With lymphostasis, the leg hurts a lot, what to do. Lymphedema of the extremities: treatment

As a rule, pain and swelling of the lower extremities disappear by morning, but if this does not happen, or does not occur fully, you should think about it and start a serious examination, during which lymphostasis of the lower extremities can be detected. According to statistics, about 10% of the world's people suffer from this disease.

A little about the lymphatic system

The connection between the cardiovascular and lymphatic networks is undoubted, since the latter is part of the circulatory network. The lymphatic system is represented by a network of vessels located throughout the body and through which lymph circulates. Lymph is formed in the process of blood plasma filtration, that is, the liquid penetrates into the intercellular space, and from there, together with coarse proteins of the interstitial space, it enters the lymphatic capillaries, and then into the lymphatic network, where the lymph is “cleansed” (in the lymph nodes), and again flows into circulatory system in the region of the lower parts of the neck.

The lymphatic system has its own "duties":

• with its help, tissue fluid is evacuated from the interstitial space (prevention of edema);
• together with the proteins of the interstitial space through the subclavian veins transports tissue fluid back into the bloodstream;
• participates in the transfer of fats from the small intestine into the blood;
• synthesizes lymphocytes, which are part of the body's defense mechanism;
• filters tissue fluid in the lymph nodes and removes toxins, microorganisms, tumor cells, foreign substances from it;
• involved in the formation of antibodies.

The lymphatic system consists of lymphatic capillaries, vessels, nodes, trunks and ducts. With any damage to the lymphatic tract (adhesion, blockage or overgrowth), the free outflow of lymphatic fluid from the tissues is disturbed, which leads to edema, which later turns into lymphostasis.

Lymphostasis of the lower extremities: definition

A pathological condition in which swelling of the tissues of the area involved in the process (in this case, the lower limbs) increases is called lymphostasis of the legs or lymphedema (lymphedema). This disease is caused by a violation of the outflow of fluid through the lymphatic vessels, which leads to its stagnation in the tissue space and edema. Among patients with peripheral vascular pathology, 3–7% are people with leg lymphostasis.

Lymphedema classification

There are primary and secondary lymphostasis of the legs. And if the primary lymphostasis of the lower extremities is congenital, then the secondary one develops during life under the influence of any provoking factors. In turn, secondary lymphostasis is divided into youthful (occurs between 15 and 30 years old) and adult (develops after 30 years).

The reasons

Primary lymphostasis of the lower extremities has the following causes:

• the diameter of the lymphatic vessels is very small;
• insufficient number of lymphatic pathways;
• anomalies of the lymphatic vessels (infection, obliteration, doubling);
• amniotic constrictions, which lead to the formation of scars that compress blood vessels;
• genetic predisposition to underdevelopment of the lymphatic system;
• congenital tumor-like formations of the lymphatic system.

Secondary lymphostasis is caused by various diseases that lead to lymph stagnation and swelling of the lower extremities:

Lymphostasis of the legs in its development goes through three stages, which have different manifestations:

First stage

The initial phase of the disease is called mild or reversible edema and is called lymphedema. Swelling / swelling of the legs with lymphostasis appears in the area of ​​the ankle joint, at the base of the fingers and between the bones of the metatarsus from the rear of the foot. Usually a similar phenomenon occurs in the evening and / or after exercise. The skin over the swollen place is pale, easily gathers into a fold when probing. There is no proliferation of connective tissue, and the edema itself is painless and quite mild. After sleep or rest, the leg / legs quickly return to normal.

Second stage

This stage is characterized by irreversible edema of the lower limb and is called fibroedema. The phase of irreversible edema proceeds slowly, up to several years, and is manifested by the growth of connective tissue. The edema “rises” upward, becomes quite dense, and the skin over it stretches and thickens, making it impossible to fold it. Edema is permanent, does not disappear at rest and is accompanied by pain or a feeling of heaviness during exercise.

At this stage, the lower limb begins to deform, the circumference of the leg increases significantly, and long standing leads to cramps in the calf muscles and joints of the foot. The skin becomes bluish, thickened (hyperkeratosis), and warty outgrowths may appear. Complications of this stage are wounds and ulcers in places of constant friction of the skin (contact with clothing, skin folds), they become inflamed and constantly ooze lymph. The difference between the diameters of a healthy and diseased leg can reach 50 cm.

Third stage

This is the final and most severe phase of the disease. At this stage, the disease is called elephantiasis or elephantiasis (elephantism). It is characterized by a significant proliferation of connective tissue under the edema, the skin becomes very dense and rough, “like an elephant”, stretched and casts blue. The affected limb is greatly enlarged in size, its contours are lost, and fibrosis and cystic changes develop in the soft tissues. The leg becomes like an elephant and completely loses its function. Complications of the third stage include: the development of osteoarthritis, contractures, eczema, trophic non-healing ulcers and erysipelas.

In addition to local manifestations of lymphostasis of the lower extremities, there are also general symptoms:

• general weakness;
• fast fatiguability;
• pain in the head;
• tongue coated with white coating;
• loss of attention and difficulty concentrating;
• weight gain, obesity;
• pain in the joints.

Diagnostics

After a thorough collection of anamnesis and complaints, a vascular surgeon (angiosurgeon, phlebologist or lymphologist) examines the lower extremities and prescribes additional examination methods:

Lymphography

Refers to X-ray methods of examination. It consists in introducing a gap (between 1 and 2 fingers) of the foot 1 - 2 cubes of lymphotropic dye, and then a transverse incision of about 2 cm is made between the bones of the metatarsus (1 and 2), in which blue-colored lymphatic vessels are visible. A radiopaque substance is injected into any of the visible vessels, and pictures are taken.

Lymphography allows you to determine the number of vessels, their shape and patency, the connection of collateral vessels and spare ones, the permeability of the wall of the lymphatic vessel. If there is a uniform filling of the vessel with contrast with a preserved diameter of its diameter along the entire length, then one speaks of the preservation of patency and damage to the contractile apparatus.

• With primary lymphostasis, underdevelopment of blood vessels is noted
• In the secondary, there is a disturbed course of the vessels, altered forms, filling the skin network with contrast and spreading the substance into the subcutaneous tissue (extravasation).

Lymphoscintigraphy

This is a method of radioisotope diagnostics (an isotope substance is injected into the subcutaneous tissue, from where it enters the lymphatic network, then pictures are taken with a special gamma camera). The method allows you to monitor the state of the lymphatic system in dynamics and determine the nature of the lymph flow: collateral, main or diffuse, as well as complete lymphostasis, assess the patency of the vessels, their tortuosity and the condition of the valves.

Dopplerography of the vessels of the lower extremities

Or duplex scanning of blood vessels - ultrasound examination of blood vessels using the Doppler effect (allows you to differentiate venous and lymphatic edema).

Other tests

• Ultrasound of the pelvic organs- Identification of inflammatory diseases or tumors that disrupt the lymph flow.
• Biochemical and general blood test- determination of blood proteins, liver enzymes, identification of signs of inflammation, etc.
• General urine analysis- to exclude kidney pathology.
• Heart study- Ultrasound, ECG of the heart are prescribed to detect / exclude cardiac pathology.

