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Major Types of Lymphedema


  • Primary lymphedema (PLE) is an inherited type of lymphedema that is caused by a defect during the formation of the lymphatic system before birth.
  • Secondary lymphedema (SLE)  is a type of lymphedema  caused by damage to the lymphatic system after birth. The most frequent causes are cancer, cancer surgery, treatment, and radiation. Other causes of SLE include injuries, surgery, burns, and injuries.


An infection in the at risk limb that develops with signs such as redness, fever, or not feeling well. If any of these signs develop, seek medical help immediately.

  • A feeling of heaviness or tightness in the affect limb. For example, a ring that suddenly feels too tight or a shoe that no longer fits properly.
  • A pins and needles sensation in the affected area can be caused by the pressure that swelling places on the nerves in the affected area.
  • Aching pain, or decreased mobility, in an affected joint can be due to the increased weight of the swollen limb.
  • An infection in the at risk limb that develops with signs such as redness, fever, or not feeling well.
  • Pitting edema is an early diagnostic indication of primary lymphedema. To test for this symptom, press a finger into  the swollen tissue and then pull the finger away. If this pressure creates an indentation that only goes away gradually, this is considered to be a positive sign of primary lymphedema.


Testing for Pitting Edema

Property of Lymph Notes.


 Stemmer's sign is a thickened fold of skin at the base of the second toe or finger that cannot be lifted when pinched. A positive Stemmer's sign is an indication of lymphedema; however a negative Stemmer's sign does not always exclude it.

Testing for Stemmer Sign.
 © Lymph Notes.



If the tests described above do no provide a clear answer additional tests are needed. These include:

  • A Family History may reveal clues as to primary (inherited) lymphedema.
  • A Patient Interview and Medical History may reveal clues to the cause of secondary lymphedema. Increasingly having the patient be overweight is a cause of secondary lymphedema.
  • Imaging techniques, such as lymphoscintigraphy, which is the use of a contrast medium that is injected in a tissues to make the structures visible.


  • Do not permit blood pressure to be taken on the affected, or at risk, limb. The blood pressure cuff can cut off circulation and damage delicate lymphatic tissues.
  • Do not allow an injection or a blood draw from the "at risk" limb. Any break in the skin can cause an infection capable of triggering the development of lymphedema.
  • Do not allow the placement of an IV in the "at risk" limb. Fluid from the IV can leak out of the vein and into the tissues. This creates yet another lymphedema risk.
  • Keep your weight within a range that is normal for your height. Eat a healthy diet to help to control weight and improve the functioning of the lymphatic system.
  • Exercise regularly to improve your health and stimulate the flow of lymph into normal channels.
  • Avoid exposure to excess heat, such as soaking in a hot tub. Such heat this can damage the structures of the lymphatic system that are located just below the skin.
  • Always carry a lymphedema wallet card  to identify that you have lymphedema. Lymph Notes makes these cards available, without charge to meet this need.  Details for requesting your free wallet card, go to the home page.


Lymphedema Identification (courtesy of Peninsula Medical Inc.)



 @ 2014 Lymph Notes. This information does not replace the advice of a qualified health care professional.

Got a question or comment? Post in the 'Lymphedema Treatment' forum.
Category: Are You at Risk for Lymphedema? Updated: 2014-10-26


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