Wednesday, May 18, 2011

Facial Swelling and Sjogren's Syndrome

I recently received a letter in which a reader asked about lymph drainage and Sjogren's syndrome. She mentioned swelling in the glands in her face, wondered if the swelling in her face could be reduced by increasing lymph node drainage in that area, and asked if swimming would be a good exercise to stimulate her lymphatic system.

Short answer? I find swimming to be good exercise - for just about any reason. It's gentle on my joints since the water supports my body weight. I can swim at my own pace and the warm water is very soothing to aching muscles and joints. There are very few contraindications for people to take leisurely swims for exercise. Just make sure to moisturize your skin well after, and take measures to avoid UV exposure.

Long answer? First, and most importantly - TALK TO YOUR DOCTOR.

For most Sjogren's patients, swelling in the facial areas, specifically in front of the ears, is not due to lymph node drainage. Sjoggies' parotid glands may swell in response to inflammation and damage caused by their own white blood cells attacking these tissues. Less frequently, pain and swelling in the parotids may indicate an infection in the gland or duct, or inflammation caused by a stone in the saliva duct. Check out the placement of the parotid glands in the image below.

Image of saliva glands found here. 

Since the parotids and the other saliva glands - the submandibular and sublingual - are not considered organs specific to the lymphatic system, lymphatic fluid is not usually the culprit in facial swelling related to Sjogren's syndrome.

However, it is possible to have enlarged lymph nodes and swelling in your face and neck for many other reasons besides Sjogren's syndrome - so here again, CHECK WITH YOUR DOCTOR. A good physical exam should help him/her differentiate between an enlarged parotid gland and enlarged lymph nodes.

The lymphatic system in the head and neck looks something like this: (lymph nodes illustrated in yellow)
Image found here

The most common cause of swollen lymph nodes is an exposure to bacteria or a virus, but there can be other reasons.

It's complicated. I know.

Bottom line? If you notice unusual swelling, check it out with your health care provider, especially if the swelling is accompanied by redness, increased temperature, or pain. Our bodies are complex and autoimmune disease raises that complexity to new heights.

You can read more about salivary glands here, and about the lymphatic system here.


faryal naaz said...

i appreciate your work this is really incredible i have get a lot of information from here thanks for providing such kind of information.
dental care

Unknown said...

Hi people,
Thank you so much for this wonderful article really!
If someone want to learn more about the Neck Pain I think this is the right place for you!

Unknown said...

I was diagnosed with SS about 8 years ago. I've noticed when I exercise my face becomes swollen. I've always had low blood pressure and noticed at the beginning of my workout I had a headache.

Any input would be greatly appreciated.

Anonymous said...

Rima, I wish someone would answer as I get the same reaction as you. It even happens to me if I'm working hard around the house or in the yard. My face isn't round but it looks very "fleshy" compared to how it used to look. Even my nose swells. I just don't look like myself.

Anonymous said...

I'm glad to get confirmation on this - something I've been trying tell people for years. Like Anonymous above, my face swells after working in dusty or moldy areas, or yard. Also, I've determined it's a reaction to an increase mold count that often happens after it rains. It's subtle and not noticeable to others unless I show them a picture of me when my face in not swollen. Yeah... I just don't look like myself.
I'm looking for a way to treat this, but other than prednisone, I haven't had any luck.