Treatment

With lymphostasis of the lower extremities, treatment is mandatory. Moreover, the earlier it is started, the higher the chances of success. Therapy of the disease is a complex task, which combines many techniques (medical nutrition, massage, medication, etc.) and is aimed at improving lymphatic drainage from the lower extremities.

All conservative methods of treatment are used only at stage 1 of the disease (lymphedema phase), when structural changes in the skin and connective tissue have not yet begun. How to treat lymphostasis depends on the cause that caused it. First of all, it is necessary (if possible) to eliminate the etiological factor (for example, in the presence of a pelvic tumor that compresses the lymphatic vessels, its removal is indicated). General recommendations for patients with this pathology:

• it is strictly forbidden to visit a bath, sauna or sunbathe (thermal exposure contributes to the expansion of blood vessels, including lymphatic vessels, which worsens blood and lymph flow in the legs);
• you can not wear shoes with heels or with lacing (the heel increases the load on the legs and worsens the lymph flow, and the lacing pulls the soft tissues and blood vessels that pass through them, which also negatively affects the disease);
• avoid heavy lifting and static loads (prolonged standing or sitting);
• treat even minor skin lesions (including bites) with antiseptic solutions;
• refuse to wear tight underwear and tight-fitting clothing (firstly, it contributes to squeezing of the lymphatic vessels, and, secondly, skin friction at the points of contact with clothing provokes the formation of trophic disorders);
• you can’t sit, especially for a long time, with your legs crossed (by the way, the favorite position of women), since this position makes it difficult for lymph and blood flow in the legs and pelvic organs;
• it is forbidden to walk barefoot outside the house (there is a high probability of damage to the skin of the feet and the formation of a long non-healing ulcer);
• when taking a bath, use special oils (Balneum Plus), and after water procedures, wipe the skin of the legs with creams and lotions without fragrances and preservatives, which not only cleanses the skin, but also softens it, and also restores the protective barrier;
• use powder (talc, baby powder) with severe sweating of the legs, which reduces sweating and the risk of developing trophic disorders;
• timely and accurately cut toenails;
• during the massage, avoid kneading techniques.

Therapeutic nutrition for lymphostasis

First of all, the treatment of the disease should begin with dietary adjustments, this is especially true for patients with obesity. The diet for lymphedema is aimed at limiting salt intake (sodium chloride causes fluid retention in the tissues and swelling) and spicy foods (cause thirst and increase fluid intake).

The amount of free fluid should be at least, but not more than 2 liters per day (tea and coffee should be replaced with herbal teas, compotes without sugar, fruit drinks), carbonated drinks should be excluded. You should also limit simple carbohydrates (bread, pastries, confectionery, sweets, etc.), which contributes to the addition of extra pounds, replacing them with complex ones (bread from wholemeal flour or bran, cereals with water or diluted milk: millet, barley, corn).

Increase the consumption of vegetables and fruits (you can bake, stew, but do not fry), give preference to salads from fresh vegetables seasoned with vegetable oil. Limit the intake of animal fats (about 10 grams per day), since saturated (animal) fats in large quantities impede lymph flow. And vegetable oils in the diet should be at least 20 grams. daily. In addition, an excess of animal fats provokes, which aggravates the course of lymphostasis.

Also in the diet there should be a sufficient amount of proteins of plant and animal origin, which is necessary for the formation of antibodies and strengthening immunity. From animal fats, preference is given to fermented milk products, sea and offal. Sources of vegetable protein are buckwheat, legumes and nuts.

Compression treatment and kinesiotherapy

Compression therapy consists in squeezing the skin and subcutaneous tissue of the diseased leg in such a way that the pressure force increases from the foot to the lower leg and thigh. During the day, the patient is advised to keep the affected leg in an elevated position if possible, and at night put a roller or pillow under it (creating an angle of 45%).

Compression is carried out by elastic bandaging of the lower limb and wearing an elastic stocking. The imposition of an elastic bandage is carried out in the morning, without getting out of bed, starting with each finger, then moving to the foot and then to the lower leg and thigh. At night, the leg is unbandaged (see).

The method of pneumocompression with the help of special devices is also used, which consists in sequential mechanical compression of the leg with a certain pressure. To do this, a special pneumatic boot is put on the sore leg, into which air is pumped in the direction from the foot to the thigh. The course relies on 10 - 14 procedures. After each session, light gymnastic exercises are carried out.

Kinesiotherapy is a lymphatic drainage massage and physiotherapy exercises. Massage with lymphostasis of the legs supports the lymph flow, "expels" the lymph from the edematous tissues, stimulates phagocytosis by macrophages, enhances the work of the capillary lymphatic pump. Also, with the help of massage, macromolecular substances that interfere with normal lymph flow are destroyed.

Lymphatic drainage massage is carried out by a specialist and is contraindicated in case of trophic disorders of the skin of the sore leg, vein thrombosis and in the presence of tumors and diseases of the internal organs. Self-massage is also allowed (in the initial stages). At home, massage is recommended after taking a warm bath, and after applying a special cream to the skin of the foot.

In the first 3 - 5 minutes, circular stroking movements are carried out (it is important to remember: the massage is performed along the lymph flow, that is, from the foot up), then rubbing movements and pressure are carried out and the session ends with pats. The duration of the massage is 15 minutes. Courses are recommended for 14 days with a 1 - 2-week break. After completing the massage session, you should make 10 light jumps on your toes or stretch 15 times on your toes.

Therapeutic gymnastics (LFK) is carried out twice a day, for 5-10 minutes and includes the following exercises (on a hard surface):

• in a horizontal position, perform a “bike” with both a sick and a healthy leg;
• raise the sore leg up (without bending) and perform circular movements with it;
• in a sitting position, bend and unbend your toes;
• rotate the legs with the knee and then the ankle joints;
• in a sitting position, draw the “eight” with your feet and rotate alternately with one and the other foot.

Exercise therapy is carried out necessarily in stockings or elastic bandages.
In addition, with lymphostasis, swimming and "Scandinavian" walking (with ski poles) are shown.

Drug therapy

Drug treatment of lymphostasis of the lower extremities includes a wide range of drugs that normalize blood and lymph flow, reduce the permeability of vascular walls and increase their elasticity:

• phlebotropic agents (, troxevasin and troxerutin gel) - improve tissue microcirculation, increase vein tone, restore lymph flow;
• enzyme preparations (wobenzym, phlogenzym) - stimulate the immune system, fight edema, have anti-inflammatory and fibrinolytic effects;
• benzopyrones (coumarin) - reduce high-protein edema, thin the blood, activate proteolysis due to the activation of macrophages; calcium dobesilate is also prescribed, which is similar in action to benzopyrones;
• homeopathic remedy - lymphomiazot, which stimulates metabolism, improves lymph flow and enhances the elimination of toxins from the body;
• angioprotectors (drugs from horse chestnut extract) - normalize the tone of the lymphatic vessels and veins, reduce the permeability of the vascular wall, which reduces the intensity of edema (escusan, venitan, aescin);
• diuretics - are prescribed with caution under the supervision of a physician;
• antiplatelet agents (thinning the blood) - trental, chimes;
• antibiotics and anti-inflammatory drugs for trophic skin disorders (ulcers, eczema, erysipelas);
• antihistamines - recommended for relapses of erysipelas and suppress the inhibitory effect of histamine on the contractile activity of lymphatic vessels (see);
• solcoseryl - reduces swelling of tissues, has a regenerative effect, increases the tone of the vascular wall (stimulates the formation of collagen in the walls of blood vessels);
• immunomodulators (succinic acid, tincture of eleutherococcus, licopid) - stimulate the immune system, strengthen the vascular wall;
• vitamins (ascorbic acid, vitamin E, PP, P) - strengthen the vascular wall, reduce vascular permeability, have an antioxidant effect.

