Signs & Symptoms

Signs & Symptoms

Signs & Symptoms

Lymphedema is characterized by the buildup of lymphatic fluid that causes painful and sometimes debilitating swelling in the affected limb. Lymphedema can occur in any part of the body, most often in the arms and legs, but also the breast or chest wall, head and neck, or genitals. At risk patients should monitor the area. Remember that lymphedema onset can be slow, often starting at the furthest part of the limb (hand/wrist, foot/ankle), but any changes should be marked down and communicated by the patient to their physician/therapist.

Normal finding (left foot) and positive Stemmer’s sign (right foot).

Clinical Signs and symptoms of lymphedema include:

  • Limb heaviness is the most common early symptom of lymphedema (LE)
  • Aching limbs or unusual and excessive pain/discomfort and fatigue in the limbs
  • Swelling in the arm or leg
    • Onset may be slow or rapid
    • Progressive
    • Pitting – evident when the skin is depressed with your finger for a few seconds and the indentation does not immediately disappear
    • Most often starts distally
  • “Ski-jump” (concave) toenails
  • Fibrosis (thickening of the tissue that creates a hardening of the skin)
  • Skin changes (redness/purplish discoloration, dryness, increased warmth)
  • Disfiguring edema – tightness of the skin and awareness that clothing, shoes and jewelry feel tighter in the affected extremity
  • Decreased range of motion
  • Decreased functional mobility
  • Decreased muscular strength
  • Open wounds (venous ulcers)

Kaposi-Stemmer sign, a thickened skin fold when pinched at the base of the second toe or finger, is a clinical indicator of lymphedema. However, a negative or absent Stemmer sign does not rule out the possibility of lymphedema.

Patients having these symptoms should be evaluated for lymphedema, even if symptoms are temporary and then resolve. Early therapy by a certified lymphedema therapist (CLT) can improve patient symptoms and outcomes.