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The rhythm of life of modern people involves spending many hours on their feet. This causes swelling of the legs, and in the future lymphostasis of the lower extremities develops. If you do not pay attention to swelling in time, then lymphostasis develops over time, and its independent treatment at home can only be done at stage 1.
Lymphostasis is a violation of the outflow of fluid that moves through the lymph. Characterized by enlarged ankles and calves. The feet and legs swell so much that size 42 trousers need to be changed to 48. In some cases, you have to buy new wide shoes because the swollen foot does not fit into the old shoes.
Lymphostasis of the lower extremities can be primary and secondary. At home, treatment can be either medicinal or non-traditional. The first form of lymphostasis affects people who are genetically predisposed to this pathology. In medicine it is called Milroy's disease. The disease is inherited through genes from parents to children, and from children to further generations.
Such people are born with pathologies of blood vessels and veins. The diameter of their veins is smaller than that of healthy ones. Because of this, people with congenital problematic blood vessels have poor blood flow. There are simply anomalies with overgrown or doubled lymphatic vessels.
An underdeveloped lymphatic system can provide a person with many diseases from the first days of his life, including lymphostasis. Congenital tumors in areas of the blood and lymph flow almost 100% lead to leg problems.
Lymphostasis of the lower extremities of the secondary type develops as a result of certain processes that occur in the human body. Below is a list of these processes and states. You can get rid of some problems if you change your diet or consult a surgeon. Treatment at home should be carried out strictly with constant consultation of the attending physician.
List of processes:
Lymphostasis has 2 forms - primary and secondary, and stages - 3.
Stage 1 is a harbinger of lymphostasis, and it is called lymphedema. Lymphedema is a reversible process if you give up bad habits in time and devote all your efforts to treatment.
With lymphedema, the swelling is localized in the area of the fingers and ankle, and has not yet risen higher.
Stage 2 - fibroedema is already irreversible due to significant damage. Constant stagnation of lymph leads to thickening of the skin and stable pain syndromes. When standing for a long time, cramps appear. The lower leg increases in size compared to the healthy leg by up to 50 cm.
Complications of stage 2 manifest themselves in the form of deformation of the leg, the skin becomes bluish, often cracks, and lymph oozes from the wound for a long time. When the sore leg is rubbed with rough clothing, the rubbed areas take a long time to heal.
Lymphostasis of the lower extremities (treatment at home occurs only under the supervision of a doctor), at stage 2, sometimes affects the vessels that are located close to the epithelium, and then the skin on the legs becomes burgundy, like a solid large bruise.
Stage 3 - final. In medicine it is called elephantiasis. With it, the limb is deformed beyond recognition and no longer resembles a human leg. It looks like an elephant's leg, without the outline of feet or knees. Due to the thickening of the skin and excess fluid, the leg becomes so heavy and painful that it is impossible to walk with it. It hurts to step, it hurts to sit for a long time.
People with elephantiasis move in a wheelchair with the help of crutches and can walk independently for short distances within their own apartment. In some cases, the leg grows to such a size that it is impossible to sit in a stroller with it.
It is impossible to live with the pain that is present; the leg is operated on or, in extreme cases, amputated at the request of the patients. People themselves ask to be rid of the elephant limb so as not to drag a leg that weighs more than its own body along the floor.
With lymphostasis, characteristic symptoms appear:
When pressing with a finger on the swollen area, a dent remains for some time. In healthy people, the skin instantly springs back.
Lymphostasis of the lower extremities (treatment at home should be postponed until a complete examination) requires professional diagnosis and prescription of a regimen by a doctor. In order not to confuse it with temporary edema, you need to contact a phlebologist or lymphologist. A vascular specialist will perform an ultrasound of the abdomen and pelvis and lymphography to determine the location of the lymphatic block.
In cases of congenital pathology, surgery sometimes helps. But it all depends on the specific case. Secondary lymphostasis can be cured with medications and folk methods, in combination with massage and exercise therapy at stage 1 of the disease. Stage 2 is difficult to treat, but you can achieve a better quality of life and maintain the result for a long time.
Lymphostasis of the lower extremities (it is better not to start treatment at home until consultation with a vascular surgeon) at stage 3 cannot be treated.
Alas, the problem can be solved radically - by amputation, or to relieve the patient’s painful sensations with medication, and physically help him in acquiring special devices for moving around the city and independently servicing himself in the bathroom and toilet - that is, in everyday life.
If for some reason it is not possible to visit a doctor, but lymphostasis develops due to symptoms, you can begin treatment at home with remedies that are not capable of causing significant harm to health and aggravating the situation. At home, you can take a comprehensive dose of vitamins nicotinic acid and E, and learn how to apply leeches yourself in the evenings.
Before hirudotherapy, a 20-minute exercise therapy in combination with a drainage massage is required. At night you need to make a compress (recipes from traditional medicine can help). In the morning, rub Traxevasin into the swollen limb and put on compression socks.
During the day you need to drink a lot of water, avoid salt and pepper, and smoked foods. Completely reconsider your diet in favor of steamed food, without meat, but with vitamin-rich vegetables and fruits.
To treat lymphostasis, a wide range of medications are needed that can normalize blood flow and lymph drainage, increase the elasticity of the walls of blood vessels and reduce their fragility and permeability.
The following groups of drugs are good for these purposes:
The treatment regimen for lymphostasis of the lower extremities using the above remedies is drawn up individually, taking into account such features as:
Individual intolerance, allergic reactions, and compatibility with other drugs are also taken into account if, in addition to lymphostasis, the patient is treating other diseases with medications that are not compatible with the above group.