Physiotherapy procedures

From physiotherapy for this disease is used:

• electrical stimulation of contractility of lymphatic vessels;
• amplipulse therapy;
• UVI autoblood - reinfusion of one's own blood after its irradiation with ultraviolet light.

Folk methods of treatment

Treatment with folk remedies is used as an additional to the main therapy for lymphostasis and is carried out after consultation with a doctor:

• compresses from birch tar and baked onions on a sore leg;
• compresses with cabbage juice or applying cabbage leaves to the affected limb;
• infusion of plantain leaves;
• infusion of garlic and honey - 250 gr. chopped garlic, 350 gr. honey, infused for 1 week, taking 1 tbsp. spoon 3 r / day for 3 months an hour before meals;
• the use of beet juice;
• intake of dandelion and plantain juice;
• a decoction (2 parts), plantain and dandelion leaves (1 part each) is poured with half a liter of boiling water, allowed to brew for 6 hours, taken for a month 4 r / day, 100 ml before meals.

But it should be borne in mind that alternative therapy is effective only in the initial stage of the disease.

Lymphostasis of the lower extremities is tissue edema, provoked by a violation of the outflow of lymphatic fluid from the capillaries and peripheral vessels of the legs. In people with a congenital or acquired disease of the lymphatic system, the processes of evacuation of the lymphatic fluid are impaired, which leads to an increase in the size of the affected limbs.

Lymphostasis (lymphedema) is of two types:

1. Congenital. Primary lymphedema is characterized by a congenital defect of the lymphatic tract, insufficiency of the valves and underdevelopment of the vessels, which lead to blockage of the outflow channels. Primary lymphostasis of the lower extremities manifests itself from childhood, can affect one or both sides at once.
2. Acquired. Secondary lymphostasis - damage to a healthy lymphatic system after certain diseases, injuries or surgery. It mainly develops only on one side at the instep of the foot or lower leg.

Failure of lymphatic circulation, leading to fluid retention in tissues, is observed in pathological disorders and diseases of the body, is the cause of secondary lymphostasis:

• heart failure;
• kidney disease;
• hypoproteinemia;
• venous insufficiency;
• arteriovenous fistulas;
• post-thrombophlebitic syndrome.

Lymphostasis of the lower extremities can be a complication after surgery, radiation therapy and injuries of a different nature. Violation of the outflow of lymph can occur from the compression of inflammatory infiltrates in tumors.

Stages and symptoms of the disease

Lymphostasis of the legs is characterized by a gradual development, during which 3 stages are distinguished with different symptoms.

First stage

The first degree of the disease is called lymphodermatitis, it is characterized by a slight accumulation of lymphatic fluid. There are minimal and mild swelling of the toes, arch of the foot and lower leg, which disappear under the influence of cold and after rest. In some cases, a fold of skin may form in the area of ​​swelling.

The patient at the first stage does not experience much discomfort: there is no pain and heaviness in the legs.

Second stage

Gradually, the disease passes into the second degree of development - fibrodermatitis. During this period, the nature of the edema becomes permanent, painful seals are observed. The patient experiences difficulty in flexion and extension of the limbs. The constant heaviness in the legs becomes unbearable, the skin becomes rough and does not gather into folds. This signals the beginning of the growth of connective cells in the tissues of the legs.

You can already notice a significant increase in leg circumference. After a long stay on the legs, cramps occur in the muscles of the calves and in the joints of the foot. There is blueness and thickening of the skin, the cause of which is the excessive formation of subcutaneous tissue. In places of constant contact with clothing, ulcers form, from which lymph oozes.

Third stage

The end stage of lemphedema of the legs is called elephantiasis. Excessive growth of connective cells deforms the limb and increases its size. Symptoms are clearly expressed: the stratum corneum of the skin increases, warts and age spots appear on it. The affected limb has no contours, fibrosis and cystic changes progress in the tissues.

A patient with the third stage of lymphastasis cannot move freely, the mobility of the joints is limited. The loss of working capacity becomes the reason for the assignment of disability.

The consequences of lymphedema become irreversible. Treatment is carried out to alleviate symptomatic manifestations and reduce the risk of complications, including: eczema, osteoarthritis, trophic ulcers, contractures and erysipelas.

Diagnostic methods

Swelling of the legs and symptoms characteristic of lemphedema may appear for other reasons. Therefore, before treating lymphostasis of the lower extremities, a consultation with a phlebologist and a complete diagnosis is necessary. To identify the disease and determine the severity, a complex of studies is carried out:

• external examination and analysis of symptoms;
• dopplerography of blood vessels;
• Ultrasound of the vessels of the lower extremities;
• blood chemistry;
• Analysis of urine;
• lymphography and lymphoscintigraphy.

After the diagnosis, the phlebologist determines a set of therapeutic measures, helps to draw up a treatment menu and recommends special exercises that can be performed at home. The prognosis of the disease depends entirely on timely treatment.

A complex of treatment for lymphostasis of the lower extremities

The first task of the doctor is to eliminate the cause of the violation in the lymphatic system.

In the treatment of the disease itself, an extensive therapeutic complex is used, which includes: pharmacotherapy, clinical nutrition, special exercises, massage and wearing compression underwear.

Conservative therapy is used only for lymphodermatitis and at the beginning of the development of fibrodermatitis, in more advanced cases, surgical treatment is indicated.

Medical treatment

Pharmacotherapy of lymphedema of the legs is the use of drugs from different groups to improve lymph flow and blood circulation, strengthen and increase the elasticity of the walls of blood vessels:

• Phleboprotectors. To increase vascular tone, regulate microcirculation in tissues, drugs are used: Detralex, Troxevasin, Troxerutin in the form of an ointment.
• enzyme preparations. They have anti-edematous, anti-inflammatory, fibrinolytic effects. Medicines: Wobenzym, Phlogenzym.
• Angioprotectors. They increase the tone and strengthen the walls of the lymphatic vessels, thereby reducing the intensity of the formation of edema. Preparations are used: Aescusan, Aescin, Venitan.
• Antiplatelet agents. Medicines are used to thin the blood: Curantyl, Trental.
• Diuretics. Diuretic drugs are prescribed with caution: Uregit, Torasemide.
• Antibiotics and glucocorticosteroids. Shown in the presence of trophic ulcers, erysipelas, eczema. The choice of drug depends entirely on the individual case.
• Regenerants. Stimulate the activity of collagen, resuming the growth of healthy cells in the walls of blood vessels. Helps reduce swelling. Used ointments: Solcoseryl, Actovegin.

