Understanding Stage 2 Lymphedema

Living with stage 2 lymphedema brings unique challenges, but understanding your condition is the first step toward effectively managing it. While this stage marks a point where the condition becomes irreversible, there are many ways to maintain your quality of life and prevent symptoms from progressing.

Keep reading to explore everything you need to know about stage two lymphedema, from its symptoms and causes to diagnosis and treatment options.

• Key Takeaways
• What Is Stage 2 Lymphedema?
• What Are the Signs Symptoms of Stage 2 Lymphedema?
• What Causes Stage 2 Lymphedema?
• How Do You Diagnose Stage 2 Lymphedema?
• How Is Stage 2 Lymphedema Treated?
• Wrapping Up: Controlling Symptoms of Stage 2 Lymphedema
  

Key Takeaways

• Stage 2 lymphedema causes lasting swelling that will not completely disappear, but proper management can help control symptoms and prevent them from progressing.
• Getting diagnosed and starting treatment promptly can help prevent progression to more severe stages and maintain your quality of life.
• While there’s no cure, treatments like complete decongestive therapy and compression garments for lymphedema can effectively manage symptoms.
• Working with healthcare providers who understand the lymphatic system is essential for creating an effective treatment plan.
• Consistent care, including lymphedema exercises and following lymphedema precautions, is vital for maintaining health and preventing complications.

What Is Stage 2 Lymphedema?

Stage 2 lymphedema is a significant point in the progression of this chronic condition, which affects the lymphatic system. Unlike stage 1, where swelling might come and go, and the condition can be reversed, the second stage of lymphedema brings more persistent changes. At this stage, the buildup of lymph fluid becomes more pronounced and doesn’t improve with simple elevation or overnight rest.¹

When comparing stages of lymphedema, it’s helpful to understand the progression. Stage 1 typically shows temporary swelling that might go down with elevation. In stage two lymphedema, the swelling becomes more permanent, and tissues start to harden. If left untreated, it can progress to stage 3, where the skin undergoes significant changes and becomes even harder and more fibrotic. This progression risk makes it even more important to understand and properly manage stage 2 symptoms.¹

What Are Signs and Symptoms of Stage 2 Lymphedema?

Recognizing the signs of lymphedema at this stage is crucial for proper management. The symptoms of stage 2 lymphedema are more noticeable and consistent than earlier stages, making them key indicators for seeking treatment.²

• Persistent swelling: Unlike in earlier stages, the swelling in stage 2 lymphedema remains present even after elevation or rest. This constant swelling can affect daily activities and comfort levels, making it an important symptom to monitor and manage. The persistence of this swelling often leads to changes in how clothes fit and may require adjustments to your wardrobe and daily routines.
• Pitting edema: When you press on the affected area, an indentation forms that takes time to fill back in. This characteristic sign occurs because excess fluid has accumulated in the tissues, creating pressure that maintains the indentation. The length of time it takes for the indentation to disappear can help healthcare providers assess the severity of your condition.
• Higher risk of infection: The compromised lymphatic system makes the affected area more susceptible to cellulitis and other infections. Even minor cuts, scrapes, and insect bites can potentially lead to complications if not properly cared for. Because of this increased infection risk, it is essential to practice meticulous skin care and seek immediate medical attention for any signs of infection.
• Increased heaviness and discomfort: The affected limb often feels heavier than normal, accompanied by sensations of tightness and discomfort that can impact daily activities and sleep. This heaviness tends to worsen throughout the day as fluid continues to accumulate. The discomfort can range from mild pressure to significant aching, particularly after long periods of standing or sitting.
• Skin changes: The skin in affected areas becomes thicker and harder, developing a firm or spongy texture. These changes occur as the body adapts to the chronic fluid accumulation and begins producing extra tissue. Over time, these skin changes can become more pronounced and may lead to a characteristic appearance that healthcare providers call fibrosis.
• Reduced mobility: The combination of swelling and tissue changes can limit your range of motion, making everyday tasks more challenging. This reduced mobility might affect your ability to bend joints or perform fine motor skills, depending on the affected area. The impact on movement often varies throughout the day and may be more noticeable after periods of inactivity.

What are the Causes of Stage 2 Lymphedema?

Understanding the causes of lymphedema can help you better manage your condition and identify potential risk factors. The root causes typically fall into two main categories: primary and secondary.

Primary lymphedema occurs when genetic factors affect the development or function of the lymphatic system. It can appear at any age but is most common during times of hormonal changes, such as puberty. However, primary lymphedema can be congenital and present at birth due to lymphatic vessels not developing properly, while others may develop lymphedema later in life, known as lymphedema tarda.

