Lymph and the lymphatic system: what they are and how they work
From swollen legs and a weakened immune system to the right time to see a vascular surgeon.
Content
Lymph and the lymphatic system play a key role in fluid balance, immune function and vascular health, and when this system no longer works properly you may develop leg swelling and other circulation problems that require specialist assessment in a vascular and endovascular surgery department.
If you have swollen legs, varicose veins or a feeling of heaviness in your lower limbs, you can book an appointment for a thorough evaluation of your venous and lymphatic circulation.
Book an Appointment
What is the lymphatic system and how does it work?
Lymph is a clear fluid rich in immune cells, proteins and metabolic waste products that circulates through a network of lymphatic vessels running in parallel with the venous system. The lymphatic system is made up of lymphatic vessels, lymph nodes and organs such as the spleen, thymus and tonsils, forming a “drainage and filtration system” for the entire body.
Through the lymphatic vessels, lymph removes excess fluid from the space between cells and returns it to the venous circulation, helping to prevent oedema and keep tissues functioning normally. Lymph nodes filter the lymph and help the body recognise and fight infections, making them a key component of immune defence.
What is the role of the lymphatic system in the body?
Fluid drainage and prevention of oedema
One of the main roles of the lymphatic system is to drain excess fluid that builds up in the tissues so that blood and lymph volumes remain in balance. When lymph flows normally, the legs and arms do not swell and the tissues receive oxygen and nutrients efficiently.
When lymph and the lymphatic system are overloaded or damaged, fluid accumulates and there is a tendency for chronic swelling of the limbs, known as lymphatic oedema (lymphedema).
Immune protection
The lymphatic system is closely linked to the immune system, with lymph transporting lymphocytes and antigens to the lymph nodes, where immune responses against infections are triggered. The nodes act as filters that trap viruses, bacteria and foreign particles, preventing them from circulating freely throughout the body.
Wound healing and recovery after vascular procedures
Lymph carries cells and substances involved in tissue repair and therefore contributes to wound healing. After vascular or endovascular surgery, a well-functioning lymphatic system helps control oedema, lowers the risk of local infections and supports faster recovery.
Conditions affecting the lymphatic system
Lymphedema (lymphatic oedema)
Lymphedema is a condition in which lymph can no longer be drained effectively and builds up in the tissues, causing chronic swelling of the legs or arms. It can be:
- Primary: caused by an abnormal development of the lymphatic vessels.
- Secondary: occurring after surgery, trauma, infection, radiotherapy or in the context of other diseases.
Symptoms of lymphedema include a feeling of tightness, heaviness of the affected limb, skin thickening and an increased risk of infections (cellulitis, erysipelas) in the swollen area. In such cases, medical assessment is essential to distinguish between lymphatic oedema, venous oedema or combined veno‑lymphatic insufficiency.
If you have persistent swelling of your legs or arms, you can book a vascular surgery consultation at VenArt to identify the cause and discuss treatment options.
Veno lymphatic insufficiency of the lower limbs
Chronic venous disease (varicose veins, venous insufficiency) can overload the lymphatic system and lead to veno‑lymphatic oedema, especially in the calves and ankles. Patients often report:
- Swelling of the ankles and feet.
- A feeling of heaviness and tired legs at the end of the day.
- Dilated veins visible under the skin.
- In advanced stages, skin colour changes and venous ulcers.
In these situations, assessment by vascular surgery and, if needed, treatment of the venous component (for example, minimally invasive varicose vein treatment) can help reduce oedema and improve symptoms.
Inflamed lymph nodes
Enlarged, tender lymph nodes often appear as a response to local or general infections. In most cases this inflammation is temporary, but nodes that remain enlarged, are very firm or are associated with fever, weight loss or a change in general condition should always be checked by a doctor.
Symptoms that may suggest a lymphatic problem
Certain signs should make you think about dysfunction of lymph and the lymphatic system:
- Persistent swelling of the legs, ankles or arms that does not fully go away with rest.
- A feeling of tightness, stiffness or “stretched skin” in swollen areas.
- Heavy legs when walking and marked fatigue of the limbs.
- Recurrent skin infections in the swollen area.
- Changes in skin colour and texture (thickening, shiny or brownish appearance).
If you notice these changes in your lower limbs and also have varicose veins or a history of venous thrombosis, it is advisable to request an assessment in the VenArt vascular and endovascular surgery department.
How are lymphatic and veno lymphatic disorders diagnosed?
Vascular surgery consultation
The first step is to see a vascular surgeon, who will discuss your symptoms and medical history (including prior surgery, trauma and associated conditions) and examine the affected limbs. The doctor will determine whether the swelling is mainly lymphatic, venous or mixed (veno‑lymphatic insufficiency).
If you already have a diagnosis of varicose veins or chronic venous disease, you can read more in the informative article What are varicose veins in the legs? and then discuss with your specialist how varicose veins and oedema are related.
Recommended investigations
For a complete evaluation, your doctor may recommend:
- Duplex/Doppler ultrasound of the leg veins to assess venous circulation, reflux and any thrombosis.
- Additional tests (imaging, blood tests) when other causes of oedema are suspected.
