Lymphedema Therapy

Causes of Lymphedema

Most frequently seen after cancer treatments to remove lymph nodes and radiation to vessels
Injuries to the lymphatic system such as “crush” injuries
Inherited lipolymphedema
Inherited traits- poorly developed vessels or missing lymph nodes
Parasitic infection- found in tropical areas of the world (filariasis)
Severe or chronic cellulitis

Symptoms

The feeling of heaviness or fullness in the limb
Occasional aching pain in the affected area
Advanced lymphedema may cause skin color changes, thickening of the skin, and skin breakdown
Symptoms are usually minor at first and worsen over time

Lymphedema Stages

Stage 0 (latent): The lymphatic vessels have sustained injury but transport capacity is still sufficient for lymph being removed. Lymphedema is not present.
Stage 1 (spontaneously reversible): Tissue is still at the pitting stage: when pressed by the fingertips, the affected area indents, and reverses with elevation. Usually upon waking in the morning, the limb or affected area is normal or almost normal in size.
Stage 2 (spontaneously irreversible): The tissue now has a spongy consistency and is considered non-pitting. Fibrosis found in stage 2 lymphedema marks the beginning of the hardening of the limbs and increasing size.
Stage 3 (lymphostatic elephantiasis):, Swelling is irreversible and usually the limb(s) or affected area is very large. The tissue is hard (fibrotic).

Lymphedema after Cancer Treatment

Most frequently seen in the United States
Removal of lymph nodes inhibits the lymph draining from the distal area causing a gradual swelling
Care should be taken after surgery and treatment to prevent injuries to the limb which can cause lymphedema to begin
Beginning care and education for patients can prevent the limb from swelling to a moderate or severe level

Treatment

Lifestyle Modifications

Low intensity exercises
Protective clothing if possible bug bites, scratch or punctures (gloves during gardening activities)
Knowledge regarding blood pressure and venous puncture on affected limb

Supportive Devices

Custom fit garment to prevent increased swelling

Manual Lymph Drainage

Specialized massage to move lymphedema safely to areas of the body that do not have damage to lymphatic system
Each patient is educated on performing home program of lymph drainage

Compression Wrapping

Short Stretch bandages (different than ACE wraps) are used with padding and gauze to apply pressure to area and facilitate lymph drainage
Each patient and caregiver, if possible, is educated on the correct technique to wrap affected limb at home

Treatment Time

For best results, patients should be seen every day for approximately two weeks
Patients have seen significant improvement with treatment three times a week for 4-6 weeks