In parallel with the main treatment, a complex of vitamins and immunomodulators is prescribed.

The reasons for the use of surgery are neglected cases in which drug treatment does not bring the desired effect. Practiced methods:

• Liposuction, lipectomy - in order to restore the functionality of the limb, excess subcutaneous fat is removed;
• The imposition of lymphovenous anastomoses - fistulas are created between the venous and lymphatic systems. This method allows you to provide additional outflow of lymph.

Surgical operations are not performed against the background of a progressive oncological disease and erysipelas.

Compression and kinesitherapy

This method of therapy consists in exerting increasing pressure on the skin and subcutaneous tissue towards the upper part of the affected limb. In a hospital setting, it is performed using pneumatic equipment.

Massage for lymphostasis of the lower extremities is an important part of conservative treatment.

During the massage, the contraction of the vessels of the lymph flow is stimulated by a manual or hardware method, which ensures the active movement of the fluid along the channel. Deep and professional massage can only be done by specialists with medical education. The procedure is contraindicated in the presence of trophic ulcers and erysipelas.

At home, you can do self-massage and stimulate lymph flow daily. The effect of massage increases if it is done after taking a warm bath and warming up exercises.

The procedure begins with the application of a massage cream. Light circular movements are carried out in the direction of the lymph flow from the bottom up. Areas with large varicose veins and warts should be avoided. Massage is done for at least 10 minutes, after which a feeling of warmth should form in the limbs. The general course is 14 days, after which a break of 10 days is required. If severe pain occurs, the procedure is recommended to be stopped.

A complex of special gymnastics is added to conservative treatment, which must be performed twice a day in compression underwear:

• exercise "bicycle" in a horizontal position;
• flexion and extension of the toes;
• drawing "eights" with feet in a sitting position;
• rotation of the knee and ankle joints.

Health food

The diet for lymphostasis of the lower extremities involves a cardinal restriction of salt, spicy, fried foods and complex carbohydrates. These products tend to retain fluid and contribute to the deposition of fat, which greatly complicates the treatment of the disease.

Nutrition should be balanced and fractional. It is recommended to limit animal fats to 10 g per day, and increase vegetable oils to 20 g. The diet can be enriched with vegetables, fruits, nuts, dairy products, cereals.

The menu must include proteins of animal and vegetable origin, which enhance immunity and are participants in the construction of new cells. You can cook dishes from seafood, poultry, buckwheat and legumes.

It is important to monitor the drinking regime, the total amount of liquid should not exceed 2 liters. Preference is given to filtered water, compotes, fruit drinks and herbal teas without sugar. After 20 hours, you need to exclude any drinks.

Folk remedies

Conservative treatment can be supplemented with folk remedies, which are used only after consultation with the attending physician. It is proposed to use infusions, decoctions and compresses from available products that can be easily prepared at home:

• Plantain. Dried and crushed leaves (2 tablespoons) are poured with boiling water (0.5 l) and infused for 8 hours. Strained infusion is taken 3 times a day, 100 ml.
• Garlic. Chopped vegetable (250 g) is poured with liquid honey (350 g) and infused for 7 days. Take 3 times a day for 1 tbsp. l. 1 hour before meals.
• Dandelion. The crushed root (1 tablespoon) is poured with boiling water (0.5 l) and boiled for 5 minutes. The decoction is taken in the morning, 100 ml. Compresses can be made from a folk remedy by applying a piece of cloth soaked in a decoction to the problem area.
• Onion. Birch tar (2 tsp) is added to the baked and mashed onion. The mixture is spread on gauze and applied to the edematous area, left to act overnight.
• Beet. Daily consumption of juice from this vegetable will help in the regulation of metabolic processes in the lymphatic system.
• Rosehip, currant. Berries and leaves are brewed like tea. The drink is consumed 100 ml 2 times a day before meals. The medicine has diuretic properties.

Hirudotherapy is widely practiced in folk medicine. Before treatment with leeches, it is necessary to consult the attending physician, the procedure has contraindications.

Content

The problem with shoes, psychological discomfort are alarming signs of a developing pathology. The tissue retains fluid, the skin coarsens, the disease progresses, and only timely and proper treatment helps to stop lymphostasis of the lower extremities. Therapy with folk remedies has proven to be effective, helping to cope even with severe edema or improve the condition of blood vessels. The main thing is to know exactly what and how much to use.

What is lymphedema of the lower extremities

Before you choose the right method of treatment, you should understand the features of the disease itself. Lymphostasis of the lower extremities is a pathological condition, which is characterized by a violation of the outflow of lymph, its retention in the tissues, which leads to the appearance of edema. An imbalance occurs in the lymphatic system, the accumulation of fluid leads to rupture of blood vessels, because the veins cannot withstand such pressure. The result of the development of lymphostasis of the lower extremities is the appearance of cracks, erysipelas, ulcers on the skin.

Symptoms

In medicine, the pathological retention of lymph in the tissues was called "lymphostasis", a variant of the folk sound of the disease - elephant's foot. The disease does not progress immediately, but gradually, letting you know about yourself with light and quickly passing edema. If you notice signs of lymphostasis of the lower extremities in the early stages, then you can get by with a short course of treatment at home using folk remedies or conservative methods. Therefore, it is important to notice the following symptoms of lymphostasis of the lower extremities in time:

• the appearance of edema in the evening, which disappears after a night's sleep;
• legs are poured after a long standing, being immobile, physical exertion;
• pain when pressed;
• tightness, thickening of the skin;
• convulsions.

Is it possible to cure lymphostasis of the lower extremities

There is no miracle cure that would help get rid of the disease forever. Nevertheless, stagnation of lymph in the legs is treatable, and the effect will be noticeable if therapy is started as early as possible. It is important to prevent the occurrence of severe complications, so any course of treatment for lymphostasis of the lower extremities should be aimed at stopping the progression of the pathology and normalizing metabolic processes. Duration, measures, success will depend on the stage of the disease, while there are no contraindications for the treatment of lymphostasis at home.

Treatment of lymphostasis of the lower extremities at home

Carrying out any procedures, taking medications, traditional medicine should be carried out strictly after consulting a doctor. An individual examination of the patient is necessary to select the correct treatment tactics, since the causes of the pathology, as well as the forms of the disease in which the lymph flow is impaired, can be different. If the diagnosis turns out to be erroneous or the source of the disease is not determined, then it will not work to count on recovery.

Before treating lymphostasis of the lower extremities, a specialist needs to determine the type of disease:

1. Congenital lymphostasis (primary) is a pathological change, the appearance of which is due to genetic heredity. Edema of soft tissues appears even in childhood or adolescence, among the reasons: the absence of some vessels, a decrease in the diameter of the pathways that remove lymph, and other anomalies of the lymphatic system.
2. Secondary lymphostasis (acquired) - a violation that appeared as a result of trauma, inflammation, infection.