- Multidisciplinary assessment (for example, vascular medicine, dermatology, rehabilitation) in more complex cases.
Based on these findings, a personalised management plan is drawn up, which may include conservative measures as well as interventional treatments for associated venous disease.
Management and treatment of lymphatic disorders
General measures and lifestyle
In many situations, lymph and the lymphatic system can be supported through lifestyle changes and daily care:
- Maintaining a healthy body weight to reduce pressure on venous and lymphatic vessels.
- Regular physical activity (walking, swimming, cycling) tailored to your doctor’s advice.
- Avoiding prolonged standing or sitting.
- Elevating the legs above heart level periodically to promote drainage.
- Careful skin care in swollen areas to prevent cracks and infections.
If you have recently undergone vascular surgery, you can find extra advice in the article Diet recommended after vascular or endovascular surgery, which helps support healing and circulation.
Compression therapy and lymphatic drainage
Lymphedema treatment often includes:
- Compression stockings or bandaging tailored to the affected limb.
- Manual lymphatic drainage or device‑based therapy performed by trained professionals.
- Special exercise programmes that activate the muscle pump and stimulate lymphatic drainage.
These methods aim to reduce limb volume, relieve discomfort and prevent long‑term skin complications.
Book an Appointment
When is collaboration with a vascular surgeon needed?
When swelling is associated with varicose veins, chronic venous insufficiency or a history of thrombosis, the venous component must be evaluated and treated when indicated.
In such cases, your doctor may recommend modern minimally invasive procedures, described on the page Varicose veins treatment: minimally invasive solutions in Cluj-Napoca and Bucharest.
If you recognise symptoms such as swollen legs, painful varicose veins or skin discolouration, you can request an appointment to discuss all options with a vascular surgery specialist.
Medical Team
Why choose the VenArt vascular surgery team?
At VenArt Clinic, patients with venous and veno‑lymphatic disorders benefit from an integrated approach that combines the experience of vascular and endovascular surgeons with modern treatment techniques.
Benefits for patients include:
- Comprehensive assessment of venous circulation and limb oedema.
- Access to minimally invasive procedures for varicose veins (laser, radiofrequency, steam, sclerotherapy) and other vascular conditions.
- Multidisciplinary collaboration for cases of veno‑lymphatic insufficiency.
- Tailored lifestyle, diet and follow‑up recommendations for each person.
You can learn more about the team here: VenArt vascular surgery doctors and book an online appointment at the VenArt centre that is most convenient for you.
Frequently asked questions about lymph, the lymphatic system and leg swelling
What is lymph and how is it different from blood?
Lymph is a clear fluid containing water, proteins, fats and immune cells that flows through the lymphatic vessels, whereas blood circulates through arteries and veins and mainly carries oxygen and nutrients. Lymph and the lymphatic system remove excess fluid from tissues and return it to the venous circulation, playing a major role in drainage and immune protection.
When is leg swelling a lymphatic problem?
Leg swelling can have venous, cardiac, renal or lymphatic causes, but persistent, asymmetric oedema with tightness and skin thickening may point to lymphedema or veno‑lymphatic insufficiency. In these cases you should be assessed in a vascular surgery clinic and undergo further tests if needed.
What is lymphedema and can it be cured?
Lymphedema is a chronic build‑up of lymph in the tissues, most often in the legs or arms, and usually has a long‑term course. Treatment focuses on controlling swelling (compression, lymphatic drainage, exercise, skin care) and preventing complications, and when veno‑lymphatic insufficiency is present, venous disease also needs to be treated.
Can varicose veins also cause lymphatic problems?
Yes. Varicose veins and chronic venous insufficiency can overload the lymphatic system and lead to veno‑lymphatic oedema, particularly in the calves and ankles. Modern varicose vein treatments available on the page Varicose veins treatment: minimally invasive solutions can help reduce swelling and improve circulation.
When should I see a doctor about lymph problems or swollen legs?
You should see a doctor if the swelling persists or worsens, is associated with pain, skin colour changes or recurrent infections. For a complete evaluation of venous and lymphatic circulation, you can book an appointment with one of the vascular and endovascular surgery specialists at VenArt Clinic.
Can lymph alone cause leg swelling?
Yes, when the lymphatic system is blocked or overloaded, lymphedema can develop; however, “swollen legs” often also have venous, cardiac or renal causes, which is why specialist assessment is important.
Is lymphedema the same as water retention?
No. “Water retention” is a general term, whereas lymphedema is a specific form of oedema caused by malfunction of the lymphatic system, with a chronic course and a risk of skin complications.
Can I prevent lymph problems only with massage and lymphatic drainage?
Lymphatic drainage techniques and specialised massage can help control symptoms, but they do not replace medical assessment and, when needed, treatment for associated venous or systemic diseases.
How long do I need to wear compression stockings for lymphedema?
The duration and type of compression are set individually, depending on the stage of lymphedema and any associated conditions; compression stockings are often needed long term and adjusted at follow‑up visits.
What risks do I run if I ignore chronic leg swelling?
If left untreated, chronic oedema can lead to skin thickening, recurrent infections, ulcers and reduced mobility, and in the presence of varicose veins or other vascular disease it can further worsen circulation.
