Swelling of the lower extremities is a very common occurrence. The swelling that appears after a hard day and disappears in the morning should alert a person. Such a symptom may be an early manifestation of varicose veins or thrombophlebitis. If the swelling only increases every day, it is necessary to consult a doctor as soon as possible to exclude lymphostasis of the lower extremities. This disease occurs in 10% of the world's inhabitants.
Features of the lymphatic system
The lymphatic system is part of the circulatory system and actively interacts with the cardiac apparatus. Vessels play the role of a transport artery for moving lymph through the body. It itself serves as a mechanism for plasma purification. The fluid first enters the intercellular space, and then, together with proteins, is redirected to the capillaries. From there, it passes to the lymph nodes, where the blood undergoes a final cleaning and is distributed throughoutbody.
The lymphatic system performs several important functions:
- antibody formation;
- participation in the formation of leukocytes;
- transportation of fats from the large intestine to the blood system;
- fluid filtration and removal of toxins, foreign substances from it.
Any malfunction of the lymphatic system causes poor outflow of fluid from the soft tissues. They occur, as a rule, due to clogging of blood vessels or their overgrowth. This contributes to the occurrence of edema, which are the first signs of lymphostasis of the lower extremities.
Description of the disease and its causes
Lymphostasis is a chronic disease characterized by a violation of the outflow of lymph. Most often it affects the area of the lower extremities. With this pathology, the lymph ceases to fully circulate throughout the body and begins to accumulate in the tissues. Therefore, the legs swell a lot, and the skin becomes very dense over time. Popularly, this phenomenon is known under the term "elephantiasis" because of the external similarity with the limbs of the animal.
The disease has 2 forms of flow: primary and secondary. They differ in the mechanism of occurrence and pathogenesis. Primary lymphostasis develops against the background of congenital pathology. It is usually diagnosed in babies, and among the causes, doctors single out several factors at once:
- genetic anomalies;
- heart valve failure;
- underdevelopment of organs.
Secondary lymphostasis of the lower extremities is not congenital. Subject to itmen and women over 30 years of age. People who lead a sedentary lifestyle also fall into the risk group. The development of the disease is due to acquired disorders that interfere with the normal outflow of lymph. These are the following violations:
- overweight;
- previously transferred thrombophlebitis;
- irradiation of the body;
- neoplasms in the lymphatic system;
- heart failure;
- kidney pathology;
- parasitic infections;
- skin burns.
The causes of lymphostasis of the lower extremities may not have a direct connection with the lymphatic system, but indirectly have a pathological effect on adjacent organs.
Clinical picture
In its development, the disease goes through 3 stages of development. Each of them has a specific clinical picture.
The initial stage, or lymphedema, is characterized by reversible processes. Puffiness appears only in the ankle and at the base of the toes. This symptom is especially noticeable after exercise, as well as in the evening. After a rest, it usually disappears without a trace. At this stage, the disease responds well to conservative treatment.
The second stage, or fibrodemus, has a more pronounced clinical picture. The swelling becomes permanent. It rises to the level of the ankle. In this area, the skin noticeably thickens, acquires a bluish tint. Possible deformation of the leg, an increase in its size in diameter. Some patients experience cramps in the calves and jointsfeet.
Elephantism is the final stage in the development of lymphostasis of the lower extremities. In the photo below you can see its characteristic features. Due to swelling, the leg increases excessively in diameter. The difference between a he althy and affected limb is about 50 cm. The skin becomes very coarse and thickened. In soft tissues, cystic-fibrous changes are manifested. The leg gradually loses the functions assigned to it by nature.
Diagnostic Methods
The lymphostasis of the lower extremities is treated by a lymphologist. In the absence of a specialized specialist in a medical facility, you need to contact a phlebologist or angiosurgeon for help.
After a physical examination of the patient, studying his complaints, the doctor prescribes an additional examination. It includes the following activities:
- Dopplerography of blood vessels (allows you to detect swelling in the veins).