An approximate scheme for the treatment of lymphostasis of the lower extremities:

Medical

Drug therapy includes a wide range of drugs that can be used as directed by a phlebologist. The action of some will be aimed at normalizing the lymph and blood flow, others - at increasing the elasticity of the walls of blood vessels, reducing their permeability. In the early stages of lymphostasis of the lower extremities, vitamins C and P have proven their effectiveness, and preparations based on horse chestnut and licorice root help reduce swelling.

Massage

Kinesiotherapy is an effective manipulation for lymphostasis of the lower extremities. An effective wellness procedure can be carried out manually by a massage therapist, an alternative is the hardware method technique. The purpose of lymphatic drainage massage is to restore lymph flow, get rid of edematous tissues from excess fluid, and strengthen the capillary system. At home, with lymphostasis of the lower extremities, it is recommended to perform self-massage with a preliminary salt bath and applying a special cream to the edematous area.

Hirudotherapy

Lymphostasis of the lower extremities is the rare case when the use of leeches helps to quickly cope with the pathology of the lymphatic system. The substance (hirudin), which is secreted by the inhabitants of fresh water, helps to improve the condition of blood vessels. For therapeutic purposes, it is necessary to apply no more than 5 leeches, for a noticeable effect, the procedure will have to be done twice a week for a month. With the help of hirudotherapy, varicose veins are also successfully treated, while there is no risk of infection.

Diet

How to treat lymphostasis of the lower extremities at home? Food should contribute to a speedy recovery, so the diet should be reviewed. Animal and vegetable proteins, fish, dairy products, cereals, stewed vegetables, olive oil - this is what should be emphasized when compiling the menu. Patients with lymphedema should definitely drink clean water every day, while limiting the consumption of spicy foods, simple carbohydrates, and salt. It is also recommended to add green tea, citrus fruits, berries, fruits to the diet, and completely refuse alcohol.

Folk remedies

It is possible to apply this direction of therapy at home as an additional one. Decoctions, infusions, compresses according to folk recipes help well at the initial stage of lymphostasis of the lower extremities or with edema during pregnancy. Some funds are recommended to be applied at night and left until the morning, others - to drink in a course. To prepare medicines for lymphostasis for treatment at home, you can take bee products, another category of useful ingredients - spices, herbs, plant fruits.

Compresses

To carry out the treatment of lymphostasis of the lower extremities at home using this procedure, the mixture will need to be prepared in advance. To fix the compress, it is recommended to use an elastic bandage or make a gauze bandage, and keep the legs in an elevated position. A dressing with an absorbable or distracting agent for the treatment of lymphostasis of the legs is made using the following products:

• cabbage leaf;
• vinegar;
• clay;
• baked onion;
• Birch tar.

Infusions for oral administration

The occurrence of unpleasant symptoms of lymphostasis of the lower extremities requires the use of effective means. To regulate the water-salt balance in the body, it is good to take fresh infusions, after consulting with your doctor. Folk remedies are prepared from plantain leaves, a mixture of chopped garlic (250 g) with honey (350 g). The time of infusion of home medicines is from several hours to a week, and the duration of the course of treatment for lymphostasis depends on the patient's condition.

Decoctions

Phytotherapy contributes to the fight against lymphostasis of the lower extremities. Decoctions prepared at home help to establish the work of many internal systems, restore lymph flow, blood flow so that the ailment recedes and ceases to cause discomfort. The scheme for preparing medicinal decoctions is simple: take the ingredients, mix, pour boiling water, wrap the dishes tightly and leave for 40-50 minutes. Then the liquid must be filtered, taken two to three times a day before meals. The recommended single volume is 100 ml (or half a glass).

Prevention

Stagnation in the tissues, a violation of the outflow of lymphatic fluid will provoke the appearance of other serious diseases and restrict movement. How to prevent the development of pathology? If lymphostasis of the lower extremities has already been diagnosed, home treatment will help to quickly cope. The system of influence on risk factors should not be neglected in patients with a genetic predisposition or in remission. To prevent lymphostasis of the lower extremities, it is recommended to follow the following rules:

• wear compression underwear;
• drink at least two liters of pure water daily;
• every day to make half an hour walking, cycling;
• regularly visit the pool;
• refuse uncomfortable shoes;
• take care of the skin of the legs: cutting nails, removing dead skin, treating wounds, treating insect bites with antiseptics or boric acid - everything must be done in a timely manner.

Video: Treatment of lymphostasis of the legs at home

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

Lymphostasis of the lower extremities is a disease caused by a violation of the outflow of lymph, which is manifested by constant swelling of one or both legs and is the cause of complications that are difficult to treat. Left untreated, lymphedema leads to gradual disability and severe disfiguring thickening of the legs.

The lymphatic system is a network of specialized vessels (lymphatic vessels) of the body, the purpose of which is to collect excess tissue (lymphatic) fluid with proteins, lipids and tissue waste products. This fluid is then collected in the lymph nodes, which filter out waste products and infection using specialized lymphocyte cells. The filtered lymph is eventually diverted into the general circulation.

Blockage of lymphatic vessels or lymph nodes leads to stagnation of lymph, swelling of the subcutaneous tissue and the development of cicatricial process and elephantiasis. The disease most often affects one leg, but in rare cases both limbs are affected. Chronic lymphostasis of the leg is called lymphedema. The presented photo shows that with lymphostasis, thickening of the fiber and expansion of the lymphatic vessels occurs.

Causes of lymphostasis of the lower extremities and risk factors

Primary lymphedema

Primary (congenital) lymphedema is a rare hereditary disease. It is a consequence of anatomical abnormalities of the lymphatic vessels or lymph nodes. Congenital (primary) leg lymphostasis is most often associated with underdevelopment of the lymphatic drainage system, sometimes there are cases of congenital amniotic constrictions (scars) that compress the superficial lymphatic vessels. There are cases of a hereditary form of the disease, which manifests itself in several members of the same family at once.

Primary lymphedema is a pathology of the human lymphatic system. Depending on the age at which symptoms develop, three forms of congenital lymphedema have been described.

• Congenital lymphedema presenting at birth is more common in women and accounts for approximately 20% of all cases of primary lymphedema. This lymphedema is called Milroy's disease.
• Lymphedema parecox is the most common form of primary lymphedema, most commonly seen in women. It is defined as a disease that becomes apparent during puberty and before the age of 35 years.
• Tarde's lymphedema becomes apparent after 35 years of age. It is less common than other forms.

Secondary lymphostasis

Other reasons:

• soft tissue tumors
• Postoperative scars in the groin area
• Inflammatory or tumor processes in the lymph nodes
• Surgical removal of inguinal and pelvic nodes
• Traumatic damage to the lymphatic pathways
• Radiation therapy
• Inflammatory processes in the skin, subcutaneous tissue, lymph nodes.