In folk medicine, lymphostasis is treated with an onion compress. You need to dry several large onions in the oven, and cover the leg with the cooled petals in the place of swelling. Wrap gauze on top, without squeezing, but not loosely. You need to go to bed with the compressor on and remove it in the morning. Potatoes also help. Wash, unpeeled large potatoes should be grated on a fine grater, and using gauze, make a compress for 1 hour.
In combination with the compressor you need to drink decoctions. Traditional medicine is rich in recipes for all diseases, so it has methods for preparing immunostimulating and diuretic decoctions. Almost all traditional medicine recipes that contain garlic are suitable for lymphostasis.
Garlic stimulates the immune system. It is not for nothing that it is recommended as the best antiviral folk remedy during the flu season. Immunity restored with garlic suppresses most viruses and bacteria. Makes the immune system work so that it restores the body’s diseases on its own, without medications.
Ginger and cinnamon have a similar effect.
Real green tea is a storehouse of antioxidants in the form of catechins. They bind to free radicals that the body cannot remove on its own and help remove unnecessary cellular debris from the blood.
For lovers of green tea, ginger and cinnamon, a tea cocktail made from the listed ingredients can serve as a decoction. If you replace green tea with raspberry leaves, you can prepare a decoction and steep it for several hours.
Garlic crushed in a blender must be poured into 350 g of liquid honey, sealed in a glass jar and left for 7 days in a dark corner at room temperature. If you are not allergic to honey, you can take a teaspoon on an empty stomach every 2 hours, but no later than an hour before meals.
2 tbsp. l. pharmaceutical plantain should be poured into a half-liter jar with boiling water and left for 24 hours. It is advisable to drink the contents of the jar during the day, in 3 servings, before meals. Freshly squeezed red beet juice cleanses the lymph well. A bitter, nasty, but effective juice can be prepared from the green leaves of dandelion and plantain.
It is better to entrust massage for lymphostasis to a specialist. He will be able to “squeeze” excess fluid upward from places of accumulation without damaging the vessels. When performing a massage yourself, you need to knead with rubbing movements from bottom to top. Visually, it looks like trying to put on invisible tights.
Hirudotherapy used to be part of official medicine, but over time it became non-traditional and folk medicine. The peculiarity of the treatment is that leeches do not drink thick blood, so nature has endowed them with a coagulant. When a leech bites, it injects its enzyme into a person’s blood, which locally liquefies at the site of the bite. Liquid blood passes through the vessels more easily.
Leeches are sold in some pharmacies, so hirudotherapy can be performed at home. 2 leeches a day are enough. Apply to the area of greatest accumulation of excess liquid. When the bodies of leeches grow in volume, they need to be removed and disposed of. Or wait until they fall off on their own, but you will have to wait a long time.
Remove leeches using a cotton swab dipped in alcohol. The bite must be treated to prevent infection.
The bite site can bleed for up to 16 hours and secrete up to 300 ml of lymph with blood. This is due to the enzyme that continues to work and thin the blood when the leeches are flushed down the toilet. There's nothing wrong with this, but it's worth considering. That is, it is better to carry out hirudotherapy from evening to night, so as not to walk around with bloody stains on your legs during the day.
Most often, overweight people suffer from lymphostasis, so treatment will be more effective if you adjust your diet. First of all, salt must be removed from the diet, because it retains excess fluid, which must be gotten rid of during lymphostasis. When consuming salt, taking diuretic medications and infusions is completely useless and sometimes harmful.
When talking about limiting salt, we are also talking about reviewing ready-made store foods that contain sodium. There is no point in eating home-made unleavened borscht with smoked sausage from the store. If you have lymphostasis, you need to drink a lot of clean, fresh water. Not liquids like tea, coffee, mineral water and juices, but clean, clear water without gas, salt, or minerals.
In general, you need to stop consuming:
You can only drink green tea without sugar, fresh juices and herbal infusions. Hot spices are prohibited. The food should become dietary, so you need to forget about the frying pan, and instead buy a double boiler and master recipes for baking in the oven without oil. Dietary food includes a maximum of fruits and vegetables, a minimum of meat and eggs.
From protein allowed:
The effectiveness of exercise therapy for lymphostasis depends on the stage of the disease. If the disease is at an early stage, the swelling is mild, and your legs don’t hurt when walking, then you can do active cardio training. But not all types of training are suitable, and there are limitations.
Cardio training should pump up the cardiovascular system, remove excess fluid and toxins through sweat, but training should not injure the knee joints and feet. Accordingly, jumping rope and running are excluded, and exercise on an exercise bike, elliptical trainer, rowing and swimming are suitable. 40 minutes a day or every other day is enough.
In all other cases, leg exercises “bicycle” or “scissors” are suitable. To do this, you need to lie on the floor and pretend to pedal or cross the sheath with your feet. The toes need to be stretched, so you can make flexion-extension movements with them.
We must not forget about the ankles. They need to be rotated clockwise and counterclockwise. You can study from 20 to 60 minutes a day, preferably without skipping. At the initial stage of the disease, you can combine cardio training with home gymnastics on the floor, and at an advanced stage - cardio training in the form of swimming. They can be performed on days when swelling is minimal and the legs do not hurt.
If you do not follow a dietary diet, self-medicate with drugs that are not suitable for a particular body or have intolerance due to a number of other diseases, aggravate all this by running in the last stage of the disease and massage, after which bruises remain, then you can bring your limbs to elephantiasis and trophic ulcers In severe cases, you can lose your legs.
