Why does lymphedema cause pain?
In several cross sectional studies, breast cancer survivors with lymphedema reported experiencing abnormal “sensations” in the territory affected by lymphedema. A range of sensations has been described: heaviness, tingling, aching, etc. Presumably, the sensations are produced by distention of neurons and sensory receptors in the skin and subdermal tissue. Traction on the nerve axons may cause them to fire spontaneously or to respond abnormally to sensory input. This phenomenon has been well characterized in other pain states. Generally, the sensations diminish or cease entirely with successful decongestion. If they persist, workup for an alternate etiology should be considered. Lymphedema does not cause intense, focal pain. Incorrect attribution of focal pain to lymphedema may delay diagnosis of a potentially harmful problem. Recurrent cancer must always be considered. The level of suspicion and diagnostic work up should be dictated by the type and stage of each patient’s malignancy. T
