5 Ways to Tell Lymphedema Apart from Venous Insufficiency

Lymphedema and chronic venous insufficiency (CVI) are two common types of edema — a condition where extra fluid builds up in your body’s tissues. Around 10 million people in the United States have lymphedema, and one in five Americans live with chronic venous insufficiency.

Edema can occur in many areas of the body but most commonly affects the legs and feet. While minor swelling can happen from everyday activities or temporary fluid retention, lymphedema and CVI are more serious issues that need attention.

Although they both cause edema, knowing the differences between lymphedema and venous insufficiency is essential because it affects how our board-certified specialists at Vascular Surgery Associates, LLC treat them. Here are five key differences.

1. Time of onset

One critical way to tell these conditions apart is by looking at when the swelling starts. Lymphedema can appear at any age. It might show up at birth, during childhood, or later in life if the lymphatic system suffers damage through surgery, trauma, or cancer treatments.

Chronic venous insufficiency typically develops gradually and often affects older adults because it takes time for the veins — especially the valves that help push blood back to the heart — to weaken.

2. Swelling characteristics

Noticing whether the swelling is one-sided or occurs in both legs can provide clues about the underlying condition.

Lymphedema usually causes uneven or asymmetric swelling, which means that one leg or arm might be noticeably more swollen than the other, and the entire limb — including the foot — could be affected.

In contrast, the swelling caused by CVI is generally symmetric, meaning both legs are usually affected similarly. With venous insufficiency, the swelling is often most apparent around the ankles and lower legs.

3. Pain levels

Pain is another distinguishing factor between the two conditions. People with lymphedema usually experience little to no pain when standing or walking, at least not directly because of the swelling. The discomfort from lymphedema, when present, might come from increased limb weight or joint stress over time.

In contrast, individuals with chronic venous insufficiency often experience pain or discomfort that becomes more noticeable during or after prolonged periods of standing or walking. This pain tends to ease when you elevate your legs, which helps blood flow more effectively back toward the heart.

4. Skin changes

Look at your skin for further clues. Lymphedema can lead to skin changes, such as thickening or a change in texture. Over time, the skin may feel tougher or drier, and you might notice a bumpy appearance in severe cases.

Venous insufficiency, however, is more likely to cause skin discoloration. The skin over affected areas might turn reddish or brownish, and it’s common to develop thick, bulging varicose veins in the affected area. Ulcers (open sores) can form due to poor circulation.

These skin changes indicate that the veins aren’t efficiently moving blood away from the extremities.

5. Response to elevation

Finally, how does the swelling react when you elevate your legs? With chronic venous insufficiency, raising the legs brings some relief. Elevation helps the blood flow back to the heart, and as a result, the swelling often decreases.

On the other hand, the swelling caused by lymphedema does not typically improve much with elevation because lymphedema results from a lymphatic system problem where the fluid remains trapped in the tissues, regardless of the limb’s position.

Managing lymphedema and chronic venous insufficiency

Lymphedema treatments often include physical therapy, specialized massage, exercises, and compression garments to help the lymph fluid move more freely.

For chronic venous insufficiency, options may include medications, compression stockings, and minimally invasive procedures to repair or remove problematic veins, such as ClosureFast™ radiofrequency ablation, Varithena™ Microfoam, and the VenaSeal™ Closure System.

If you notice persistent or worsening swelling, contact one of our offices by phone or online to ensure you receive a prompt diagnosis and effective treatment.