The course of the disease

Lymphedema is a continuously progressive disease that leads the patient to disability. If in the early stages lymphedema brings only aesthetic inconvenience, then later the disease - lymphostasis makes life difficult for patients.

An increase in the volume and weight of the affected limb leads to an increased load on the affected leg. Often, these patients develop arthrosis of the hip and ankle joint, which leads to limited physical activity and contributes to weight gain. Lymphostasis of the legs causes symptoms, the treatment of which requires great effort from the patient and doctors.

Patients with lymphostasis are characterized by the frequent development of erysipelas of the skin, accompanied by high fever, pain when touched. Although erysipelas is well stopped by modern antibiotics, each episode of inflammation aggravates the course of lymphedema and leads to an increase and induration of edema.

At the extreme stage of lymphedema, the outflow of lymph from cracks in the skin and the formation of extensive trophic ulcers develop. This condition is potentially dangerous by the development of a general blood poisoning (sepsis) and requires active treatment in a hospital.

Treatment of lymphostasis in the Innovative Vascular Center

In the Innovative Vascular Center, the best treatment scenario for lymphostasis is currently used. Our clinic combines a network of lymphology rooms in outpatient vascular centers, a lymphology clinic with conservative treatment of lymphedema, and a surgical hospital where microsurgical operations are performed to improve lymph outflow.

For the first time, the innovative vascular center was able to transfer the experience of the leading lymphological clinics in Germany to our country. The lymphologists of our center have been trained in one of the leading clinics for the treatment of lymphostasis in Germany and know well how to treat lymphostasis of the affected lower extremities using modern methods.

The Rehabilitation Department of Lymphedema has comfortable rooms with all amenities. The sanatorium is located in a forest area, has everything for rest and treatment. For physiotherapy exercises, special routes through the forest with ups and downs are organized. The method of treatment and diet are specially selected according to the recommendations of the doctor of medicine F.-J. Schingale is a recognized specialist in the treatment of lymphedema.

The specialists of our center can treat lymphostasis with the help of modern microsurgical technologies. We have introduced into Russian clinical practice microsurgical operations of lymphovenous anastomoses for lymphedema of the legs, transplantation of lymph nodes. Our surgeons have extensive positive experience in reconstructive plastic surgery for elephantiasis. Every year, our surgeons make life easier and restore health to dozens of patients with severe chronic lymphostasis.

The Innovative Vascular Center is the only medical organization in Russia that has an inpatient department for the treatment of lymphedema. All modern methods of conservative and surgical treatment allow achieving impressive results in treatment. Only a stationary approach, followed by outpatient monitoring and treatment, allows you to achieve the best results in lymphostasis of the legs.

Treatment is carried out in clinics:

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Advantages of treatment in the clinic

The experience of German clinics transferred to Russia

Top MLD Specialists

Complete rehabilitation program

Surgery for elephantiasis

Lymphatic venous microanastomoses

Lymph node transplants

Diagnostics

Signs of lymphostasis of the legs

The constant accumulation of fluid and proteins in the tissues leads to inflammation and subsequent scarring of the tissues, resulting in a hard, tight swelling. The skin in the affected area thickens, becomes bumpy with papillary growths. Scales and cracks appear through which a secondary bacterial or fungal infection can join. Affected areas of the skin can become inflamed and hurt, trophic ulcers often form. Lymphostasis can cause deformations of the soft tissues of the legs, which leads to a decrease in the range of motion in the joints and impaired mobility of the patient. Lymphostasis has the following stages:

First stage- characterized by the occurrence of edema in the ankle joint, the base of the fingers and on the back of the foot. Symptoms of lymphostasis of the lower extremities of the initial stage: mild and painless swelling, which disappears some time after rest. The skin over the edema may fold.

Second stage- the edema does not completely disappear, however, with a long stay of the patient in a horizontal position, it may decrease. Compaction of the subcutaneous tissue is not observed. However, if the conditions causing lymphostasis persist, thickening of the connective tissue begins to develop and treatment becomes more difficult. Swollen feet and fingers can draw the attention of others.

Third stage- Fibredema stage. This stage develops slowly. Fibredema is characterized by constant and dense swelling and does not go away with prolonged rest, the skin cannot be folded. The swollen leg is deformed, increases in volume, its physical capabilities worsen. With a long duration of the disease, hyperpigmentation of the skin, hyperkeratosis, warty formations on the feet develop. At this stage, most patients are already thinking about how to treat lymphostasis of the affected limbs.

Fourth stage- The formation of ulcers and cracks on the skin, accompanied by abundant outflow of lymph, worsens the course of the disease. The difference in the volume of the affected and healthy limbs can be more than 50 cm. The patient may be disabled due to the inability to walk and bend the joints.

To establish the correct diagnosis, it is necessary to examine a lymphologist with a thorough history taking, measuring the volume of the limb at different levels, assessing the density of the subcutaneous tissue, and the presence of trophic changes. The color, presence of hair, visible veins, size, and any ulcers or lymphatic leakage are noted. Lack of hair may indicate a problem with arterial circulation. The circumference of both limbs is measured at various levels.

Diagnosis is usually based on an objective measurement of the difference between the affected or at-risk limb and the opposite, unaffected limb, such as volume or circumference. After detecting edema, it is necessary to conduct a differential diagnosis with other diseases.

Chronic venous insufficiency can mimic early lymphedema, however, in this pathology, the volume is increased due to deep tissue edema, and there is no symptom of a fossa when pressed. Leg lymphedema should be distinguished from edema in heart failure. They are usually bilateral and are accompanied by fluid accumulation in the abdominal and thoracic cavities, shortness of breath, and cyanosis. Local accumulation of adipose tissue - lipedema can also mimic lymphedema. Lipedema is common in overweight women.

Instrumental diagnostic methods

In order to plan surgical interventions, additional diagnostic methods are carried out. Ultrasound examination of the veins makes it possible to exclude venous pathology as the cause of edema. To determine the nature of changes in the subcutaneous tissue, a study of soft tissues is carried out. Ultrasound reveals the accumulation of lymph in the subcutaneous tissue, thickening of the superficial fascia. With lymphedema, free "lakes" of fluid in the subcutaneous tissue can be determined. Using ultrasound, you can evaluate the effectiveness of conservative and surgical treatment.

Lymphography is a method of contrast study of lymphatic vessels. It implies direct injection of contrast into a peripheral vessel and X-ray control over the movement of the contrast agent. Lymphography allows you to identify the level of block lymph flow. Lymphography is a mandatory method before planning a surgical intervention.

Lymphoscintigraphy is a method of isotopic research, which determines the level of the lymphatic outflow block and the condition of the lymph nodes. The method does not allow to finally determine the surgical tactics. We do not use it in preparation for surgical treatment.

More about diagnostic methods:

Since lymphostasis is a chronic disease, its treatment must be persistent. The meaning of the treatment is to eliminate excess fluid from the subcutaneous tissue and prevent its subsequent accumulation. Effective treatment stops the progression of the disease and prevents the development of complications. Persistent conservative therapy allows you to keep the volume of the limb at a normal level.

