Parkinson's and Lymphedema: Causes, Warning Signs, and Treatment

Do your legs feel heavy by late afternoon, or do your shoes fit tighter than they did this morning? If you live with Parkinson's disease (PD), ankle swelling may be more than a nuisance. In a recent PASWFL PD Talk, occupational therapist Lexi Lundquist explained how slower movement and swelling can feed each other. Keep reading to learn the warning signs, the simple movements that help, and when to call a professional.
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Here's the part most people miss: your calf muscle works like a "second heart," and one small ankle movement you can do right now from your chair helps power it. Keep reading to find out how.

What Is the Link Between Parkinson's Disease and Swelling?
Parkinson's disease can lead to swelling because slowness, stiffness, and freezing reduce movement. Less ankle and calf motion means less "muscle pump" action to push fluid up the legs, so fluid can pool in the ankles. Swelling that does not go away may be lymphedema, a chronic condition that needs a professional evaluation.

Symptoms such as bradykinesia (slow movement), rigidity, freezing, and balance changes often reduce walking and ankle motion, and swelling usually starts at the ankles. A cycle can follow: swollen legs feel heavy and stiff, which makes moving harder, which allows more swelling. Steps may get shorter, shoes may be hard to put on, and getting in and out of bed or the shower takes more effort.

Edema vs. Lymphedema: What's the Difference?
Edema is swelling with many possible causes, including vein, heart, or kidney problems and some medications. It is usually temporary and eases once the underlying issue is treated. Lymphedema is different: it is chronic, it persists, and it results from a problem in the lymphatic system, the network of vessels and nodes that moves fluid through the body as part of the immune system. Early lymphedema often shows pitting, meaning a dent stays when you press the skin.

Lundquist stresses that swelling alone does not mean lymphedema, which is why a proper diagnosis matters. She also notes that lymphedema can often be reversed at stage 0 or 1, while stages 2 and 3 usually require ongoing management.

What Warning Signs Should You Watch For?
Lundquist advises against jumping to conclusions. Ask these questions first:
•How long has the swelling lasted, and is it getting worse?
•Is it in one leg or both?
•Does the skin pit when you press it?
•Is there pain, warmth, redness, or tenderness?
Redness, warmth, and pain can also signal an infection or a blood clot, so get a professional opinion promptly. One leg that suddenly swells and turns red is not just aging, and it is not just Parkinson's.

How Is Lymphedema Treated?
Therapists trained in complete decongestive therapy use four parts: compression, manual lymphatic drainage, exercise, and skin care education. Treatment starts with an intensive decongestion phase, about three visits a week, then moves to self-management with compression garments. For people with PD, a therapist also weighs hand dexterity, skin sensitivity, movement, and thinking skills when choosing garments, and may include a care partner in applying them.

What Can You Do at Home?
For minor swelling, start with movement:
•Ankle pumps, heel raises, and marching
•Weight shifts and sit-to-stands
•Walking or pool exercise
Try "movement snacks," such as a short walk each time you head to the restroom. Avoid long stretches of sitting with legs down or standing in one spot; walk or elevate your legs a few times a day. With PD, emphasize big movements. Over-the-counter compression exists, but swelling that happens daily deserves a professional's guidance.

Frequently Asked Questions
What causes swelling in the legs with Parkinson's?
Slow movement, stiffness, and freezing reduce ankle and calf motion, which weakens the muscle pump that moves fluid up the legs. Fluid can then collect in the ankles.
Is leg swelling with Parkinson's always lymphedema?
No. Swelling can also come from vein, heart, or kidney issues, medications, infection, or a blood clot. A professional can tell the difference.
Can lymphedema be reversed?
According to Lundquist, early stages (0 and 1) can often be reversed with proper treatment. Stages 2 and 3 usually need ongoing management.
What exercises help with ankle swelling?
Ankle pumps, heel raises, marching, weight shifts, sit-to-stands, walking, and pool exercise. Check with your care team before starting.
Where Can I Find Lymphedema Education for PD?
The Parkinson's Association of SWFL offers lymphedema education free to members. Membership is also free, and you don't need to live in SWFL to take part in many of their programs because they are offered online through Zoom. Click here to join: https://parkinsonassociationswfl.org/signup.html

The Bottom Line
Swelling is common, but swelling that persists deserves attention. Movement matters for both Parkinson's and lymphatic health, and the earlier you act, the more you can do. Don't wait: talk with your doctor or a trained therapist about a referral. PASWFL offers more than 21 exercise classes a month, from gentle seated to a 45-minute standing workout, and members can watch recorded classes on the website.

This article is educational and based on a PASWFL PD Talk. It is not medical advice. Talk with your doctor or a qualified therapist about your symptoms.

Why Support Matters
A diagnosis of any form of Parkinson’s can feel overwhelming. But with the right support and resources, individuals can maintain independence, quality of life, and emotional well-being.
For resources, referrals, and support in navigating Parkinson’s and related conditions, contact the Parkinson’s Association of Southwest Florida at www.paswfl.org or call 239-417-3465.

For 30 years, PASWFL has provided free, high-quality services and programs to individuals and families touched by Parkinson’s disease in Southwest Florida. Their goal is simple: help people live well with PD, regardless of where they are in their journey.

Each week, PASWFL offers more than 25 free programs and support groups, including:
•Wellness and fitness classes
•Speech Exercise classes
•Educational seminars
•Support for care partners
•Support groups
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There are no fees to become a member, and PASWFL welcomes anyone touched by PD.
Take the First Step Toward Living WellIf you suspect early Parkinson’s or have been recently diagnosed, you don’t have to face it alone.

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To learn more, visit www.paswfl.org and discover the power of support, education, and community.
You don't have to live in SWFL to benefit from membership to the PASWFL. Membership is free and open to anyone with PD, their care partners or family members.