Signs & Symptoms of Lymphedema
Lymphedema (LE) typically manifests itself with the following signs and symptoms:
- Limb heaviness is the most common early symptom of lymphedema (LE)
- Aching limbs or unusual and excessive pain/discomfort and fatigue in the limbs
- Pitting edema – evident when the skin is depressed with your finger for a few seconds and the indentation does not immediately disappear
- “Ski-jump” (concave) toenails
- Fibrosis (thickening of the tissue that creates a hardening of the skin)
- Skin changes (redness/purplish discoloration, dryness, increased warmth)
- Disfiguring edema – tightness of the skin and awareness that clothing, shoes and jewelry feel tighter in the affected extremity
- Decreased range of motion
- Decreased functional mobility
- Decreased muscular strength
- Open wounds (venous ulcers)
Stemmer sign, a thickened skin fold when pinched at the base of the second toe or finger, is a clinical indicator of lymphedema. However, a negative or absent Stemmer sign does not rule out the possibility of lymphedema.
Stages of Lymphedema
Stage 1 (Mild)
With rest and/or elevation, the swollen limb, returns to normal size. Pitting (when pressure is applied to the skin of the swollen area and released an indentation remains) may be present.
The tissue can present with pitting, but often in this stage more significant skin changes are present with development of fibrosis tissue and the tissue may have a spongy feel.
The tissue at this stage can be hard (fibrotic). The swelling may be largely irreversible and the limb can be very large and swollen. Infections are possible at any stage of lymphedema, however, the risk increases as the stages progress.
It is important to note that while the above is generally true, there may be differing levels of severity within each stage.