In case of severe changes in the subcutaneous tissue and the ineffectiveness of conservative therapy, our clinic performs the most complex microsurgical operations to improve lymphatic outflow, from lymphovenous anastomoses to lymph node transplantation.

Treatment of lymphedema in the Innovative Vascular Center without surgery

The course of treatment of lymphostasis of the legs during the initial treatment should be at least 14 days, and preferably 21 days. During this time, it is possible to remove most of the edema and select a special compression stocking for the leg. The calculation of some patients that the edema will go away faster is unjustified. Untimely termination of active therapy leads to rapid accumulation of fluid. The task of the specialist is to minimize the volume of the limb so that the use of compression stockings becomes possible. Without it or a good bandage, a relapse is inevitable in the shortest possible time.

Manual and machine lymphatic drainage massage (MLD)

A special massage technique that allows you to completely remove swelling from the affected tissue and prepare the limb for wearing compression products for long-term control. Regular courses of manual drainage can effectively prevent the progression of lymphedema. Pneumatic Compression Devices: These are sleeves or stockings connected to a pump that provides progressive compression from the end of the limb to the body. They can be used in the clinic or at home and are helpful in preventing scarring of the skin.

Compression therapy (volume retention)

A special technique of compression bandaging is called bandaging. It is used in conjunction with manual lymphatic drainage to consolidate the result after the removal of edema between sessions. The goal of conservative treatment is to completely remove the edema so that later the result can be maintained with the help of special compression stockings. Elastic sleeves or stockings for maintaining the effect after conservative therapy have a special structure and provide a pressure gradient from the bottom up to promote effective outflow of tissue fluid.

Physiotherapy

Physical activity and a set of special exercises in the air and in the pool can improve the results of conservative treatment of lymphedema. This complex prevents the development of stiffness in the joints, improves lymphatic drainage and promotes weight loss in patients. Our center has developed a set of special exercises to stimulate physical activity and improve the results of treatment of leg lymphostasis.

Surgery

Modern surgical methods for the treatment of lymphostasis are aimed at improving the outflow of lymph, or removing excess fibrous tissue. In our clinic, microsurgical methods for restoring the patency of the lymphatic tract and transplantation of lymph nodes are actively used. Lymphatic venous anastomoses - an operation to create an outflow of lymph into the smallest veins, which leads to the correction of venous outflow. The innovative vascular center has unique and exclusive technologies for the surgical treatment of lymphedema.

In the case of elephantiasis, resection methods of treatment are used - removal of altered skin and subcutaneous tissue (dermatofasciolipectomy) followed by skin grafting. Such operations can reduce the volume of the limb.

Prognosis for lymphedema

Modern medicine does not allow counting on a complete cure for lymphedema. The goal of treatment is to reduce edema, prevent erysipelas and trophic ulcers, and maintain patient mobility. Even the slightest effort to change lifestyle and control allows us to hope for a good prognosis of stopping the progression of the disease.

Conservative treatment (lymphatic drainage and bandaging), as well as elastic compression, keep the edema at an acceptable level and prevent the progression of the disease. This can be achieved with regular treatment from specialists. This method does not cure lymphedema, but is a necessary tool to prevent severe complications. Patients under the control of a lymphologist have the ability to maintain the volume of the limb.

Surgical treatment can significantly reduce the severity of lymphedema without resorting to the constant use of lymphatic drainage and compression stockings, but does not completely exclude its use. After successful operations of lymphovenous anastomosis, significant clinical improvement is achieved in 70% of patients.

More about treatment methods:

Treatment results

The result of conservative treatment of severe lymphedema of both legs in our clinic of lymphology is presented. A 54-year-old patient has been suffering from lymphostasis for more than 25 years. The disease is constantly progressing. She was treated with pneumocompression and elastic stockings, but without effect. Contact our center. Ultrasound examination revealed no pathology of deep veins and arteries. There is fibrosis and fluid accumulation in both legs. It was decided to conduct conservative therapy.

A 46-year-old patient with grade 3 lymphedema of the right leg. The disease began to develop after a gynecological operation and within 10 years led to a disabling edema that interfered with normal life and movement. We contacted our clinic. A course of manual lymphatic drainage and bandaging (14 days) was prescribed, which led to a good regression of edema. Subsequently, fasciolipectomy was performed and the volume of the leg decreased significantly.

A 38-year-old patient with lymphedema of the right leg. Repeated cases of erysipelas on the right leg. He wore compression stockings that didn't hold back the swelling. In our center, complex therapy was carried out, including manual lymphatic drainage massage, bandaging and pneumocompression. As a result of treatment, edema significantly decreased after 14 days. The patient is fitted with a flat-knit compression stocking. Recommendations on lifestyle and further treatment are given.

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Price

The cost of outpatient treatment of lymphedema consists of the cost of materials for bandaging, the labor of a doctor and masseur, depreciation of rehabilitation equipment.

Treatment at the lymphology clinic includes material for bandaging, the work of a doctor and a massage therapist, a course of exercise therapy and a stay in a country clinic with food and treatment. For convenience of assessment and calculations, the cost of one day of treatment is estimated.

The cost of surgical operations and treatment in a surgical hospital is paid separately.

Expert advice

Ultrasound diagnostics

What it is? Lymphostasis is the development in the body of stagnant lymph processes in the extracellular space of tissues. In addition to the characteristic localizations of the pathology of lymphostasis (in the limbs), other variants of the manifestation of functional disorders of the lymphatic system are also known - in the tissues of the breast, face or scrotum.

According to statistics, more than 200 million people worldwide are subject to lymphostasis, and their main category is women (the age of Balzac's heroines). And the lion's share of violations of the lymph flow is due to localization in two or one lower limb (in almost 90% of cases).

The development of lymphostasis begins with pathological processes that disrupt the functions of small vessels of the lymph system (capillaries, collectors), which is manifested only by subtle swelling in the legs. Gradually, large vessels are involved in the process, leading to trophic changes in the limbs and an increase in their volume, manifesting as elephantiasis.

Genesis of development

Lymphatic outflow disorders can develop due to many reasons. The main ones are due to:

The main genesis of the development of the disease is the accumulation of lymphoid fluid in the intercellular structure of tissues, provoked by an increase in intra-lymphatic pressure caused by an imbalance in the formation and outflow of protein-rich lymph.

This process causes limited or widespread localization of tissue edema. With such edema in lymphostasis of the legs, you can successfully fight, since swelling does not cause thermodynamic (irreversible) tissue changes.

But, when changes in the form of protein destruction begin in the lymphoid fluid, fibrin and collagen fibers develop in the skin and fiber structure, muscle and fascial tissues.

The rapid growth of connective tissue leads to thermodynamic changes in the affected tissues, in the form of cicatricial neoplasms that inhibit blood flow, disrupt trophism, and provoke the development of inflammatory reactions. In accordance with the causative factor, two forms of lymphostasis are distinguished in the development of the disease:

1. Primary, due to congenital anomalies in the development of the ducts of the lymphatic system, with the manifestation of symptoms from early childhood, or in early puberty.
2. Secondary, characterized by the development of the disease due to various pathological conditions. In addition to lymphedema affecting the lower and upper limbs, this group also includes lymphostasis of the hand after mastectomy.

