About Lymphedema of the Legs

This video explains what lymphedema is and how you can reduce your risk of developing lymphedema of the legs. Lymphedema is a type of swelling that can develop in your legs after the lymph nodes in your groin or pelvis have been removed or injured.

Your lymph nodes may have been removed surgically to get rid of cancer, but this puts you at risk for developing lymphedema in your leg or legs.

Lymph nodes are small bean shaped structures that are located throughout your body, primarily by your neck, armpits, and groin. They absorb water, protein, and waste from your tissues and send them to the bloodstream. If this fluid cannot get out of your legs, it stays in the tissue causing it to swell.

There are some things we know that make a person more likely to develop lymphedema such as gaining weight or being overweight, having an infection in the affected leg, having radiation to the pelvis, and having cancer that comes back.

There are other things that may increase your risk such as being inactive, the activities associated with air travel, constricting the leg such as wearing tight clothes, shoes, or jewelry that cause a red mark or indent on your leg.

Being exposed to extreme temperatures such as saunas or hot tubs, ice or ice packs that are placed on your leg for extended periods of time. At this time there is no way to know who will develop lymphedema, but there are things you can do that may lower your risk.

One way to reduce your risk of getting lymphedema is to protect your skin from injury or infection. This is because cells that fight infection go to the injured area and cause swelling.

Your legs may not be able to drain this added fluid. Moisturize your skin often to prevent cracking. Apply lotion when your skin is damp, such as after a bath or shower. Keep the area between your toes dry to prevent infection. Wear sunscreen with a SPF of 30 or higher to protect your skin from the sun when you are outdoors.

When taking care of your toenails, be careful not to cut too close to the nail bed. If you get pedicures, make sure that the salon uses clean instruments. Do not cut your cuticles instead gently push them back or use cream to keep them soft.

To remove unwanted hair, use an electric razor. Avoid waxing and shaving with a regular razor. Getting a cut can increase your risk for infection. If you are trying something new on your skin, first, try it on an area where lymphedema is not a concern.

If you get a cut or scratch, wash the area with soap and water and apply a first aid ointment. Keep the area covered with a bandage until the skin has healed completely. Check your skin closely if you have any numbness. Taking good care of your skin is important to minimize risk for infection.

Signs of infection include progressive redness, swelling, warmth, or tenderness. Also be aware of other general signs of infection, such as a temperature higher than 104°F (which is 38°C) and chills. If you develop any signs of infection, call your doctor or nurse.

Extreme heat and cold may cause increased swelling in your leg. Avoid burns. When taking showers and baths, make sure the temperature is not too hot. You can travel by air; however, flying may increase your risk of developing lymphedema because of the decrease in pressure and long periods of sitting.

Consider the physical demands of your trip and try to plan ahead and pace yourself throughout the day if you plan to travel by air, pack and plan early so that you are less tired and stressed. Get enough sleep stay well hydrated and do not skip meals. Try to avoid salty foods which are often found in airport and airplane items.

Wear loose comfortable clothing and exercise throughout the flight this helps the circulation movement of lymphatic fluid and decreases your risk of blood clots. Also remember to get up and walk around as often as possible.

While you're on the plane, you can do simple foot and ankle exercises in your seat. Point your toes towards the ceiling and then back down towards the floor. Also rotate your feet in circles and then reverse the direction.

Other ways that can reduce your risk for developing lymphedema include: maintain your ideal body weight (having more weight leads to increased strain on your lymphatic and venous systems), minimize your salt intake (salt can cause swelling which may overwhelm your lymphatic system), try to avoid crossing your legs as much as possible, avoid having anything too tight on your legs and feet.

For example, make sure your footwear fits properly and if you wear toe rings or ankle bracelets, make sure they're loose. Lymphedema can develop at any time after your surgery. So, these precautions are lifelong.

Our bodies do not regenerate lymph nodes after they have been removed or damaged. Lymphedema is different from regular swelling after surgery. Anyone who has had surgery will have some swelling in the area near the incision. This is normal and should go away within weeks after surgery.

Early symptoms of lymphedema include swelling that starts in your lower leg which may move up your leg towards your torso if left untreated. At first, the swelling may come and go. It may get better when you raise your leg above your chest. Other early symptoms may include a feeling of heaviness in your leg or the feeling that your clothing, socks, or shoes fit too tightly.

Many people have what they call an increased awareness of the leg. Although lymphedema is a chronic condition, it is manageable and treatable. Treatment for lymphedema is called Complete Decongestive Therapy or CDT. CDT includes bandaging, manual lymphatic drainage, compression stockings, skin care, and exercises.

MSK’s lymphedema therapists will work closely with you to meet your individual needs. If you notice any signs of lymphedema, call your doctor or nurse. Your doctor can refer you to a certified lymphedema therapist. You can find more information about lymphedema in the resource Reducing Your Risk of Lymphedema of the Legs. You can also find it online at www.mskcc.org/pe.