Lymphedema is a chronic and progressive condition. As it advances, lymphedema may be accompanied by infection, skin changes and wounds. Therefore, proper lymphedema management is extremely important.
Approximately 2.5 million people in the United States develop lymphedema with swelling that occurs in the legs, arms, face, trunk or genitalia.
Types of Lymphedema
There are two types of lymphedema: primary and secondary. Primary Lymphedema develops without obvious cause and may be present at birth due to improper development of the lymphatic system.
Causes of Secondary Lymphedema
Secondary Lymphedema develops after surgery, lymph node removal, radiation, chemotherapy, infection or trauma to the lymphatic system.
Signs and Symptoms
Contact your doctor or nurse when symptoms first appear, as early diagnosis and treatment prevent complications. Some signs and symptoms of lymphedema may include:
- A full or heavy feeling
- Texture changes in the skin
- Aching or discomfort
- Less movement or flexibility in nearby joints such as your shoulder, hand and wrist
- Trouble fitting into jewelry and / or clothes in one area such as the sleeve of your jacket, a pant leg or sock
In order to decrease the risk of developing or the worsening of existing lymphedema symptoms, the following precautions should be taken:
- Avoid extreme hot and cold temperatures
- Avoid hot baths and showers
- Avoid saunas and hot tubs
- Avoid insect bites
- Avoid skin punctures, needle punctures, cuts and acupuncture to the swollen limb
- Avoid pet scratches
- Avoid blood pressure cuffs on the affected limb
- Avoid wearing tight clothes, rings or watches on the affected limb
- Avoid deep massage or swedish massage
While lymphedema cannot be cured, it can be treated effectively. A referral from your physician is needed to receive an evaluation and treatment for lymphedema by one of our certified lymphedema therapists. Once the referral is received you will be scheduled for an evaluation. Your therapist will then develop an individualized, evidence based treatment plan and will manage your lymphedema treatment. Our complete rehabilitation team consists of expert lymphedema management occupational therapists, physical therapists, speech and language pathologists, social workers, and neuropsychologists in case there are other impairments that warrant treatment besides lymphedema.
We base each patient's treatment plan on individual needs and medical history. Currently, the most effective and least invasive approach recommended by physicians is complete decongestive therapy (CDT).
To explore all of the available treatment options available, please choose a convenient location to speak to one of our qualified professionals.
Phase One: Intense Treatment Phase
An evaluation consists of a one-hour session with subsequent treatment sessions of 1-1.5 hours in duration. You will receive treatment four to five days per week for an average of 4-6 weeks or until maximum volume reduction is achieved. Complete Decongestive Therapy incorporates:
Manual Lymphatic Drainage
This light touch massage is used to help open lymph channels and allow lymphatic fluid to flow from the swollen area. Effective in promoting wound healing in areas of edema, or swelling, this also helps break fibrotic tissue resulting from chronic edema.
Manual lymphatic drainage (MLD) facilitates reabsorption of large protein molecules found in lymph fluid and increases the frequency of lymph vessel contraction. MLD consists of specific light, rhythmic pressure along lymphatic pathways that empties and releases obstructive lymph vessels, stimulating the movement of lymph fluid along the vessel pathway.
Hygiene and Topical Skin Care
Lymphedema patients are at increased risk of infection, making education in skin care techniques imperative. We teach meticulous skin and nail care and the use of pH-balanced skin lotions that eliminate bacterial and fungal growth.
Bandaging and Compression
Bandaging follows each manual lymphatic system drainage session. Bandages are minimally elastic and prevent lymph fluid from re-entering the affected arm or leg. When lymphedema is reduced to an acceptable level, patients are custom-fitted with an elastic compression garment.
Contraindications for Manual Lymphatic Drainage:
- Congestive heart failure
- Local or acute infection with fever or undiagnosed swelling
- Deep vein thrombosis
- Presence of a malignant tumor
Therapeutic Exercise Instruction
Therapeutic exercise is one of the lymphedema drainage methods that involves movement of the affected extremity, vital to the reduction of edema. There are simple lymphedema drainage exercises that allow muscle contractions to assist in pumping excess fluid out of the body via veins and lymphatic vessels. Our therapists work with patients to exercises their limbs while using compression bandages. Exercise enhances the compression function of bandages.
To promote optimal edema control, it is important for patients to maintain a healthy weight that is in proportion to their body height and frame. We also recommend that patients limit their intake of salt and monosodium glutamate (MSG). Our therapists provide further nutrition information over the course of the therapy.
Phase Two: Self-Maintenance Phase
Once maximum volume reduction is achieved, you will be measured for compression garments which you will wear during the day. Additionally, you will use bandages at night or alternative nightwear compression. You will continue to perform exercises, skin/nail care, self-manual lymphatic drainage as well as attend follow-up visits with your certified lymphedema therapist as needed.