- Lymphoscintigraphy (required to assess the state of the lymphatic system). This diagnostic method involves the introduction of a substance under the patient's skin that enters the lymphatic flow and takes several pictures using a gamma camera.
- Lymphography (a special case of X-ray, which can be used to determine the number of vessels and the permeability of their walls). During the procedure, the doctor injects dye between the first toes. Then he makes a small incision at the bones of the midfoot. Blue-colored vessels subsequently appear through it.
- Urine test (helps evaluate kidney function).
- Ultrasound examinationlymph flow (recommended for determining the functioning of the lymphatic system).
- Blood tests (required to detect inflammation in the body).
- ECG of the heart (allows you to establish the relationship between the work of the heart and the underlying disease).
Based on the results of the examination of the patient, the specialist tells how to treat lymphostasis of the lower extremities. Therapy can be both conservative and operative. The main course is well complemented by massage and physiotherapy. Some patients are helped by the recipes of folk healers. Each treatment option used in modern medical practice is described in more detail below.
Dietary recommendations
Treatment of lymphostasis of the lower extremities at home should be comprehensive and consist of drug and compression therapy, special massage, exercise therapy. Adjusting the diet has a positive effect on the development of the disease. The diet should be low in calories and practically s alt-free. The seasoning so beloved by many retains fluid in the body and only contributes to the occurrence of edema. It is recommended to choose foods rich in vegetable and animal proteins, fatty acids.
Doctors recommend sharply limiting the consumption of baked goods and sweets, pasta. But the presence in the diet of fresh vegetables and fruits, dairy products is only welcome. Do not forget about the drinking regime. It is recommended to consume up to 2 liters of clean water per day. It is better to replace coffee and tea with fruit drink orcompote without sugar, herbal infusions.
Medication use
Drug treatment of lymphostasis of the lower extremities involves taking drugs to normalize lymph flow, increase vascular elasticity. Usually prescribed medicines from the following groups:
- Enzymes ("Wobenzym", "Phlogenzym"). They stop swelling, stimulate the immune system and have an anti-inflammatory effect.
- Diuretics. These drugs help to remove excess fluid from the body, but they need to be taken under the constant supervision of a doctor.
- Antiaggregants ("Trental", "Kurantil"). Medicines from this group thin the blood well.
- Angioprotectors. Medicines are designed to normalize the tone of the lymphatic vessels and reduce the permeability of their walls.
- Benzopyrones ("Coumarin"). The course use of such funds helps to reduce swelling.
Taking into account the general clinical picture and the cause of lymphostasis of the lower extremities, antihistamines and antibiotics are additionally prescribed. The former are recommended for relapses of erysipelas, and the latter for trophic changes in the skin.
Benefits of massage
Massage for lymphostasis of the lower extremities is an important part of the course of treatment. Equal efficiency has a hardware and manual impact on the affected area. Trying to carry out this procedure yourself is not worth it. The study of stagnation begins with the groin area, which is physically difficult for the patientdo it yourself. Therefore, with severe swelling, it is recommended to undergo a massage course with a specialist.
Already after the first session, many patients note that the affected limb has significantly decreased in size. If there is a slight tingling and a feeling of "goosebumps" in the body, then the stagnation of fluid and lymph in the soft tissues subsides.
Massage is not for everyone. Among the contraindications to this procedure, doctors note the presence of varicose veins, trophic ulcers and other violations of the integrity of the skin. If discomfort occurs during the session, it is immediately terminated.
Compression garments
Judging by the reviews, with lymphostasis of the lower extremities, medical knitwear is a real salvation for patients. Patients report that special compression underwear has a number of advantages:
- Functionality. Stockings and socks gently compress the affected limbs and also provide support for them.
- Convenience. Few are skilled in bandaging or lymphatic drainage massage. And everyone can wear compression stockings.
- Beauty. The treatment of even such an unpleasant disease can be fashionable. Today knitwear is produced in various colors and unusual designs. It can be worn under clothes and instead of the usual underwear.
