• Chez Leon

UNDERSTANDING PAIN & REDNESS OF SWELLING

Updated: Jan 1


Swelling occurs when the remaining lymph nodes and vessels can’t keep up with the tissues’ need to get rid of extra fluid, proteins, and waste. With fewer lymph nodes, too, the proteins and wastes do not get filtered out of the lymph as efficiently as they once did. Very gradually, waste and fluid build-up in the tissues of the leg, foot, arm, hand, breast, chest, or trunk. One or more of these areas may be affected. The result is typically mild lymphedema, which can get worse if it’s not treated. At first, you might notice that your arm, leg, or chest feels a little bit different — tingly, uncomfortable, achy, or “full”— or that your bra, sleeve, pants, shoes, watch, or ring feels a little tight.


Personally, I noticed the tightness around my groin and pubic bone first. The tightness is when the lymph vessels become full of fluid, pressure is being exerted onto the walls of the lymph vessel in order to push the fluid into the next chamber but there is a blockage. As more lymph vessels fill up they resemble a cord like structure which is normally referred to as cording or axillary web syndrome. Cording is painful, tight & feels like a string of lumps down the central channel from the lymph nodes. When the large lymphatics and capillaries are full, unable to take on more Interstitial fluid and the remaining lymph nodes are not coping with the amount of lymph fluid swelling occurs. The pressure on the lymphatic system and the tissue layers of the skin causes the pain associated with the swelling. This is why clearing of the existing nodes, then the large lymphatics followed by the capillaries is vital in allowing more fluid to pass through the lymphatic system. Excess Interstitial fluid can be brushed or encouraged to another area to allow take up by the lymphatic system in that area. If the fluid is not moved through the lymphatic system or encouraged to another area where it can be processed, the fluid begins to thicken as proteins start to stick together & long term can become fibrous causing major disruption to the lymphatic system. Fluid can be encouraged through & in some cases out of the lymphatics and capillaries through a gentle slow pumping action. This action encourages the lymph fluid to find an alternate path around the blockage via the network of lymph capillaries.


Your bodies normal immune response to injury or infection.

Most cells in the interstitial layer release histamine as part of your first line of defence of the immune system, increasing blood flow resulting in redness & heat. The heat makes it harder for bacteria/virus’s to spread.

Cells in the blood vessels enlarge allowing immune responders & extra fluid to pass through the cell wall into the interstitial fluid which causes the swelling.

Pain – when swelling occurs there is more pressure applied that tingles the many nerves in the skin causing the pain.

T-Cells (Tregs) act to suppress immune response, thereby regulating the immune system.


Lymphoedema – Immune system response.

The Lymphatic System is the drainage system of the body. Lymph fluid contains a variety of substances, including proteins, salts, glucose, fats, water, and white blood cells taken up from the interstitial fluid. The lymphatic system also regulates immune responses by transporting bacteria, foreign antigens, particulate matter, exosomes, and immune cells to regional lymph nodes and lymphoid structures.

When the lymphatic system is blocked and the fluid in the lymphatic vessels has not been encouraged to move through the system and around the blockage fluid backs up until no more fluid can enter and swelling or pooling occurs. If left untreated the fluid becomes stagnate. Bacteria, foreign antigens etc build up, collagen proteins begin to stick together causing the fluid to thicken and slow down the system.


Your body’s natural immune response then kicks in. Mast cells release histamine causing heat. Cells in the blood vessels enlarge allowing immune responders & extra fluid to pass through cell walls help transport the stagnate fluid, causing the redness & swelling. Resulting in tingling numbness, heaviness and pain.


Recent studies using animal models and clinical samples have established that immune function is significantly compromised in secondary lymphedema, and demonstrated that a variety of T-cell-related networks are up-regulated in this condition. Tregs, in particular, are increased in abundance in lymphedematous tissue and are thought to compromise immune function in this disease by promoting immunosuppression, although they can make a positive contribution by reducing the degree of inflammation.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361763/


These changes may modulate the severity of the underlying condition and, in some cases, may promote the development of a vicious cycle of events.

https://www.frontiersin.org/articles/10.3389/fimmu.2019.00470/full


In other words, if T-cell (Tregs) are left to increase, the immune system can be compromised. Hence, the importance to get the interstitial fluid into the lymph vessels to lymph nodes into the thoracic or lymphatic ducts for recycling or elimination out of the body. Keep the circulation of lymphatic fluid moving.


Obviously if swelling/redness/pain continues to exist & do not reverse following treatment, medical attention is required to treat a possible underlying infection.


Effect of Radiation on Sweat Glands

In most cases, healing occurs by regenerative means; however, large radiation doses to the skin can cause permanent hair loss, damaged sebaceous and sweat glands, atrophy, fibrosis, decreased or increased skin pigmentation, and ulceration or necrosis of the exposed tissue. In some studies changes in sweat gland function can be detected and quantified in skin which may otherwise appear normal.


On the other hand, sweating and hot flushes can be a side effect of some drug treatments, including chemotherapy and morphine.


This is a very simplified version of events of a very complex and less understood response to the build-up of fluid resulting in lymphoedema.

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