Understanding Lymphoedema & Chronic Leg Swelling
Lymphoedema is a chronic condition involving impaired lymphatic drainage, which can lead to fluid build-up, swelling and changes within the tissues over time.
It most commonly affects the legs, although other areas of the body may also be involved. Symptoms can range from mild heaviness or swelling through to more persistent skin and tissue changes in longstanding disease.
At Better Veins Clinic, Dr Nicholas Teo provides doctor-led assessment of swelling, venous and lymphatic conditions on the Gold Coast, Brisbane and Toowoomba.
What Is Lymphoedema?
The lymphatic system plays an important role in fluid balance, immune function and tissue health. When lymphatic drainage is impaired, lymphatic fluid may accumulate within the tissues, contributing to swelling and inflammation.
Lymphoedema may occur due to congenital or inherited lymphatic abnormalities (primary lymphoedema), or develop secondary to other medical conditions, surgery, injury, infection or longstanding swelling (secondary lymphoedema).
Symptoms and severity can vary significantly from person to person.
Common Symptoms of Lymphoedema
Symptoms may include:
- Persistent swelling of the legs or ankles
- A feeling of heaviness or tightness
- Discomfort or aching
- Skin thickening or fibrosis
- Reduced flexibility or mobility
- Recurrent cellulitis or skin infections
- Tight-fitting shoes or clothing
- Skin changes over time
Symptoms may gradually progress if swelling becomes longstanding.
Lymphoedema, Veins & Chronic Swelling
In some patients, lymphatic swelling may coexist with venous disease or other causes of leg swelling.
Conditions that may overlap with lymphoedema include:
- Chronic venous insufficiency
- Varicose veins
- Lipoedema
- Reduced mobility
- Fluid retention from other medical conditions
Longstanding venous insufficiency may place additional strain on the lymphatic system over time, and underlying venous reflux may contribute to worsening swelling in some patients.
Because multiple factors can contribute to swelling simultaneously, a comprehensive assessment is important in understanding the broader clinical picture.
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Assessment of Lymphoedema
Assessment begins with a thorough medical history and physical examination.
Depending on symptoms and clinical findings, assessment may include:
- Evaluation of swelling patterns and tissue changes
- Assessment of skin health and fibrosis
- Ultrasound assessment of the veins and surrounding tissues where appropriate
- Evaluation for venous insufficiency or overlapping venous disease
- Consideration of other contributing medical factors
Because swelling can have multiple causes, assessment focuses on developing a more complete understanding of the contributing factors affecting each individual patient.
Management Approaches
Management depends on the severity of symptoms, underlying contributing factors and individual patient circumstances.
Approaches may include:
Conservative & Supportive Management
- Compression therapy and compression garments
- Swelling management strategies
- Exercise and movement
- Walking and calf muscle activation
- Skin care and moisturisation
- Weight management where appropriate
- Lifestyle measures to support circulation and tissue health
Venous Assessment & Treatment Where Appropriate
In some patients, underlying venous insufficiency or varicose veins may contribute to worsening swelling or discomfort.
Where clinically appropriate, management of underlying venous reflux may form part of a broader swelling management approach.
Treatment recommendations are individualised based on symptoms, examination findings and ultrasound assessment.
When Should You Seek Assessment?
Medical review may be appropriate if you experience:
- Persistent or progressive leg swelling
- A feeling of heaviness or tightness
- Recurrent cellulitis
- Skin thickening or fibrosis
- Swelling that does not improve with rest
- Swelling associated with varicose veins
- Ongoing discomfort or reduced mobility
Sudden swelling, chest pain or shortness of breath should be assessed urgently.
A Comprehensive Approach to Swelling Assessment
At Better Veins Clinic, assessments focus on understanding the broader contributors to swelling through a comprehensive and holistic approach.
This includes consideration of venous circulation, swelling patterns, skin and tissue changes, and potential overlapping venous or lymphatic factors where appropriate.
Clinics are available on the Gold Coast, Brisbane and Toowoomba.