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Lymphedema is swelling caused by excess lymphatic fluid (lymph) collecting in the body’s soft tissues, usually in the arms or legs. It is a chronic (ongoing) condition seen mostly in people who have undergone cancer interventions including surgery, radiation and chemotherapy.

In treatment for some cancers, lymph nodes and vessels are removed or damaged throughout the course of treatment. This can cause a disruption in lymphatic drainage, where lymphatic fluid doesn’t drain properly from your body.

The condition can be mild with minor swelling and discomfort, to severe, when swelling is extensive, bringing with it secondary skin changes. If you’ve developed lymphedema, a skin infection can be a serious problem.

Treatment of lymphedema includes treating swelling and prevention of infections. Exercise, compression garments and pumps, manual lymph drainage, meticulous skin care, therapy and a healthy lifestyle can all help control your swelling.

The lymphatic system is responsible for filtering out waste products from your body. It filters out cellular debris and transports white blood cells to fight infection throughout the body. When you are sick, it helps filter out toxins, bacteria and viruses.

Lymph is made of proteins, fats, glucose, salts, blood cell fragments and water. The plasma protein molecules in lymph are large. Disruption to the lymphatic system can make filtering out these protein molecules harder. Lymphedema is a protein-rich swelling and bacteria feeds on protein – which means a person with lymphedema is more likely to get infections. So avoiding cuts, scrapes or any trauma to the affected region is very important.

There are two types of lymphedema:

Primary lymphedema comes from rare, inherited conditions when the lymphatic system doesn’t develop properly. Lymphedema from these conditions can appear at these ages:

After age 35: A rare, late-onset lymphedema (lymphedema tarda) can cause lymphedema after 35. This type usually causes swelling only in the legs.

Secondary lymphedema is the most common form of lymphedema. It is caused by disruption to the drainage of the lymphatic system that occurs with trauma. In the U.S., cancer treatments are the most common cause of damage to the lymphatic system. However, not everyone who has cancer treatment develops lymphedema.

In the U.S, primary lymphedema is rare and affects only 1 in 100,000 people. Secondary lymphedema affects around 1 in 1,000 Americans. It’s most common in women who have been treated for breast cancer.

Causes and risk factors for lymphedema include:

Lymphedema is unpredictable, which makes it a frustrating condition. It may occur right after cancer interventions or it may happen months or even years later. Depending on the type of surgery and cancer treatments you receive, you may never experience lymphedema. It’s important to tell your provider right away if you notice any of the symptoms listed below.

Symptoms of lymphedema may develop slowly over time or they may have a sudden onset. If you are at risk for lymphedema, or have had a history of lymphedema and experience an injury or infection, this could cause a case to occur suddenly.

These milder, early signs may happen before you can see any swelling:

If you notice these symptoms, especially after cancer treatment, call your healthcare provider. Early treatment is important to keep swelling under control.

If you notice any signs of swelling after cancer surgery that involved lymph node removal, contact your healthcare provider right away. At your visit, your provider will do a physical exam to check for swelling.

You may be asked to do imaging tests, which are non-invasive (not surgical). These can help find problems with your lymphatic system. Imaging tests may include:

Treatments vary, depending on the stage and cause of the condition. Physical treatment is the standard, though antibiotics may be prescribed for infections. Antibiotics used for treating these infections can include penicillin (amoxicillin) or, in case of penicillin allergy, clindamycin or clarithromycin. Diuretics (water pills) don’t play a major role in treatment of lymphedema.

As of now a cure for lymphedema has not been found, however symptoms such as swelling, pain and discomfort can be improved with proper management and treatment.

The most effective treatment for lymphedema pain is to reduce swelling. Usually this helps to ease some of your discomfort. Because everyone is different, your provider can advise you on use of non-steroidal anti-inflammatory drugs (NSAIDs), like aspirin, ibuprofen and naproxen, or non-NSAIDs like acetaminophen. The prescription NSAID ketoprofen has shown promise in some patients in reducing pain and swelling.

Your providers may send you to a lymphedema therapist. These trained specialists can get you started on the best ways to keep swelling under control.