Models are best selected according to individual standards. In free sale, you can also choose the right underwear.
On the importance of exercise therapy
Treatment of lymphostasis of the lower extremities at home is not complete without physicalexercises. A set of exercises should be selected by a specialist. The first classes are held under his supervision, but after 2 weeks you can start independent work. They require little time - only 15 minutes twice a day. In this case, a compression bandage must be present on the affected leg.
What exercises can be included in the exercise therapy complex?
- "Bicycle" with a sore leg.
- Bending and alternately straightening the toes.
- Drawing a figure-eight with your feet.
- Rotation with feet in different directions, but alternately.
The above exercises are quite easy, but it is important to repeat them daily.
Help of traditional medicine
Treatment of lymphostasis of the lower extremities with folk remedies is permissible only as an addition to the main course of therapy. Before doing this, you should consult with your doctor. Due to the impossibility to present all the recipes recommended against the disease, we will consider only the most popular ones.
- Apple cider vinegar. This tool helps to strengthen the walls of blood vessels, well stops swelling. For rubbing, vinegar should be diluted with liquid in a ratio of 1: 2. After the procedure, the skin should be washed under running water and lubricated with a moisturizer.
- Compress based on pharmaceutical tar. To prepare it, the onion needs to be baked in the oven and mashed with a fork. Add 2-3 tablespoons of tar to the resulting mixture, put it on gauze or a soft cloth. The bandage must be fixed with a bandage.
- Decoctions based on healing fees can beuse as night applications. To prepare a compress, you will need to take St. John's wort, yarrow and plantain in equal proportions. In a decoction of these herbs, you need to add an aspirin tablet and 25 ml of medical alcohol. The composition can be soaked in gauze and applied to the affected area of the leg, securely fixed with a bandage.
During the treatment of lymphostasis of the lower extremities, one should not forget about other recommendations of doctors. For example, during the entire course of therapy and for some time after it, you will have to refuse to visit the bath, sauna and solarium. You should also rethink your wardrobe. It is better to put aside tight and rubbing clothes, replacing them with more comfortable options made from natural materials. Shoes with high heels, unfortunately, will have to be abandoned.
Need for surgery
When conservative methods of treatment of lymphostasis of the lower extremities are ineffective, and irreversible destructive processes in soft tissues are actively progressing, surgery is recommended for the patient. In uncomplicated cases, doctors resort to bypass surgery. This is a microsurgical intervention, during which the doctor creates fistulas between the lymphatic vessels and veins. As a result, there is a discharge of lymph into the venous bed, which prevents fluid stagnation.
More complex operations are prescribed for irreversible fibrotic processes in soft tissues. They are also referred to in case of loss of the contractile function of the lymph nodes. To similarinterventions include various skin-plastic surgeries. During their conduct, the overgrown fiber is excised, and the wound is carefully sutured. Such an operation does not guarantee a complete cure, but it makes life much easier for the patient. It should be remembered that in such patients, due to impaired metabolism in the affected limb, the wounds heal slowly. Therefore, the risk of attaching a secondary infection of bacterial etiology is quite high. This fact once again confirms that the treatment of lymphostasis of the lower extremities should be resorted to immediately after confirmation of the diagnosis.
Prognosis for recovery
The disease itself does not pose a threat to the patient's life. However, its course is often accompanied by complications that lead to irreversible consequences.
For example, severe swelling can restrict the patient's movement, causing pain. With untimely treatment, a person loses the opportunity to serve himself independently, which negatively affects the quality of his life. Developing lymphostasis sometimes provokes functional disorders in tissues. As a result, multiple seals and trophic ulcers form on the affected limb. This condition is complicated by a decrease in local immunity and the inability to fully resist various infections. A neglected disease leads to erysipelas and sepsis, which often ends in death.
If the patient does not neglect the doctor's advice and immediately proceeds toprescribed treatment, these complications are easily avoided. In general, experts give a favorable prognosis for recovery.
