeutic tool, offering numerous benefits to patients. Their effectiveness is based on carefully engineered technical features:

Structure and design:

• Flat-knit fabric: allows for uniform containment

• Graduated compression, stronger at the ankle and decreasing toward the top

• Custom-made to ensure an optimal fit to the limb

Materials and technology:

• Breathable fabrics for patient comfort

• Antibacterial properties to reduce the risk of infection

• Various compression classes available (typically class 2 or 3) to suit individual needs

In addition to daytime stockings, nighttime garments are also used to help maintain the results achieved during daily treatment. By preventing fluid buildup during sleep, they can improve both comfort and symptom control.

Mechanism of Action and Therapeutic Benefits

The effectiveness of compression stockings in managing lymphedema is based on several mechanisms:

• Graduated decreasing compression: encourages lymph fluid movement toward the center of the body, counteracting fluid accumulation in the limbs

• Tissue support: the pressure exerted on subcutaneous structures improves lymphatic valve function

• Microcirculation stimulation: compression promotes blood flow, which indirectly supports lymphatic drainage

• Prevention of further accumulation: compression limits tissue expansion, reducing the buildup of new lymph

These mechanisms result in tangible benefits for patients:

• Significant reduction in swelling

• Improved lymphatic drainage

• Relief from heaviness and tension

• Increased mobility in the affected limb

• Prevention of complications associated with chronic lymphedema

Guidelines for Effective Use

To maximize the benefits of compression stockings in lymphedema treatment, the following practical guidelines should be followed:

• Compression garments must be fitted and supplied by a specialized orthopedic technician who will guide the patient through measurement, fitting, and training on how to wear and care for the stockings

• Put on stockings in the morning, before getting out of bed, when swelling is minimal

• Use specific tools to help with proper application (gloves, plastic donning aids, etc.)

• Ensure the stockings are worn correctly, without folds or rolls that may reduce effectiveness

• Wear the stockings daily, especially during physical activity or when standing for long periods

• Combine their use with other treatment elements, such as specific exercises and proper skin care

• Replace the stockings when they lose elasticity, generally every 4 to 6 months with daily use

• Regularly consult a specialist to monitor treatment effectiveness and make necessary adjustments

Conclusions and Future Perspectives

Compression stockings are a key component in managing lymphedema, offering an effective and non-invasive solution to improve patients’ quality of life. Their action, based on well-established scientific principles, integrates seamlessly with other therapies in a comprehensive treatment plan.

However, it is important to emphasize that lymphedema treatment must be personalized according to each patient’s specific condition. Consulting a lymphology specialist is essential to develop an optimal therapeutic plan that includes appropriate use of compression stockings alongside other management strategies.

Research in the field of lymphedema continues to advance, promising new therapeutic options and improvements in existing technologies. In this context, compression stockings are likely to evolve, incorporating increasingly advanced materials and innovative designs to offer even greater comfort and effectiveness.

For patients living with lymphedema, the combination of proper treatment, correct use of compression stockings, and regular follow-up with qualified professionals is the best strategy to manage this chronic condition effectively and significantly improve quality of life.

Book an appointment with our specialized technicians — they are available to answer all your questions and create a personalized care plan.

? Contact us at 035 212110 — Location: Via T. Taramelli 21/23, Bergamo.