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Oedema
What is oedema?
Oedema is an abnormal accumulation of fluid in the body. Oedema can be a result of cancer, blood vessel problems, scars, radiotherapy, chemotherapy, surgery or an accident. This can damage the lymphatic vessels, resulting in fluid accumulation.
There are different types of oedema, such as lymphoedema, lipoedema and venous oedema.
Different treatments are also available, you can find these on the page oedema therapy.
What is lymphoedema?
A disorder of the lymphatic system causes insufficient drainage of tissue fluid. Fluid accumulation in the skin and underlying tissues causes (painful) swelling and stiffness, among other things.
Symptoms
Lymphoedema results in the affected area, e.g. arms, legs and/or the rest of the body, feeling heavy and/or tense. Sometimes the swelling causes nagging or stabbing pain and stiffness in joints. Movements may be restricted. Weight and body size may increase. Lymphoedema may also occur in the midline (chest, abdomen, back and genital region). This is often the result of cancer treatment. You can see the skin therapist for this too, treatment and compression in these regions can provide tremendous relief.
How does lymphoedema occur?
The lymphatic system is a network of lymphatic vessels and lymph nodes, often called glands. They are part of our bodily cleansing and immune system. The lymphatic vessels collect the fluid located between the cells of our tissues. Through the lymphatic vessels, this tissue fluid flows to the lymph nodes, better known as glands. These glands, located in our groins, armpits and neck, among others, filter and clean the tissue fluid. They filter waste products and thus render any pathogens harmless. If parts of the lymphatic system are damaged or missing, the tissue fluid is not drained or only partially drained. The accumulated fluid causes swelling that we call lymphoedema.
At primary lymphoedema lymphatic system abnormalities are congenital. The lymphoedema may manifest itself immediately after birth, or at a later stage, for example after trauma or surgery.
Secondary lymphoedema results from external influences, such as a (wound) infection, severe burning of the skin or an open bone fracture. Secondary lymphoedema can also be a result of radiotherapy (cancer treatment) or surgery that damages the lymphatic system.
What is lipoedema?
Lipoedema is a condition in which fatty tissue is unevenly distributed throughout the body. Localised fat deposits develop on hips, thighs, lower legs, inner knees or arms, unaffected by weight reduction and exercise. Moreover, these fat deposits can cause pain symptoms or make the legs tire quickly. Lipoedema literally means 'fat swelling' and is also known as painful 'fat syndrome'. It is an infrequent chronic condition of adipose tissue that mainly affects women. Lipoedema is characterised by symmetry: the abnormal fat distribution occurs on both sides. This is in contrast to lymphoedema, which can also occur on one leg or one arm.
Symptoms
The first symptoms of lipoedema are disproportionately heavy legs, hips, buttocks and/or arms where the excess fatty tissue stops abruptly at knees or ankles or at elbows or wrists. Weight loss hardly affects the disproportionate fat and fluid deposits. Upper and lower body may differ by as much as two to three clothing sizes. Lipoedema tissue is sensitive, pain can range from mild to extreme where even a light touch or pressure is intolerable. The skin looks walnut-like like an extreme form of cellulite (orange peel). Bruising develops quickly. Legs feel heavy and swollen due to fluid accumulation. The volume can lead to joint problems, such as knee problems, and the skin of the legs can be damaged by abrasion.
Patients suffer from fatigue and are sometimes limited in their mobility.
How does lipoedema occur?
There is still much uncertainty about the origin of lipoedema. However, it is known that the disease occurs more in women than in men and that it is not caused by overeating. Moreover, it is certain that hereditary factors play an important role. Lipoedema generally develops during or just after puberty, but the condition can also manifest during pregnancy or later in life during menopause. Hormones play a role; sometimes a thyroid disorder is the cause.
What is venous oedema?
Defective valves in the veins (the venous system) of the legs prevent optimal return flow of oxygen-poor, waste-rich blood from the legs towards the heart. Lymph fluid is insufficiently drained. The legs become heavy, restless and swell. Fluid accumulation and dilated blood vessels or varicose veins can cause pain.
Symptoms
Venous oedema causes a (lead) heavy or restless feeling in the legs during the day. The legs and ankles swell due to fluid accumulation, leading to a burning sensation or convulsive pain and stiffness, also known as 'restless legs'. Increasing pressure in the malfunctioning veins causes the blood vessels to dilate, leading to the formation of varicose veins. Various skin abnormalities may appear such as eczema, a brown or white discolouration or sometimes even wounds. Venous oedema frequently occurs in combination with lymphoedema.
How does venous oedema occur?
The blood vessels in the legs contain valves that open when blood is drained from the legs. To prevent this deoxygenated and waste-rich blood from flowing back, the valves close. If the valves do not function properly, blood is not drained properly. This also affects the lymph fluid in the tissue which is also not drained properly by the lymphatic system. Fluid accumulates in the legs, especially around the ankles which become thick and swollen during the day. Blood pressure in the leg vessels increases, vessels and vessels dilate and varicose veins develop. Venous oedema, also known as chronic venous insufficiency (CVI), is a combination of fluid accumulation (oedema) and malfunctioning blood vessels (the venous system). It can occur at any age, but the elderly, pregnant women and the disabled are at higher risk.
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