Secondary lymphedema is more common and develops due to damage to or disruption of the lymphatic system. This often occurs after cancer, cancer surgery, radiation therapy, injury, or infection. Understanding lymphedema risk factors can help you identify if you might be at risk for developing this condition.²

How Do You Diagnose Stage 2 Lymphedema?

You can only get an accurate diagnosis from a healthcare provider; lymphedema isn’t a condition you can diagnose on your own since it can sometimes be mistaken for other conditions. Healthcare providers use several methods to confirm stage two lymphedema and determine how to treat lymphedema with the best approach. A few ways your doctor might diagnose you with lymphedema are:²

• Physical examination: This allows healthcare providers to assess swelling and skin changes and perform specific tests to evaluate the extent of fluid accumulation. They’ll often measure and compare the affected area to the unaffected side.
• Medical history: Your doctor will ask about previous surgeries, infections, or conditions that might have led to lymphedema. They’ll also want to know about any family history of similar problems.
• Advanced diagnostic tools: These help confirm the diagnosis and may include bioimpedance spectroscopy. This non-invasive test measures fluid levels in your tissues, helping to quantify the extent of swelling.
• Diagnostic imaging: Imaging provides detailed views of your lymphatic system and affected tissues. Common imaging methods include:
  • Lymphoscintigraphy: A special type of imaging that shows how lymph fluid moves through your body.
  • Ultrasound: Helps evaluate tissue changes and rule out other causes of swelling.
  • MRI: Provides images of soft tissues and can show the extent of fluid accumulation.
  • CT scans: May be used to rule out other conditions or assess complicated cases.
    

How Is Stage 2 Lymphedema Treated?

Managing stage 2 lymphedema requires a comprehensive treatment plan. While the condition can’t be cured, proper treatment can help control symptoms and prevent complications. A few ways stage 2 lymphedema is treated include:

• Complete decongestive therapy: This cornerstone treatment combines multiple techniques to manage swelling and maintain tissue health. Working with a certified therapist helps ensure you learn the proper techniques for long-term success.
• Compression therapy: Regular use of compression garments during the day and compression wraps at night helps control swelling and maintain results. Your healthcare provider will help determine the right type and level of compression for your specific needs. You can also use pneumatic compression devices, which mimic manual lymphatic drainage by delivering intermittent dynamic pressure to encourage the flow of fluid.
• Exercise and movement: Regular physical activity helps maintain mobility and promotes lymphatic drainage. When done properly, specific lymphedema exercises can reduce swelling and keep joints flexible. Doctors often recommend light aerobic exercises, such as walking, swimming, or yoga, for lymphedema.
• Skin care routine: At this stage, maintaining healthy skin is crucial to preventing complications and infections. Keep skin clean and moisturized, and inspect it daily for changes or concerns.
• Manual lymphatic drainage: This specialized massage technique helps stimulate lymph flow and reduce swelling. A trained professional can perform the treatment or teach you proper self-administration techniques.
• Elevation techniques: Strategic elevation of the affected area, especially during rest or sleep, helps reduce swelling and complement other treatments. Your therapist can show you the most effective positions for your situation.
• Healthy lifestyle choices: Taking lymphedema precautions can also help manage symptoms. Following a balanced diet, staying well-hydrated, and maintaining a healthy weight all contribute to managing symptoms and supporting overall treatment success.
  

Wrapping Up: Controlling Symptoms of Stage 2 Lymphedema

Living with stage 2 lymphedema requires dedication to your treatment plan, but you don’t have to face it alone. Working closely with your healthcare team helps ensure you take the right steps to manage your symptoms and prevent progression to stage 3. Regular monitoring, consistent care, and open communication with your healthcare providers create the foundation for successful long-term management.

For many people, at-home treatment options can make a significant difference in managing symptoms. Tactile Medical’s lymphedema products, including the Flexitouch Plus and Nimbl systems, offer doctor-prescribed pneumatic compression devices that can be used at home. These systems can complement your overall treatment plan, helping you maintain better control over your symptoms while fitting treatment into your daily routine.

References:
1. “Lymphedema Stages.” Breastcancer.Org – Breast Cancer Information and Support, Breastcancer.org, 15 Aug. 2023, www.breastcancer.org/treatment-side-effects/lymphedema/stages.
2. Greene, Arin K, and Jeremy A Goss. “Diagnosis and Staging of Lymphedema.” Seminars in Plastic Surgery, U.S. National Library of Medicine, Feb. 2018, pmc.ncbi.nlm.nih.gov/articles/PMC5891654/.