It is difficult to make predictions for successful treatment of the disease, because lymph stagnation affects other diseases, which further aggravate lymphostasis. In treatment, it is important that the patient himself understands his problem and follows all the doctor’s instructions. I didn’t indulge in eating sweets and smoked foods, I gave up smoking and alcohol, regardless of nicotine and alcohol addiction.
And if the patient’s work involves spending the working day on his feet, lifting heavy objects, or sitting at the computer for 12 hours at a time, then, understanding all It was impossible to combine such work and treatment, so he agreed to change jobs. Money plays an important role.
Eating sausage on sale is cheaper than eating vegetables and fruits in winter, pine nuts and quality seafood. Preparing infusions and fresh juices costs money. The patient must be able to financially provide himself with quality treatment and nutrition. Under such conditions, getting rid of the initial stage or minimizing the consequences of the advanced stage becomes more realistic.
It is better to prevent any disease than to treat its consequences.
Lymphostasis of the lower extremities can be avoided by wearing compression clothing made from natural materials. If you choose tight pants, they should be made of breathable, elastic material. Pants should not be synthetic and interfere with blood flow, so that treatment of edema at home does not become part of everyday life. The skin in them must breathe.
More information about lymphostasis of the legs:
Treatment of lymphostasis:
Lymphostasis of the lower extremities (lymphedema of the legs, lymphatic edema of the legs) is a disease of the lymphatic system, characterized by impaired lymph circulation and pathological retention of lymph in the tissues.
According to WHO statistics, lymphostasis is currently diagnosed in 10% of the population of our planet. The progression of this pathology to the development of elephantiasis causes physical and psychological suffering for the patient and almost always leads to disability. That is why the prevention and treatment of lymphostasis is currently receiving increased attention from phlebologists and lymphologists around the world.
Lymphostasis is a lesion of the entire lymphatic system and a violation of the outflow of lymph. It simply stops circulating and accumulates in the tissues. This is why the legs swell a lot, and the skin becomes very dense over time. The problem does not go away on its own and develops into a more serious form, when a person can hardly move due to severe thickening of the legs.
This phenomenon is popularly called elephantiasis due to its external similarity to the limbs of this animal. Similar stagnation of lymph can develop on one leg or two, and can also affect the arms. From an aesthetic point of view, such a sight is very unpleasant, and it is quite difficult to hide it. On the Internet you can see photos showing examples of this disease.
The development of lymphostasis can be caused by a number of factors, if excluded, the development of the pathological process can be prevented or lead to persistent regression.
The causes of the development of the disease may not have a direct connection with the lymphatic system, but indirectly have a pathological effect through adjacent organs or systems.
Each stage of lymphostasis of the lower extremities has its own symptoms (see photo).
There are three levels of development of pathology:
Lymphostasis of the legs can develop primarily or secondary. Primary lymphedema is characterized by malfunctions of the lymphatic system caused by congenital malformations of the lymphatic tract and affects either one or both limbs. Primary manifestations of lymphostasis appear in childhood and progress in the future.
Secondary lymphostasis develops as a result of injury to the legs or the development of acquired diseases of the initially correctly formed lymphatic system.
When determining therapeutic tactics, it is advisable to conduct an extensive examination of the patient, which includes:
Most likely, all these diagnostic measures will not only indicate the development of lymphatic edema, but will also find the cause of these disorders.
All conservative treatment methods are used only at the first stage of the disease, when structural changes in the connective tissue and skin have not yet begun. How lymphostasis will be treated directly depends on what caused it. First of all, the etiological factor must be eliminated (for example, if there is a pelvic tumor that compresses the lymph vessels, its removal is required).
Treatment of lymphedema at home should be comprehensive, including medication and compression therapy, special massage, careful foot care, diet, sports and therapeutic exercises.
It is worth noting that drug treatment for lymphostasis of the legs contains a wide range of drugs that normalize lymph and blood flow, reduce the permeability of the walls of blood vessels, and also help increase their elasticity:
Medical knitwear is a salvation for patients with pathologies of the blood circulation and lymphatic system.
The products have a number of advantages:
It is necessary to choose therapeutic knitwear only according to individual standards. They are removed by a surgeon or medical consultant. For a positive effect against congestion, swelling, long-term use, wash your stockings or sleeves daily.
The method involves a combination of lymphatic drainage massage and physical therapy exercises. According to the rules, a massage that improves lymph flow using a special technique is performed for 15 minutes, followed by 15 minutes of exercise. The course of treatment consists of 14 procedures.
For lymphostasis, this is the basis of treatment. Hardware and manual effects on deep layers and large blood vessels are equally effective. You will not be able to massage your arm or leg yourself if there is swelling. The treatment of stagnation begins from the groin area or armpit area, which is physically difficult for the patient to do on his own. If you are prone to accumulation of lymph and interstitial fluid, or swelling, take a massage course from a specialist.
After the first session, after 1 hour, you will notice that the affected limb has decreased in size, and pleasant “goosebumps” and tingling may run through your body. This is a signal that stagnation of fluid and lymph, swelling is subsiding. During the session, the massage therapist wraps a ring of fingers around the arm or leg, slowly warms it up and works the deep layers of tissue. Lymphostasis of the lower extremities or arms can be treated with a massage brush or roller. And strengthen the blood vessels, and remove stagnation and swelling. Areas with large varicose nodes, trophic ulcers and other violations of the integrity of the skin are bypassed. If discomfort appears during the session, the session is stopped.
In addition to massage, physical exercise is very important for lymphostasis of the lower extremities. They are included in the treatment of this disease. Of course, it is necessary to develop a special complex that needs to be done 2 times a day. You should devote only a quarter of an hour to classes. In this case, a compression bandage must be present on the sore leg.
What exercises can be included in the complex?
The exercises are very easy, but the important rule is to do them daily.
At home, various folk remedies are used to treat lymphostasis (as an auxiliary medication and only in the initial stages). Without being able to describe them all, here are a few examples:
In addition, we should not forget about other recommendations from doctors to patients who are developing or experiencing similar problems. They will have to avoid baths, saunas, solariums, fragrances and preservatives in foot cosmetics, give up high-heeled shoes, tight clothes that rub the skin, avoid heavy lifting, long standing or sitting (especially with one leg crossed).
The issue of surgical treatment is considered in case of severe congenital pathology of the lymphatic system, lack of effect from conservative therapy, progression of lymphedema, soft tissue fibrosis, frequent episodes of erysipelas, etc.
Types of surgical intervention:
After any type of surgical intervention, drug treatment is prescribed. Every patient with lymphostasis, regardless of the stage of the process, is observed by an angiosurgeon. Courses of maintenance therapy in most cases are carried out throughout the patient’s life.
To prevent lymphostasis of the lower extremities, it is recommended to follow the following rules:
Stagnation in tissues and impaired outflow of lymphatic fluid will provoke the appearance of other serious diseases and limit movement. How to prevent the development of pathology? If lymphostasis of the lower extremities has already been diagnosed, treatment at home will help you quickly cope. The system of influencing risk factors should not be neglected in patients with a genetic predisposition or in remission.
Swelling of the lower extremities - frequent occurrence, found in a large number of people.
Swelling that appears in the legs after a hard day and disappears on its own in the morning after rest should alert a person, because such signs can be early symptoms varicose veins or the initial stage of thrombophlebitis.
However, if swelling in the foot or leg area becomes more pronounced every day, it is important consult a doctor as soon as possible in order to prevent the development of lymphostasis.
Lymphostasis is a pathological process that is characterized by the development of persistent edema caused by lymph flow disorders. The disease develops due to a disorder in the peripheral lymph system and its central parts.
This condition helps slow down fluid outflow from lymphatic capillaries and vessels. The pathology is manifested by significant swelling of the extremities, accumulation of fluid in the abdominal cavity and sternum.
There are 3 stages in the development of pathology:
The photo below shows three stages of lymphostasis of the lower extremities:
Lymphostasis is classified into:
The occurrence of lymphostasis Women aged 35-45 years are more susceptible. The risk group also includes people leading a sedentary lifestyle.
Lymphostasis in most cases develops in the legs and arms. Much less often, pathology is concentrated in the area of the reproductive system, the peritoneum, mammary glands and face.
Lymphostasis of the lower extremities occurs almost in 90% of cases.
The disease itself does not pose a threat to human life, however, has a number of complications that can lead to irreversible consequences.
For example, severe swelling can limit the patient's movements, causing discomfort and pain.
If treatment is not timely, a person loses the ability to care for himself independently, which significantly worsens the quality of his life.
Also, developing lymphostasis leads to functional disorders of tissues located in the area of the epicenter of the pathology, as a result of which in this place fibrosis (tissue compaction) and trophic ulcers are formed.
This condition is complicated by a decrease in local immunity and the inability to resist various types of infections.
In addition, advanced lymphostasis leads to erysipelas, a complication of which can be sepsis, often leading to death.
With timely diagnosis and treatment, specialists give a positive prognosis for the course of the disease.
Among the reasons causing the development of pathology are:
Watch the video about the reasons for the appearance lymphostasis:
Each stage of the disease has its own signs and symptoms:
Common symptoms of the disease include:
A specialist should diagnose and prescribe the necessary treatment for lymphostasis!
After the doctor collects anamnesis, including family history, and also examines and palpates the affected areas, he will prescribe a number of additional diagnostic measures, among which:
Pay attention to the condition of the lymph nodes. If they are, start treatment, otherwise the disease may develop into a more serious one.
Lymphostasis of the lower extremities is a pathology that can become irreversible, therefore treatment (both medication and folk remedies) should be carried out under the supervision of a specialist.
Treatment of lymphostasis comes down to normalizing lymph flow in the affected leg. Medicines play an important role in therapy:
During treatment of leg lymphostasis, it is necessary to adjust the patient’s diet. To do this, you should strictly limit:
The patient's diet should include:
Treatment of lymphostasis is a long process. It is important to understand that it is possible to cope with the problem at home only at the initial stage of the disease’s development.
If after 2 months there are no changes in the patient’s condition, or the disease progresses, it is necessary to urgently consult a doctor, who will adjust the treatment tactics or prescribe surgery.
You can prevent the development of lymphostasis by following a number of simple rules:
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 causes complications that are difficult to treat. Without treatment, 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 then collects in the lymph nodes, which filter waste and infection using special lymphocyte cells. The filtered lymph is ultimately drained into the general bloodstream.
Blockage of lymphatic vessels or lymph nodes leads to stagnation of lymph, swelling of the subcutaneous tissue and the development of scarring and elephantiasis. The disease most often affects one leg, but in rare cases both legs 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.
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) lymphostasis of the leg is most often associated with underdevelopment of the lymphatic drainage system; sometimes there are cases of congenital amniotic bands (scars) that compress the superficial lymphatic vessels. There are cases of a hereditary form of the disease that manifests itself in several members of the same family.
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.
Secondary lymphostasis
Other reasons:
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.
The increase in volume and weight of the affected limb leads to increased stress on the affected leg. Often, such patients develop arthrosis of the hip and ankle joints, which leads to limited physical activity and contributes to excess 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 and pain when touched. Although erysipelas is easily treated with modern antibiotics, each episode of inflammation aggravates the course of lymphedema and leads to an increase and thickening of the edema.
At the extreme stage of lymphedema, leakage of lymph from cracks in the skin and the formation of extensive trophic ulcers develop. This condition is potentially dangerous due to the development of general blood poisoning (sepsis) and requires active treatment in a hospital.
The Innovative Vascular Center uses the best treatment scenario for lymphedema to date. 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 drainage.
For the first time, the innovative vascular center was able to transfer the experience of leading lymphological clinics in Germany to our country. Lymphologists at our center have been trained in one of the leading clinics for the treatment of lymphostasis in Germany and are well aware of how lymphostasis of the affected lower extremities can be treated using modern methods.
The lymphedema rehabilitation department has comfortable rooms with all amenities. The sanatorium is located in a forest area and has everything for relaxation and treatment. For physical therapy, special routes through the forest with ascents and descents are organized. The treatment method and diet were specially selected according to the recommendations of Doctor of Medicine F.-J. Schingale is a recognized specialist in the treatment of lymphostasis.
Our center’s specialists can treat lymphostasis using modern microsurgical technologies. We have introduced microsurgical operations of lymphovenous anastomoses for leg lymphedema and lymph node transplantation into Russian clinical practice. Our surgeons have extensive positive experience in reconstructive plastic surgery for elephantiasis. Every year, our surgeons make life easier and restore health for 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 treatment results. Only an inpatient approach, followed by outpatient observation and treatment, allows us to achieve the best results for 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
Comprehensive rehabilitation program
Surgical operations for elephantiasis
Lymphovenous microanastomoses
Lymph node transplants
Diagnostics
The constant accumulation of fluid and proteins in the tissue leads to inflammation and subsequent scarring of the tissue, resulting in a hard, tight swelling. The skin in the affected area thickens and becomes lumpy with papillary growths. Scales and cracks appear, through which a secondary bacterial or fungal infection can join. The affected areas of the skin can become inflamed and painful, and trophic ulcers often form. Lymphostasis can cause deformation 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 toes and on the back of the foot. Symptoms of lymphostasis of the lower extremities at the initial stage: mild and painless swelling that goes away after some time after rest. The skin over the swelling may form a fold.
Second stage- the swelling does not go away completely, however, if the patient remains in a horizontal position for a long time, it may decrease. No thickening of the subcutaneous tissue is observed. However, if the conditions causing lymphedema persist, thickening of the connective tissue begins to develop and treatment becomes more difficult. Swollen feet and toes can be an eye-catcher.
Third stage- stage of fibroedema. The development of this stage occurs slowly. Fibredema is characterized by constant and dense swelling and does not go away with long rest; the skin cannot be folded. A swollen leg becomes deformed, increases in volume, and its physical capabilities deteriorate. With a long duration of the disease, hyperpigmentation of the skin, hyperkeratosis, and 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 lymph flow, 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 become disabled due to the inability to walk and bend joints.
To establish a correct diagnosis, an examination by a lymphologist is required with a thorough history taking, measuring the volume of the limb at different levels, assessing the density of subcutaneous tissue, and the presence of trophic changes. Color, presence of hair, visible veins, size, and any ulcers or lymphatic drainage are noted. Lack of hair may indicate a problem with arterial circulation. The circumference of both limbs is measured at different levels.
Diagnosis is usually based on objective measurement of differences between the affected or at-risk limb and the opposite unaffected limb, such as volume or circumference. After identifying edema, it is necessary to carry out differential diagnosis with other diseases.
Chronic venous insufficiency can mimic early lymphedema, however, with this pathology, the volume is increased due to edema of the deep tissues, and there is no pitting symptom when pressed. Leg lymphedema should be distinguished from edema due to heart failure. They are usually bilateral and are accompanied by accumulation of fluid in the abdominal and chest cavity, shortness of breath, and cyanosis. Local accumulation of fatty tissue - lipedema can also imitate lymphedema. Lipedema is common in overweight women.
In order to plan surgical interventions, additional diagnostic methods are carried out. Ultrasound examination of the veins allows us to exclude venous pathology as the cause of edema. To determine the nature of changes in the subcutaneous tissue, a soft tissue examination is performed. Ultrasound reveals accumulation of lymph in the subcutaneous tissue and thickening of the superficial fascia. With lymphedema, free “lakes” of fluid can be detected in the subcutaneous tissue. Using ultrasound, you can evaluate the effectiveness of conservative and surgical treatment.
Lymphography is a method of contrast study of lymphatic vessels. It involves direct injection of contrast into a peripheral vessel and X-ray control of the movement of the contrast agent. Lymphography allows you to identify the level of lymphatic drainage block. Lymphography is a mandatory method before planning surgery.
Lymphoscintigraphy is an isotope research method that helps determine the level of lymphatic drainage block and the condition of the lymph nodes. The method does not allow definitive determination of surgical tactics. We do not use it in preparation for surgical treatment.
Since lymphostasis is a chronic disease, its treatment must be persistent. The point of 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 complex microsurgical operations to improve lymphatic drainage, from lymphovenous anastomoses to lymph node transplantation.
The course of treatment for leg lymphostasis at initial treatment should be at least 14 days, and preferably 21 days. During this time, it is possible to remove most of the swelling and select special compression hosiery for the leg. The expectation of some patients that the swelling will go away faster is unjustified. Untimely cessation of active therapy leads to rapid fluid accumulation. The specialist’s task is to reduce the volume of the limb as much as possible so that the use of compression hosiery becomes possible. Without it or a good bandage, relapse is inevitable in no time.
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 consistent compression from the end of the limb to the body. They can be used in the clinic or at home and are useful in preventing scarring of the skin.
A special compression bandaging technique is called bandaging. Used in conjunction with manual lymphatic drainage to consolidate the result after removing swelling between sessions. The goal of conservative treatment is to completely remove the swelling so that the result can subsequently be maintained using special compression stockings. Elastic sleeves or stockings to maintain the effect after conservative therapy have a special structure and provide a pressure gradient from bottom to top to facilitate the effective outflow of tissue fluid.
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 joint stiffness, improves lymphatic drainage and promotes weight loss for patients. Our center has developed a set of special exercises to stimulate physical activity and improve the results of treatment of leg lymphostasis.
Modern surgical methods for treating lymphostasis are aimed at improving lymph outflow or removing excess fibrous tissue. Our clinic actively uses microsurgical methods for restoring the patency of the lymphatic tract and lymph node transplantation. Lymphovenous anastomosis is an operation to create lymph outflow into the smallest veins, which leads to correction of venous outflow. The innovative vascular center has unique exclusive technologies for the surgical treatment of lymphedema.
In the case of elephantiasis, resection treatment methods are used - removal of altered skin and subcutaneous tissue (dermatofasciolipectamia) followed by skin grafting. Such operations can reduce the volume of the limb.
Modern medicine does not allow us to count on a complete cure for lymphedema. The goal of treatment is to reduce swelling, prevent erysipelas and trophic ulcers, and maintain patient mobility. Even the slightest efforts to change lifestyle and control allow us to hope for a good prognosis and a halt in the progression of the disease.
Conservative treatment (lymphatic drainage and bandaging), as well as elastic compression, can keep swelling 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 means to prevent severe complications. Patients under the control of a lymphologist are able 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 hosiery, but does not completely eliminate its use. After successful lymphovenous anastomosis operations, significant clinical improvement is achieved in 70% of patients.
Treatment results
The result of conservative treatment of severe lymphedema of both legs in our lymphology clinic is presented. A 54-year-old patient has been suffering from lymphostasis for more than 25 years. The disease is continuously progressing. She was treated with pneumocompression and elastic stockings, but without effect. Contacted our center. An ultrasound examination did not reveal any pathology of the deep veins and arteries. There is fibrosis and fluid accumulation in both legs. It was decided to carry out conservative therapy.
A 46-year-old patient with grade 3 lymphedema of the right leg. The disease began to develop after gynecological surgery and over the course of 10 years led to disabling swelling that interfered with normal life and movement. Contact our clinic. A course of manual lymphatic drainage and bandaging was prescribed (14 days), which led to good regression of the swelling. 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. I wore compression stockings, which did not contain the swelling. Our center provided complex therapy, including manual lymphatic drainage massage, bandaging and pneumocompression. As a result of treatment, after 14 days the swelling decreased significantly. The patient was 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 the doctor and massage therapist, and the depreciation of rehabilitation equipment.
Treatment at the lymphology clinic includes material for bandaging, the work of a doctor and massage therapist, a course of exercise therapy and a stay in a country clinic with food and treatment. For ease 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.
Ultrasound of soft tissuesAssessment of the volume of fluid in the limb with lymphedema and the presence of fibrous elements. It is carried out to predict the success of conservative therapy. |
A fairly large number of people have swollen feet. When swelling of the foot or lower leg with tense veins is observed in the evening, and in the morning the swelling disappears, then there is little good in this: these are distant harbingers of varicose veins or thrombophlebitis... But if the swelling becomes more noticeable every day and does not go away in the morning, then here an equally alarming diagnosis is likely - lymphostasis of the lower extremities.
Doctors call lymphostasis a pathology of the lymphatic system, which is expressed in the complete cessation of lymph circulation (lymph flow). That is, lymph ceases to perform its functions and carry out constant drainage of body tissues. And edema is a clinical manifestation of this pathological process. In this case, the legs suffer the most, and in women five times more often than in men.
Lymphostasis of the lower extremities (lymphedema, lymphedema) is a chronic disease with swelling of only one or both legs. The disease does not go away on its own, but progresses into an irreversible form, in which the formation of fibrous tissue leads to thickening of the legs - elephantiasis (elephantism).
Among the factors contributing to the development of leg lymphostasis, experts name kidney disease, cardiovascular disease, pathologically low levels of total protein in the blood (hypoproteinemia), varicose veins, damage to lymphatic vessels with their blockage or compression (for example, tumors or inflammatory infiltrates).
The cause of lymphostasis of the lower extremities may lie in chronic damage to the lymphatic vessels by streptococcus and other microorganisms against the background of weakened immunity. In addition, congenital defects of the lymphatic system can cause lymphostasis.
With a congenital anomaly, lymphostasis is called primary, and the disease begins to make itself felt in childhood, worsening with age. Acquired lymphostasis of the lower extremities is defined as secondary and appears, as a rule, only on one leg - due to trauma, inflammation, tumors of the lymph nodes or lymphatic vessels, previous radiation therapy or surgical treatment of the vessels of the extremity. Lymphostasis of the lower extremities during pregnancy is most often observed when disorders of the lymph circulation in the expectant mother are congenital in nature, and this is primary lymphedema.
It should be noted that impaired outflow of lymphatic fluid during lymphostasis is accompanied not only by edema. Lymph stagnation inhibits the removal of waste from tissue cells, and this, in turn, increases the acidity level of the skin, causing unpleasant itching sensations. As a result, the skin becomes thicker and denser, its protective function decreases, and microbes from the upper layer of the skin can easily penetrate into the subcutaneous tissue, causing various inflammations.
The course of lymphostasis of the lower extremities has three stages: reversible edema (lymphedema), irreversible edema (fibredema) and elephantiasis.
Typical localization of swelling in the first stage of the disease is the area of the ankle joint, the base of the toes and the muscle layer between the metatarsal bones on the back of the foot. The swelling is easily palpable, almost painless, the skin over the swollen area is pale and often forms a fold. In the cold season, after several hours of rest, swelling may almost disappear or significantly decrease.
The main symptom of lymphostasis of the lower extremities in the second stage (irreversible edema) is the spread of permanent swelling up the leg, which does not go away even after a long rest. Moreover, the nature of the swelling also changes: it becomes denser (pressure marks remain for a long time), and it is simply impossible to gather the skin into a fold. Patients with chronic lymphostasis of the lower extremities complain of pain and a feeling of heaviness in the affected leg. The leg begins to deform, and it becomes difficult for the patient to bend it when walking. And if you stay on your legs for a long time, you may experience cramps.
This stage occurs over a long period of time, and as the disease progresses, the skin of the affected limb darkens (sometimes with a bluish tint), the skin becomes tight and causes pain, and the stratum corneum of the epidermis thickens and becomes rough (hyperkeratosis).
Symptoms of elephantiasis, the third stage of lymphostasis of the lower extremities, are the proliferation of connective tissue in the skin, subcutaneous tissue and between the muscles of the leg and an increase in the volume of the leg so much that it resembles an elephant’s limb. At the same time, even the bones become thicker, and ulcerations and inflammation may appear on the skin.
Diagnosis of lymphostasis of the lower extremities begins, as usual, with a history and examination of the affected leg. A biochemical blood test and a urine test are also prescribed. To exclude possible chronic venous insufficiency or thrombosis of the blood vessels of the extremities, a duplex scan of the veins is done. To determine the exact size and structure of the lesion, the doctor prescribes an ultrasound of the soft tissues and blood vessels of the legs. As well as ultrasound of the abdominal and pelvic organs - to identify provoking or concomitant pathologies.
For the purpose of a more detailed examination of the state of the patient’s lymphatic system, as well as to confirm the final diagnosis, lymphography or lymphoscintigraphy can be used, which give a clear picture of the lymphatic vessels of the extremities and the degree of their patency.
Where is lymphostasis of the lower extremities treated? In specialized clinics or departments of clinics with a wide profile, where there are lymphologists or phlebologists. In the treatment of this disease, amateur performance is fraught with disability. After all, the appearance of persistent swelling of the legs can be a symptom of many other diseases, so the first priority is to make the correct diagnosis. And only specialists can do this.
Treatment of lymphostasis of the lower extremities is not an easy matter, and doctors are fighting this disease simultaneously in two directions - physical and medicinal. Thus, complex treatment of lymphostasis of the lower extremities includes, first of all, an attempt to mechanically rid the lymphatic system of excess volumes of lymph.
Massage is also prescribed for lymphostasis of the lower extremities. This is not just a massage, but a special lymphatic drainage massage (manual lymphatic drainage), which activates the contraction of lymphatic vessels and thereby helps the movement of lymph. Due to this, leg swelling is significantly reduced, and the volume of the affected leg during the first two stages of lymphostasis of the lower extremities (lymphedema and fibroedema) can be reduced by 10-15 cm.
In addition, hardware massage is used - pneumocompression. At the same time, a prerequisite for achieving positive results from physiotherapeutic methods of treating lymphostasis of the lower extremities is the use of special bandaging - bandaging. To do this, the attending physician selects an elastic bandage of appropriate density or medical compression hosiery in the form of special stockings and knee socks.
The main task of treating lymphostasis of the lower extremities is the maximum possible restoration of lymph outflow from the tissues of the diseased leg. For this purpose, so-called phlebotonic drugs are used, the pharmacological action of which is aimed at improving lymphatic drainage and microcirculation in tissues.
The most common of them (including in European medical practice) is the bioflavonoid detralex (diosmin, phlebodia, vasoket). The drug Detralex is used to treat symptoms of venous-lymphatic insufficiency: one tablet twice a day (with meals). The course of treatment is from two to six months. The medicine has practically no side effects, except for diarrhea and dyspepsia in case of individual intolerance. Use during pregnancy and breastfeeding is acceptable.
Such drugs for lymphostasis of the lower extremities as troxerutin, troxevasin, paroven, venoruton are effective in the treatment of edema in the first and second stages of the disease.
They increase the tone of the veins and improve their lymphatic drainage function. Troxerutin gel is applied in the morning and evening to the skin of the swollen area of the leg, gently massaging until completely absorbed (the drug is applied only to intact skin). Troxevasin is taken 1 capsule 3 times a day.
The homeopathic drug lymphomasot stimulates metabolism, improves lymphatic drainage and enhances the removal of toxins from tissues. Release form: tablets for oral or sublingual administration, as well as drops. Dose for adults - 10 drops 2-3 times a day 30 minutes before meals. Lymphomyosot N in ampoules of 1.1 ml is intended for injection: adults are prescribed one ampoule up to three times a week, in case of acute illness - daily. This medicine is contraindicated for thyroid diseases.
Glycoside saponin from horse chestnut fruit is the basis of the venotonic and anti-exudative drug escin (other trade names are aescin, venoplant, escusan, venastat, venitan, Theiss Venen gel). The drugs have different release forms. So, venastat in tablet form is taken - 40 mg 3 times a day after meals, washed down with plenty of water. Venastat gel is applied to the skin of the affected areas of the extremities several times a day. Contraindications: hypersensitivity, renal failure, early pregnancy, lactation, renal dysfunction.
