Lymphedema After Surgery: Arm Swelling and What to Do

Dr. Boris Wydoff

If your arm swells after surgery, it may be lymphedema, and it is important to find out what is causing the swelling as soon as possible. Do not wait until it becomes noticeable to others. First, rest your arm comfortably on a pillow in an elevated position, making sure your clothing does not constrict it. Keep track of any changes: measure the circumference of both arms at the same points, write down the results, and note when you first experienced heaviness, a feeling of fullness, or tingling. Then contact your treating physician, surgeon, or oncologist.

One possible cause of this condition is lymphedema, which is the buildup of lymphatic fluid in the tissues due to impaired drainage. You should not knead, vigorously massage, or apply heat to the swollen area on your own. It is important to identify the cause of the swelling and find the appropriate treatment.

Lymphedema can cause heaviness, an increase in arm size, skin tightness, tingling, and numbness. Similar sensations can occur with other conditions. That is why you should not try to diagnose yourself.

What is lymphedema after surgery, and why does the arm swell?

The lymphatic system consists of lymphatic vessels, nodes, and organs. They collect and transport lymph throughout the body. The system also helps protect against infections and diseases. When the flow of lymphatic fluid is disrupted, it builds up between the skin and muscles. This causes swelling that doctors call lymphedema or lymphostasis.

After surgery, this condition sometimes develops because lymphatic vessels have been damaged or their function has changed. Women who have undergone breast cancer surgery are particularly likely to experience this problem. During treatment, one or more lymph nodes in the armpit may be removed. If lymph drainage on that side is disrupted, the arm, hand, and even the chest may become swollen.

Arm lymphedema does not always develop immediately after surgery. Sometimes the first changes become noticeable shortly after the procedure. In other cases, the problem appears months or years later. So feeling well after leaving the hospital does not mean that swelling cannot develop in the future.

In the early stages, a person may feel heaviness, fullness, or tightness in the arm. The hand may seem larger, and the fingers may become less flexible. Clothing that normally fits comfortably may begin to feel tighter around the arm. As the swelling progresses, the arm may become noticeably larger, and movement may become more restricted.

When lymphedema persists for a long time, the skin may thicken and change color. Tingling, numbness, and discomfort may occur. Some people notice that their arm has become weaker. It becomes more difficult to use it for everyday activities.

Why does swelling occur after breast surgery?

One common cause of lymphedema is disruption of normal lymph flow after cancer treatment. Surgery may affect the lymph nodes and vessels that drain fluid from the tissues. If part of this system is removed or damaged, drainage may become more difficult.

Breast cancer surgery sometimes involves removing lymph nodes from the armpit. Radiation therapy can also contribute to the formation of scar tissue. This can interfere with normal lymph flow. As a result, swelling develops on the treated side of the body.

However, surgery does not necessarily lead to lymphedema. The risk depends on the nature of the disease, the location of the tumor, and the type of treatment received. Infections and slow healing after surgery also play a role. Previous surgeries and radiation therapy are among the risk factors as well.

Being overweight is another factor that increases the likelihood of developing lymphedema. That is why, after treatment, it is helpful to discuss not only the condition of the surgical area with your doctor but also your overall health.

Lymphedema after breast cancer surgery can affect more than just the upper arm or forearm. Sometimes the swelling extends to the hand, fingers, and chest on the side where surgery was performed. The location of the swelling depends on which parts of the lymphatic system were affected.

How can you tell lymphedema from normal postoperative swelling?

After surgery, tissues need some time to heal. Therefore, swelling alone does not necessarily mean that lymphedema is developing. The circumstances in which the symptom appeared, its severity, and how it changes over time are all important. The situation needs to be assessed as a whole.

People with lymphedema usually notice several signs:

• A feeling of heaviness and fullness in the arm, as though it has become heavier than usual.
• Skin tightness and a feeling of pressure in the hand, forearm, or upper arm.
• A visible difference between the right and left arms.
• Difficulty moving the arm and a feeling of weakness.
• Tingling, numbness, or discomfort in the swollen area.
• Pressing on the swollen area sometimes leaves a small indentation that gradually disappears.

In the later stages, the swollen tissue may become firmer. Pressing on the skin may no longer leave a noticeable indentation. If the condition remains untreated for a long time, the skin may change color and become thicker.

However, these signs are not enough to diagnose yourself. For example, an increase in arm size may have other causes. Redness and tenderness sometimes indicate a skin infection. Some conditions require an entirely different approach to examination and treatment.

A doctor examines the affected arm and assesses its condition. Additional tests may be ordered if necessary. These may include an ultrasound to check for a blood clot that could explain the swelling. The choice of tests depends on the patient's symptoms and medical history.

It is especially important to pay attention to new changes after breast cancer treatment. Even a mild but increasing feeling of heaviness in the arm deserves to be discussed with a healthcare professional. Do not wait until the swelling becomes noticeable to others.

What should you do if your arm swells after surgery?

The first rule is to tell your treating physician about any new swelling without delay. If the swelling has appeared recently or has become worse, contact your surgeon, oncologist, or another healthcare professional.

Before your appointment, you can take a few simple steps:

1. Rest your arm comfortably. Support it with a pillow, raising it above its usual position. Avoid putting pressure on the swollen area or constricting the arm with tight clothing.

2. Keep track of changes. Measure the circumference of both arms at the same points and write down the results. Repeated measurements will help you see whether the difference between the arms is increasing.

3. Write down your symptoms. Note when you experience heaviness. Record whether you have tingling, tenderness, redness, or changes in skin temperature.

4. Contact a healthcare professional. Share your observations. Explain when you had surgery and what treatment you received.

You should not start vigorous massage, strength exercises, or heat treatments on the swollen arm on your own. Different causes of swelling may require different approaches. What is suitable for one person after surgery may not be suitable for another.

If your doctor confirms that you have lymphedema, they will develop an individual treatment plan. It may include complete decongestive therapy (CDT). This aims to reduce swelling and maintain the improvement achieved. The program usually combines compression therapy, specific exercises, skin care, and manual lymphatic drainage massage performed by a trained specialist.

A compression sleeve helps support fluid drainage and control swelling. However, you should not choose one on your own. The compression level, size, length, and duration of wear are determined according to the condition of your arm and the specialist's recommendations. An unsuitable garment can create excessive pressure.

Manual lymphatic drainage massage is different from ordinary massage. It is a specialized procedure that takes the condition of the lymphatic system into account. Do not try to reproduce professional techniques on your own without training and approval from a healthcare professional.

Lymphedema can be a chronic condition. This does not mean that you will have to live with constant heaviness and discomfort. Medical care and an appropriate rehabilitation program aim to reduce swelling and improve your ability to carry out everyday activities.

If you have cancer, all additional supportive measures must be compatible with your prescribed treatment. Arm swelling is not a reason to stop chemotherapy, radiation therapy, or prescribed medications on your own.

How do diet and lifestyle affect the lymphatic system?

Nutrition and everyday habits are important for overall health. Blood and lymph help transport substances between tissues and organs. That is why I have always viewed health not as the function of a single organ, but as the interaction of many systems.

After surgery, it is especially important to avoid extremes. There is no need to change your diet drastically, fast, or attempt to cleanse your body on your own. During recovery, your diet should remain balanced and nourishing. It is best to discuss any significant changes with your treating healthcare professional.

Your regular diet can include vegetables, fruits, grains, and other familiar foods. It is important to consider how well you tolerate different foods and follow the recommendations of your medical team. Your fluid intake should also suit your individual health needs, especially if you have heart or kidney disease.

Physical activity should match your abilities. The postoperative period is not the time to begin intensive workouts on your own. But prolonged inactivity should not become a permanent way of life either.

If your doctor has cleared you to move your arm, your rehabilitation program may include gentle hand and finger movements. It may also involve bending and straightening the arm, along with other exercises selected by a specialist. Start with the recommended level of activity. Do not push through pain or increase the intensity of your exercises on your own.

Do not lift heavy objects or return to your usual strength training without consulting your doctor. If swelling, tenderness, or a feeling of pressure increases during exercise, stop the activity. Tell your specialist about these changes.

Pay particular attention to the skin on your swollen arm. With lymphedema, it can become more vulnerable. That is why it is important to watch for scratches, redness, and other changes. For daily care, you can use suitable alcohol-free moisturizers, provided they do not cause irritation. Try to prevent your skin from becoming too dry, and carefully examine your hand, fingers, and forearm.

Even a minor skin injury in the swollen area deserves attention. This is especially true if tenderness, redness, or warmth develops. Seeking medical care promptly helps ensure that an infection does not go unnoticed.

My advice: how I approach supporting the body with lymphedema

Over my years of practice, I have come to believe that blood and lymph are closely connected to the body's overall health. In my books, I look at them not separately, but as part of a single system. Within this system, tissue nourishment, fluid movement, and the function of blood and lymphatic vessels are all important.

At the same time, arm swelling after surgery requires special attention. My naturopathic views do not explain the cause of surgically impaired lymph drainage and are not a substitute for medical rehabilitation.

First — I recommend remembering the importance of drinking water.

In my book “Water — The First Helper of Metabolism,” I write that metabolism is connected to the movement of water. Blood carries nutrients, while the kidneys remove what the body does not need. In another chapter, I discuss the relationship between water and lymph flow.

In my view, maintaining a normal water balance is important for the body's overall fluid balance. But I do not recommend increasing your water intake on your own in an attempt to eliminate swelling. If you have heart or kidney disease, your doctor should determine your fluid intake.

Second — I draw attention to beetroot in the diet.

In my books, I devote special attention to beetroot and associate its chlorine content with support for the liver, kidneys, and lymph flow. That is why I consider it one of the foods that can be included in a plant-based diet. You can add it to your usual meals.

However, I do not claim that beetroot can eliminate postoperative lymphatic congestion or restore damaged lymphatic vessels. It is a food, not a treatment for lymphedema.

Third — I associate movement, warmth, and breathing with the health of the blood and lymph.

In my book “Heat, Movement, and Breathing,” I write that blood and lymph bathe the tissues, bring nutrients, and carry away metabolic waste. I consider a sedentary lifestyle and shallow breathing to be unfavorable factors.

That is why I believe that gentle physical activity within your abilities and calm breathing are important. But after arm surgery, exercises should be selected by a rehabilitation specialist. You should not put strain on your arm or apply heat to the swollen area on your own.

Fourth — I recommend viewing the body as a single, interconnected system.

In “The ABCs of Health,” I write that every organ is connected to others through blood, lymph, nerves, and metabolism. In my view, caring for a person should not be limited to addressing a single outward symptom.

That is why I pay attention to overall well-being, balanced nutrition, and regaining strength. It is especially important not to try to solve the problem of swelling with a single food or home remedy.

Here, it is necessary to distinguish between my naturopathic approach and the medical explanation. Doctors associate postoperative lymphedema primarily with damage to or removal of lymph nodes and vessels, which disrupts lymph drainage. The foundation of care remains prescribed rehabilitation, compression therapy when indicated, and monitoring by healthcare professionals. My recommendations can only complement this care.

What to avoid during chemotherapy without your doctor's approval

If breast surgery was part of cancer treatment, a person may also be undergoing chemotherapy or radiation therapy. During this period, it is especially important to be cautious with additional remedies. Even natural products and herbal supplements can affect how medications work.

You should not use St. John's wort or grapefruit without your oncologist's approval. They can alter the concentration of anticancer medications in the body. High doses of antioxidants during chemotherapy and radiation therapy also require prior approval.

It is not advisable to take herbal concentrates and extracts on your own. Their composition and effects may differ from those of ordinary foods. Just because something comes from a plant does not automatically mean it is safe.

Ordinary vegetables and fruits, however, are not prohibited. There is no need to exclude beetroot, apples, or other familiar foods simply because you are receiving cancer treatment. Your diet should be adjusted according to how well you tolerate food, your health condition, and the recommendations of your medical team.

You should not resort to fasting, detox programs, or severe dietary restrictions during treatment. Your body needs nourishment that meets your individual needs and takes food tolerance into account.

Before using any herb or supplement, or before changing your diet, inform your oncologist. All recommendations for supporting the body should be followed alongside prescribed treatment, not instead of it.

When to see a doctor

With lymphedema, it is especially important not to overlook infections and other causes of swelling. Swelling is sometimes accompanied by inflammation of the skin. This condition requires prompt medical attention.

When to call emergency services:

• You suddenly develop severe shortness of breath or chest pain.
• You faint or experience a racing heartbeat.
• You notice blood in your vomit or stool, or your stool becomes black.
• Vomiting continues for more than a day, or you are unable to drink.

Chest pain that radiates into the arm and is accompanied by a cold sweat also requires an immediate call to emergency services. Do not try to explain these symptoms as lymphedema on your own.

When to contact your oncologist immediately during chemotherapy:

• Your temperature reaches 38 °C or higher.
• You develop chills, even if you have not yet measured your temperature.

Do not try to bring down a fever on your own instead of seeking medical care. During chemotherapy, fever and chills may require urgent medical assessment.

When to seek medical attention without delay:

• The swollen arm becomes red, painful, or hot to the touch.
• You develop a fever along with changes in the skin.
• The swelling increases noticeably or is accompanied by tenderness.
• You develop new feelings of heaviness, tightness, or numbness.
• It becomes more difficult to move your arm or carry out everyday activities.
• You develop swelling in a leg, especially if it is accompanied by pain or redness.

Redness, tenderness, warmth, and fever may indicate cellulitis — a bacterial skin infection. With lymphedema, the risk of this complication is higher because stretched skin becomes more vulnerable to bacteria entering the body. This is a potentially dangerous condition. It requires prompt medical attention.

When to schedule a routine appointment:

If you notice swelling, heaviness, or a change in the size of your arm after surgery, tell your treating physician. Do not put off seeking advice until you experience significant discomfort. A healthcare professional will examine your arm and order tests if necessary.

Monitoring is especially important after breast cancer surgery. Lymphedema can develop gradually, even long after treatment has ended. That is why any new changes in your arm should be discussed with your oncologist or rehabilitation specialist.

Learn more about my approach to this subject on the “Oncology” page.

Boris Wydoff — naturopath and author, Ph.D. in nutrition. For over fifty years I have helped people restore health through nutrition, cleansing and the power of the mind — in Europe, America and Asia. About the author →

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