Almost no one thinks about their lymphatic system. Until it stops working properly.
We know that the heart pumps blood through the body and that our organs cannot function without oxygen. Far fewer people know that the circulatory system does not work alone. Every second, a second system works silently alongside the heart: the lymphatic system.
Without this network, fluid, proteins, and waste products would accumulate between the body cells. The immune system would also function less effectively, and wound healing would be severely disrupted.
What is lymph?
On hot days, many people say: I am retaining fluid.
That is understandable, but that sentence tells only a small part of the story. Lymph is not the same as water or simply “fluid”. It is a bodily fluid with an important function.
In addition to water, lymph contains, among other things, proteins, immune cells, fats, waste products, and various signaling molecules that are continuously transported throughout the body.
Lymph is not produced in a single, isolated organ, like blood cells in the bone marrow. Lymph is continuously generated throughout the body as part of a process in which the circulatory and lymphatic systems work closely together.
Where does the journey of lymph begin?
Every heartbeat pumps blood through a network of arteries that eventually branches into millions of microscopic capillaries. It is precisely in these capillaries that one of the body's most important processes takes place.
A thin layer of tissue fluid is situated between the blood vessels and every body cell. Here, oxygen, nutrients, and signaling molecules are continuously released, and waste products are absorbed. Virtually every body cell depends on this continuous exchange.
When a portion of this tissue fluid is absorbed by the smallest lymphatic vessels, we speak of lymph.
What is the function of lymph?
The lymphatic system helps the body maintain a balance of tissue fluid. Excess tissue fluid is absorbed by the smallest lymphatic vessels and eventually returned to the bloodstream.
In addition, lymph transports larger molecules, such as proteins, which cannot easily return directly via the capillaries. This is important because residual proteins can attract extra fluid and thus contribute to swelling.
In addition to maintaining fluid balance, the lymphatic system plays an important role in the immune system. Along the way, lymph passes through multiple lymph nodes, where pathogens, damaged cells, and other foreign particles are recognized and, where necessary, cleared by the immune system.
The lymphatic system also plays a role in the transport of dietary fats from the small intestine to the bloodstream. Consequently, the lymphatic system is important not only for fluid balance, but also for immunity, recovery, and metabolism.
How does lymph flow through the body?
The smallest lymphatic vessels have no muscle layer. They absorb tissue fluid as soon as the pressure in the tissue increases. From that moment on, we speak of lymph.
Only in the larger lymphatic vessels are small smooth muscle cells found in the vessel wall. These vessels consist of successive segments with valves that ensure the lymph can flow in only one direction.
The smooth muscle cells contract rhythmically and push the lymph step by step to the next segment. The force of these contractions is limited.Therefore, lymphatic flow is also supported by body movement, such as walking, contracting the calf muscles, and the pressure changes that occur during breathing.
Unlike the circulatory system, the lymphatic system has no central pump, like the heart. The transport of lymph is therefore dependent on the interplay between the rhythmic contractions of the larger lymphatic vessels and the movements of the body.
What do lymph nodes do?
During this journey, the lymph passes through hundreds of lymph nodes. These function as checkpoints of the immune system.
In the lymph nodes, specialized immune cells check the lymph for bacteria, viruses, damaged body cells, and other foreign substances. When necessary, they initiate an immune response before the lymph returns to the bloodstream.
When does edema develop?
Under normal circumstances, the body maintains a precise balance of tissue fluid. The blood vessels supply fluid, and the lymphatic system ensures that excess tissue fluid is drained away.
Edema develops when this balance is disrupted. This happens when more tissue fluid is produced than the lymphatic system can drain, when lymph drainage is reduced, or when both processes occur simultaneously.
This can have various causes. After surgery or an accident, for example, the body temporarily produces more tissue fluid as part of the recovery process. Lymph drainage can also decrease after cancer treatment in which lymph nodes have been removed or irradiated.
In chronic conditions, such as venous insufficiency, the return flow of blood functions less effectively. As a result, more fluid is pushed from the capillaries into the tissue. Congenital abnormalities of the lymphatic system can also cause the drainage capacity to be limited.
When the lymphatic system can no longer cope with this extra load, tissue fluid remains behind between the body cells, resulting in a visible or palpable swelling: edema.
Why is chronic edema a problem?
Temporary swelling following, for example, a sprain or surgery is a normal reaction of the body and usually subsides on its own. The situation changes, however, when edema persists for a longer period.
When tissue fluid accumulates between the body cells, the pressure within the tissue increases. As a result, the exchange of oxygen, nutrients, and waste products becomes less efficient. Proteins also remain behind in the tissue, attracting extra fluid and further increasing the burden on the lymphatic system.
Over time, the connective tissue can change. The skin and underlying tissue may feel firmer, become less supple, and the risk of skin problems or infections increases. The longer edema persists, the more difficult it is for the body to repair these changes on its own.
Therefore, it is important not to view persistent swelling merely as an accumulation of fluid, but as a disruption of a system that normally ensures a healthy balance in the tissue.
Edema therapy and scar therapy at Medikadermis in The Hague
As a skin and edema therapist and owner of Medicadermis in The Hague I treat people with various forms of edema, including lymphedema, lipolymphedema, venous edema, and edema after surgery or oncological treatment.
In addition, I treat scars that can restrict skin mobility, cause discomfort, or affect lymphatic drainage.
Every treatment begins with a thorough examination of the cause of the complaints. Based on this, I draw up a personalized treatment plan. Depending on the nature of the request for help, the treatment may consist of manual lymphatic drainage, compression therapy, fitting of therapeutic elastic stockings (TES), bandaging, scar therapy, exercise and movement advice, skin care, and guidance on self-management.
My goal is not only to reduce swelling, but above all to support the function of the lymphatic system as effectively as possible, maintain the condition of the skin and underlying tissue, reduce symptoms, and prevent further changes as much as possible.
Because the range of options and information online can sometimes be overwhelming, it can be helpful to look together at what suits your situation. You are therefore welcome for a personal consultation. consultation in practice, or if you find that more accessible, via a video consultation.
In this way, a treatment plan is created that is aimed not only at reducing symptoms but also at sustainably improving skin condition.
Literature
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- Scallan JP, Zawieja SD, Castorena-Gonzalez JA, Davis MJ. Lymphatic pumping: mechanics, mechanisms and malfunction. The Journal of Physiology. 2016;594(20):5749-5768. View source
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- Sleigh BC, Manna B. Lymphedema. StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf. View source
- International Lymphoedema Framework. Best Practice for the Management of Lymphoedema. International consensus document. London: MEP Ltd; 2006. View source