Lymphedema

Comprehensive Care for Lymphedema

Lymphedema is a chronic condition that can significantly impact physical health, mobility, and quality of life. However, with proper management, the symptoms of this condition can be effectively controlled, allowing individuals to lead more comfortable and active lives. Physical therapy, combined with innovative modalities and lifestyle adjustments, plays a crucial role in addressing this condition.

Understanding Lymphedema

What is Lymphedema? Lymphedema is a type of swelling that occurs when the lymphatic system is unable to properly drain fluid from the body. It typically affects the arms or legs but can occur in other areas like the face and neck, abdomen, or genitals. Lymphedema is progressive, meaning that without treatment, it tends to worsen over time.

Types of Lymphedema:

• Cancer-Related Lymphedema: Often resulting from lymph node removal and/or radiation therapy during cancer treatment.

• Phlebolymphedema: A combination of venous insufficiency and lymphedema, typically affecting the lower limbs.

• Primary Lymphedema: A congenital condition caused by poorly developed lymphatic vessels.

• Lymphedema Tarda: Develops later in life, often due to an underlying issue such as obesity or venous insufficiency.

• Traumatic or Post-Operative Lymphedema: Occasionally, a traumatic injury, like a fracture, severe infection, severe burns, 

• Obesity Related Lymphedema: With morbid obesity, the body is under significant extra stress and one of the side effects is that the lymphatics must work harder than they're able to keep up with. This causes damage to the vessels until they are unable to move the excess fluid. 

Common Symptoms:

• Persistent swelling in one or more limbs.

• Tightness or heaviness in the affected area.

• Decreased range of motion.

• Increased risk of cellulitis infections, usually affecting the lymphedema limb.

Complete Decongestive Therapy (CDT)

Phases of CDT:

1. Decongestion Phase:

   • Focuses on reducing swelling through intensive treatment.

   • Includes manual lymphatic drainage (MLD), compression bandaging, and exercise.

2. Maintenance Phase:

   • Aims to sustain the results achieved during the decongestion phase.

   • Involves wearing compression garments, performing self-MLD, and maintaining an active lifestyle.

How Physical Therapy Helps:

• Provides professional guidance for both phases of CDT.

• Teaches techniques for effective self-care and maintenance.

• Addresses mobility restrictions and promotes overall physical health.

Management Strategies

1. Manual Lymphatic Drainage (MLD):

   • A gentle hands-on technique to stimulate lymphatic flow.

   • Reduces swelling and improves lymphatic system efficiency.

   • Pneumatic compression pumps are tools generally covered by insurance that should be used daily to help mobilize fluid to manage symptoms long term

2. Compression Therapy:

   • Helps prevent fluid accumulation and maintain limb size.

   • Includes bandages during the decongestion phase and garments during maintenance.

   • Compression garments like stockings, pantyhose, sleeves, and gloves come in a range of material types depending on the severity of the lymphedema, and can even be custom made if necessary.

   • Insurance generally covers compression garments though it is helpful to understand your policy and suppliers that are in network with your insurance.

3. Exercise:

   • Maintaining activity supports lymph vessel pumping and lymphatic drainage.

   • Most exercise is safe, though pool-based exercises combine the benefits of exercise with compression while being gentle on joints.

4. Lifestyle Adjustments:

   • Maintaining a healthy weight.

   • Regular physical activity.

   • Skin care to prevent infections.

5. Surgical Options:

   • Includes lymphovenous bypass or lymph node transfer.

   • Pairing surgery with physical therapy is essential for optimal outcomes.

Additional Therapies and Modalities

Physical therapy for lymphedema is enhanced with various supportive therapies:

• Cupping Therapy: Improves blood flow and relieves tightness in affected areas.

• Visceral Mobilization: Improving the natural mobility of the liver and GI organs, can help improve venous return and lymphatic drainage since both are strongly associated with the gastrointestinal system.

• MedWave Narrow Light Therapy: Reduces inflammation, promotes collagen production, lowers cortisol, increases dopamine, and supports psychological well-being.

• SoftWave TRT: Reduces inflammation which is a driver of swelling. Research is ongoing on additional benefits to the lymphatic system as a whole.

Early Intervention for Traumatic or Post-Surgical Swelling

Chronic swelling that lingers for more than 6–9 months following surgery or injury should be evaluated for lymphedema. Many medical providers are not trained to recognize subtle forms of lymphedema, such as vascular or obesity-related cases. Seeking professional assessment from a certified lymphedema specialist can ensure accurate diagnosis and treatment.

The Importance of Early Treatment of Lymphedema

Lymphedema benefits significantly from early intervention. Prompt treatment can:

• Prevent progression.

• Reduce the risk of complications.

• Improve overall quality of life.

If you or a loved one are experiencing symptoms of lymphedema, physical therapy and specialized modalities can offer effective relief. Reach out today to learn more about comprehensive care options tailored to your needs.