The most common treatments include:

Surgery is considered if other nonsurgical treatments aren’t working. Not everyone is a candidate for surgery, but for some people symptoms can be eased with a surgical procedure.

Generally, compression sleeves and stockings for lymphedema aren’t covered by Medicare. A home compression pump will be covered if compression garments aren’t working well. If you have a secondary insurance to Medicare, they may cover compression garments and pumps as well. Talk to your provider about all your payment options with lymphedema therapy.

While there’s no cure for lymphedema, lifestyle changes can help control your discomfort and reduce swelling. Exercising, practicing good hygiene, wearing the right clothing and eating healthy can all help you feel better and more in control of your condition.

Exercise is one of the best ways to keep fluid moving within your body. Always check with your provider before starting a new exercise program. Your therapist may have special exercises for you depending on the stage of your condition.

Stop exercise if it’s causing pain and discuss this with your provider. If your affected arm or leg becomes tired during the exercise, cool down, rest and elevate it. As you resume exercise you want to make sure you slowly increase frequency and duration to allow your body time to adjust.

Avoid infections by practicing good hygiene and skin care

Avoid tight clothing, shoes or jewelry. Wear loose clothing that won’t restrict movement of your arms and legs. Wear comfortable, closed-toe shoes and avoid tight hosiery and socks. If you have to wear watches or jewelry, be sure they’re worn loosely on the affected arm.

Sit properly. To keep fluid flowing in your legs, try practicing a good posture by keeping your feet flat on the floor and avoid crossing your legs. Try not to sit longer than 30 minutes.

Consider wearing compression garments if traveling by plane. If you plan to fly in the near future, ask your provider if you should wear a compression garment on your affected arm or leg to minimize swelling. For long flights, you may need to bring additional bandages.

Be careful at medical checkups and blood draws. Ask to have your blood pressure checked on the unaffected arm. Avoid injections, IV lines or blood draws on the affected side when possible.

Swelling is better controlled with good nutritional habits. Your lymph systems works more effectively with better nutrients taken from minimally processed, natural foods (fruits, veggies, whole grains). Healthy eating keeps you closer to your ideal weight, an important factor in reducing symptoms. And it makes you feel better overall.

There is no sure way to prevent all cases of lymphedema. But symptoms can be caught early and minimized. No matter the type or cause of your lymphedema, you can take steps to reduce or even prevent swelling.

If you’ve had breast cancer surgery:

Other ways to prevent symptoms:

Though lymphedema isn’t generally life-threatening, it’s a life-long condition. Controlling swelling and preventing infection in swollen areas is essential to good health. With the help of lymphedema specialists you can better manage your symptoms.

If you don’t treat lymphedema it can become dangerous to your health. If swelling becomes unmanageable you’ll be more likely to get infections and other complications. Every infection can weaken your immune system and make you more vulnerable to life-threatening illnesses.

Chronic and untreated lymphedema can also lead to the fatal condition lyphangiosarcoma. Though very rare, this soft tissue cancer (also called Steward-Treves syndrome) can occur in women after double mastectomy. Signs of this condition are blue-red or purple markings on the skin that become ulcers and spread quickly.

Other causes of lyphangiosarcoma include primary congenital lymphedema, trauma or filarial lymphedema (a type rare in the U.S.).

A note from Cleveland Clinic

Many people with lymphedema have mild cases and cope with it well. Swelling in the legs, arms or other areas can be minor, barely noticeable. Keeping up with proper management and treatments such as regular exercise and eating well can help keep symptoms at a minimum.

But what if your symptoms are severe? Moving around freely with swollen legs and arms, doing normal activities and even dressing yourself are next to impossible. You’re constantly on the lookout to avoid infections that can happen through even the slightest injuries to the affected areas.

Lymphedema is a serious side effect to cancer treatment that can take a toll on your spirits and self-esteem, and even lead to depression. It’s a tough condition. But you can take steps to control your symptoms and make living with it easier.

If you’re hurting physically or emotionally, please reach out to your therapist or healthcare provider. They can give you the help you need or point you in the right direction to find it.

Last reviewed by a Cleveland Clinic medical professional on 06/15/2020.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy