Home > Protocols & Procedures > Diabetes > Lower Extremity Compression for Lymphedema

Lower Extremity Compression with Lymphedema

There are a few different reasons someone might experience lower extremity compression, but one of the most common is lymphedema. Lymphedema is a condition that results in swelling due to a blockage in the lymphatic system. This can be caused by infection, injury, or genetics.

In patients with diabetes, we often see swelling in the extremities as the result of circulatory problems. Whether a patient is experiencing a lymphatic blockage or is showing signs of complications from diabetes, heart disease, or venous insufficiency, compression for lymphedema should be part of the treatment plan.

Compression garments and bandages work by applying pressure to the affected area, which helps to reduce swelling by encouraging the flow of fluid of the limb through the proper avenues. These aids also help to prevent further damage to the lymphatic system and can improve circulation. In addition, compression garments and bandages can also help to prevent ulcerations by providing support to the muscles and tissues in the affected area.


More About Lymph

Lymph is a colorless extracellular fluid containing a variety of nutrients and other molecules, such as proteins, salts, glucose, and water. In addition, lymph plays an important role in immune defense because it carries white blood cells.

In healthy adults, lymph circulates throughout the body at about 20 liters per day. While some lymph is naturally not reabsorbed in the filtering process, about 85 percent of all lymph manages to re-enter the blood vessels to rejoin the cardiovascular system.

Lymph has different compositions in different parts of the body. In the small intestine, for example, lymph is higher in certain fats, and in the liver, the concentration of proteins is about 10 times higher than elsewhere.



More About the Lymphatic System

The lymphatic system is a network of tissues and organs that helps rid the body of toxins, waste, and other unwanted materials. The system includes the thymus, spleen, lymph nodes, and lymph vessels.

The lymphatic system helps to protect the body from infection and disease. It also helps to keep the body's fluid levels in balance. The system does this by collecting excess fluid and removing it from the tissues.

A healthy cardiovascular system pumps blood into capillary beds, which allows for the exchange of nutrients via oxygen. Once the blood has gone through this process, it circulates back to the lungs to pick up more oxygen and is subsequently pumped back out to the rest of the body via the heart.

To do all of this work, the heart exerts quite a bit of pressure. This pressure forces fluid out, particularly through the capillaries. As lymph leaves the capillaries, the concentration of smaller proteins, such as albumin, is lowered while the concentration of red blood cells and larger proteins increases. This change affects the pressure on the outside of the capillaries, making blood more osmotically active and pulling molecules on the outside of the capillaries back in.
Without the lymphatic system, fluids would accumulate and a buildup would occur. The lymphatic system addresses the issue of accumulation by acting as the body's internal plumbing system. Lymphatic vessels collect excess fluid and bring it back into circulation. These vessels are different from blood vessels because they don't function in a loop. Rather, fluids are picked up from outside of the blood vessels and then redeposited back in the blood vessels.

Signs of Lymphedema


There are numerous ways to identify lymphedema. Some of the more common symptoms can include:
  • Swelling, in your limbs, especially your arms or legs
  • A feeling of heaviness or fullness in your limbs
  • Aching or discomfort in your limbs
  • Restricted range of motion in your joints
  • Difficulty fitting into clothing or jewelry
  • Skin changes, such as thickening, hardening, or skin infections