Side effects of the drug include: feeling of heat, nausea, skin rash, urticaria, swelling of the subcutaneous tissue.
In the drug treatment of lymphostasis of the lower extremities, drugs for systemic enzyme therapy (Wobenzym, phlogenzyme) are used, which have anti-inflammatory, decongestant and fibrinolytic effects and increase immunity. The dose of Wobenzym is 5 tablets three times a day 40 minutes before meals (with a glass of water). Flogenzym is taken 3 times a day, 2 tablets, half an hour before meals, also with plenty of water.
Specialists use diuretics (diuretics) in the treatment of lymphostasis of the lower extremities with caution, since the fluid that accumulates in the tissues (transudate) during lymphatic edema is characterized by the ability to quickly gain lost volume. So diuretics (for example, furasemide) are not always prescribed for lymphedema.
In case of inflammation of the subcutaneous tissue (erysipelas) or lymphatic vessels (lymphangitis) accompanying lymphostasis of the lower extremities, injections of antibacterial drugs of the penicillin, oxytetracycline and sulfonamides group are used.
If complex treatment of lymphostasis of the lower extremities does not give the desired effect and lymph sacs and fibrosis appear on the affected leg, then surgeons get down to business. During the operation, bypass pathways are created for the outflow of lymph (lymphovenous anastomoses), and this makes it possible to significantly improve the condition of patients with chronic lymphostasis of the lower extremities.
A proven and very effective folk remedy for treating lymphostasis of the lower extremities is compresses with baked onions and birch tar. To do this, you need to bake the onion in the husk in the oven, peel it and mix it with a tablespoon of birch tar (you can buy it at the pharmacy). The mass is applied to a cotton cloth and applied (fixed with a bandage) to the sore spot overnight. The course of such procedures lasts two months.
In folk medicine there is a recipe for a medicinal infusion, for the preparation of which you should take 350 g of honey and 250 g of chopped garlic. The mixture is infused for one week, and then taken for two months, a tablespoon three times a day - an hour before meals.
A decoction of plantain leaves (1 part), dandelion leaves (1 part) and immortelle flowers (2 parts) is recommended. The mixture of medicinal plants is poured into 0.5 liters of boiling water, left for 5-6 hours and taken 100 ml 4 times a day before meals for a month.
It is useful to drink this drink twice a day: add a tablespoon of natural apple cider vinegar and a teaspoon of bee honey to a glass of warm boiled water.
When treating lymphostasis of the lower extremities, the main task is to, through the integrated use of all methods (physiotherapy, bandaging, medications), free the lymphatic system of the legs from excess lymphatic fluid and restore lymph circulation in the affected lower extremities.
Long-term use of anti-inflammatory and diuretic drugs, as well as drugs aimed at increasing the tone of the veins and improving the rheological properties of the blood (that is, reducing blood viscosity), unfortunately, does not always lead to the desired result.
Experts note that in the complex treatment of lymphostasis of the lower extremities, including its extremely severe form - elephantiasis, it is advisable to use hirudotherapy: with the help of medicinal leeches, the lymphatic drainage function of the veins can be significantly improved. The use of leeches increases the overall therapeutic effect of treatment, since swelling and tension of the lower extremities are reduced. This prolongs the period of remission of patients and increases their level of activity.
Leeches are placed - 3-5 pieces twice a week (the course of treatment is 8-10 sessions) - on the collecting lymphatic vessels (lymphatic collectors) and in places corresponding to the projection of the venous system of the legs. As a result of the therapeutic effect of leeches, collateral (roundabout) lymph flow is stimulated, since additional lymphatic vessels, which were not the main routes of lymph outflow, are connected to the removal of excess lymph from the tissues of the affected limbs.
However, some lymphologist specialists note that treatment of lymphostasis of the lower extremities with leeches is useless, since leeches are not able to relieve swelling.
We talked about the need and effectiveness of special massage above, and now about the benefits of exercise therapy for lymphostasis of the lower extremities. There is no way to cope without physical therapy for such a diagnosis. Doctors say that it is best for such people to practice swimming or “Nordic walking” (with ski poles). But there are also gymnastics for lymphostasis of the lower extremities.
The following exercises for lymphostasis of the lower extremities are recommended to be done twice a day for 10-15 minutes. These exercises should only be performed with a compression bandage (or compression stockings).
So let's begin. The first and main exercise is “bicycle with one leg.” It is done lying down, with the healthy leg completely at rest. Here you will have to remember how to ride a bicycle, and not be lazy to move not only the hip joint, but also the ankle joint - as if you were pressing the pedals - bending and unbending the sole of the foot.
The following exercise (and all others) are performed while sitting on the floor (15-20 times):
As you can see, the exercises are simple, the main thing is to do gymnastics for lymphostasis of the lower extremities every day.
Nutrition for lymphostasis of the lower extremities is of great importance, since in the vast majority of cases this disease affects people with excess body weight.
The diet for lymphostasis of the lower extremities involves limited consumption of salt and liquid. As you know, excessively salty foods contribute to the accumulation of fluid in tissues and complicate recovery.
Nutritionists advise consuming no more than 100 g of protein of plant and animal origin per day. Next - fats. Patients with this diagnosis should eat at least 10 g of animal fat and 20 g of vegetable oil per day.
To reduce calories, you need to limit your carbohydrate intake, so give up bread made from wheat flour (loaves, buns, etc.), sugar, pasta, semolina and rice porridge, not to mention candy, halva and ice cream. But fermented milk products, as well as cabbage, zucchini, pumpkin, carrots, beets, apples and citrus fruits, are not only good for your health, but also very tasty.