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.