Symptoms of lymphostasis by stages and localization

lymphostasis, photo of symptoms after breast removal

In principle, the pathological signs of the primary and secondary forms of lymphostasis do not have any special differences. In the secondary variant, the symptoms of lymphostasis of the lower extremities manifest themselves in accordance with the severity of clinical manifestations due to the stages of the disease:

1) The beginning of the primary stage of lymphostasis is marked by the formation of a persistent and growing edema during the day on the back of the feet. The skin is stretched and shiny. Light pressure leaves a depression, which soon straightens out.

In addition to a slight discomfort in the form of bursting, the patient does not feel. There are no pain symptoms - since the swelling disappears by morning, the patients have no particular concerns, and no one is in a hurry for medical help. Although it is in this period that the treatment of lymphostasis gives the most effective result.

2) Signs of the second stage are characterized by fibrotic changes in edematous tissues. The consistency of edematous tissues is dense, with pressure, pain is noted, a deep trace remains for a long time. The skin over the edema is hypersensitive and has an unattractive appearance.

Its surface is dry, covered with cracks and folds that do not level out when stroked. At this stage of lymphostasis, there are no clear symptoms of traffic disorders yet, but inflammatory reactions are noted that appear on the skin in the form of small hyperemic spots. Often there are muscle cramps.

3) In the third stage of lymphostasis, noticeable changes occur in the skin. It is cracked, dry, and severely stretched. Massive swelling is very noticeable, which visually increases the size of the affected limb. A diffuse red spot appears on the skin - evidence of the development of inflammation reactions and infection. Over time, obvious signs of trophic damage to the skin cover appear.

4) At the fourth, last stage of the development of the disease, it manifests itself with extensive signs of damage to the limbs, spreading to the lower leg and femoral zone. Pathological changes cover the joints and bones, causing their deformation.

The limb loses its original size, greatly increasing. In tissue structures, areas of induration (compaction) and fibrosis with an unnatural bluish tint are noted. In the absence of treatment of lymphostasis, warty neoplasms and oozing ulcers (trophic) may appear.

- often a phenomenon - the loss of part of the lymph nodes, along with the tissues of the gland itself, its fiber and muscle tissue, does not stop the function of the lymphatic system, resulting in the accumulation of lymphoid fluid in the tissues, forming edema. Its excess can seep through the surgical sutures, which is often regarded by patients as the release of postoperative ichor.

Puffiness, after surgery, develops on the arm from the side of the pathological process. The symptomatology corresponds to the general signs that appear at different stages of lymphostasis.

The most terrible complication at the last stage of the disease is sepsis or the development of dense swelling (fibriderma) - this is an irreversible process that cannot be reversed.

In the vast majority, lymphostasis of the hand after mastectomy does not require treatment, it goes away on its own for six months. Facilitate the situation of self-massage manipulation, and special therapeutic exercises recommended by the doctor.

Treatment of lymphostasis - drugs and methods

Unfortunately, there is no single protocol for the treatment of lymphostasis today, although therapy is being carried out. Its purpose is due to:

1. Stopping the progression of the disease;
2. Normalization of metabolic processes;
3. Preventing the development of deep lesions and complications.

Treatment is individual and complex, due to the different genesis of the pathology. First of all, it begins with the elimination of the causative factor (sometimes by an operative method that eliminates neoplasms that impede the movement of lymph).

The use of drug therapy in the treatment of lymphostasis of the lower extremities is advisable only in the early stages of its manifestation, when there are still no structural changes in the tissue and skin structure, or as an addition in the postoperative period. Its goal is to reduce the secretion of lymphoid fluid and restore its free movement with the help of various medications:

• Drugs that improve the processes of lymphatic circulation - "Detralex", "Venoruton", "Troxevasin".
• Normalizing blood circulation in micro-vessels - "Trental" and peripheral vessels - "Theonicol", "Drotaverine" or "No-shpy".
• Providing the withdrawal of lymph from the interstitial space - "Nicotinic acid" or "Coumarin".
• Means that ensure the normalization of metabolic processes and tissue traffic - Troxerutin, Hyaluronidase and Reopirin.
• Means that thin the blood - "Kurantila" and stimulate immune functions: "Succinic acid", "" and various vitamin complexes.
• Antibiotics, with the addition of erysipelas.

In addition to conservative treatment, methods of physiotherapeutic treatment are prescribed in the form of electro, magneto, laser stimulation and pneumomassage. That allows you to speed up metabolic processes and normalize the flow of lymph through the system. Together with drug treatment of lymphostasis, these procedures contribute to the normal restoration of lymphatic outflow and strengthening of the vascular walls.

When therapeutic treatment fails, numerous surgical techniques are used. Of all the options, liposuction, lymphangiectomy, lymphatic drainage, and combinations thereof are the most commonly used.

In the treatment of lymphedema in the lower extremities, including the treatment of lymphostasis after mastectomy, along with drug therapy and physiotherapy, it is mandatory to bandage the extremities with an elastic band and use compression therapy (use of compression underwear).

How can you help yourself?

massage and compression underwear

Treatment of lymphostasis of the lower extremities at home is possible only at the initial stage of the development of the disease. Various methods of kinesiotherapy (active and passive) recommended by a doctor can be used - active kinesiotherapy in the form of therapeutic exercises selected by a specialist and passive techniques in the form of massage. Therapeutic massage can be carried out independently, or with the help of household members.

1) Massage should begin with light circular strokes of the limb only with upward movements. Since the lymphatic system does not have a valve apparatus, the movement of the lymph provides a pressure difference, and this is precisely the function that the hands should perform.

2) Then there are not too zealous kneading, patting and rubbing. Massage movements alternate with stroking actions.

3) Stroking and finishing the massage session.

Massage with lymphostasis is carried out in a course of two weeks, taking breaks between courses for 1-2 weeks. It should be remembered that exercise therapy exercises should only be done in compression underwear (stockings, leggings, golfs).

As an addition to treatment, it is possible to use traditional medicine recipes, in the form of compresses from cabbage leaves, plantain, birch and immortelle, brewed and infused for half an hour.

About food and diet

Treatment of lymphostasis will not be successful even at its initial stage, if the diet is not corrected, aimed at reducing the patient's excess weight, which aggravates the clinical picture and restores normal processes in the vascular system. For this, the diet recommended by the scientist M.I. Pevzner is suitable, the diet of which consists of a balanced and complete piranha, which has a beneficial effect on circulatory functions.

At the same time, you should abandon solarium procedures, visiting saunas or public baths, uncomfortable and tight shoes and clothes, avoid lifting weights, avoid situations where you need to stand for a long time, or sit in an uncomfortable position.

Treatment prognosis

The result of the untimely start of treatment of lymphostasis is disability. In addition, the timeliness of identifying the causative factor and adequate treatment can protect patients from the development of infectious processes, the prerequisite for which are erosions, ulcers and ordinary wounds on the edematous surface of the skin.

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