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Lymphedema

What is Lymphedema?

An estimated 2.5 million people in the United States suffer from lymphedema, a condition caused by the accumulation of lymphatic fluid in the body that causes swelling in the arms or legs. Lymph, a clear fluid that develops in tissue spaces throughout the body, is part of the circulatory system of veins and arteries and accumulates as a result of trauma to the lymph nodes.

Edema, or swelling, occurs when venous and/or lymphatic vessels become restricted and fluid cannot flow freely through them. Lymphedema most often causes a feeling of heaviness, slight discomfort, cosmetic deformity and repeated episodes of infection, such as cellulitis.

If left untreated, lymphedema can lead to the hardening of underlying soft tissue (fibrosis) and overall bulkiness in the arms or legs. It also reduces the level of oxygen flowing to the tissues, which interferes with wound healing.

There are two different types of lymphedema, primary and secondary.

Primary Lymphedema may occur:

  • Without any obvious cause
  • In newborn babies, known as Lymphedema Praecox
  • Later in life, after age 35, known as Lymphedema Tarda

Secondary Lymphedema may occur:

  • As a result of injury, scarring or excision of lymph nodes
  • As a result of radiation and/or surgery on the lymph nodes
  • Either immediately following surgery or several years later
  • After a traumatic injury to a person who has undergone cancer treatment
  • In breast, gynecological, testicular, bladder, colon, prostate or skin cancer survivors

What symptoms are Associated with Lymphedema?

The most common symptoms associated with lymphedema include:

  • Deceased flexibility in the affected extremities
  • Tightly fitting clothing on a particular extremity
  • Persistent and sometimes painful swelling
  • Feeling of heaviness
  • Repeated episodes of infection, such as cellulitis

What Are the Treatments for Lymphedema?

The treatment plan for lymphedema depends upon its cause. Each patient's treatment plan is based upon individual needs and medical history.

Presently, the most effective and least invasive approach recommended by physicians is Combined Decongestive Therapy (CDT), a combination of hygiene/topical skin care, manual lymphatic drainage, bandaging/compression and remedial exercises.

Patients attend five therapy sessions a week, consisting of the following:

Hygiene And Topical Skin Care

  • Eliminating bacterial/fungal growth
  • Using pH-balanced skin lotions
  • Teaching meticulous skin and nail care

Manual Lymphatic Drainage

  • Specific manual movements along lymphatic pathways that empty and release obstructive lymph vessels
  • Applying light, rhythmic pressure in circular motions to stimulate movement of lymph fluid along the vessel pathway

Manual Lymphatic Drainage should be avoided if the following conditions exist: congestive heart failure, thrombosis (blood clots), local or acute infection with fever and undiagnosed swelling.

Bandaging/Compression

  • Bandaging follows each manual lymphatic drainage session
  • Bandages are minimally elastic and prevent lymph fluid from reentering the affected arm or leg
  • Bandages are worn overnight until the next session
  • Upon completion of the course of treatment, the patient is custom-fit for an elastic support garment when the arm or leg is close to normal

Remedial Exercises

  • Exercises with bandages in place are prescribed for each patient to complete daily
  • Exercise activates each muscle group and causes the swollen arm or leg joint to have better lymph flow

Preventative Measures

Several everyday occurrences can lead to lymphedema. In an effort to decrease the risk of developing lymphedema, the following precautions should be taken:

Avoid extreme temperatures including:

  • Hot baths or showers, hot tubs
  • Turkish baths, saunas
  • Burns due to cooking, smoking or sunburn
  • Travel to extremely hot or cold climates

Infections caused by:

  • Insect bites
  • Manicures, pedicures
  • Vaccinations, venipunctures or acupuncture
  • Pet scratches
  • Skin punctures and cuts

Blunt trauma caused by:

  • Lifting heavy objects
  • Playing tennis or golf
  • Blood pressure cuffs
  • Tight clothing, especially bra straps
  • Heavy breast prosthesis
  • Rings, watches or bracelets worn too tightly

Lifestyle Choices

Certain lifestyle choices can help prevent lymphedema:

  • Maintaining good nutrition - low salt, few fried foods, lots of fresh fruit and vegetables
  • No alcohol or nicotine consumption
  • Practicing meticulous skin and nail care
  • Sleeping with extremities wrapped
  • Exercise including walking or swimming
  • Using hypoallergenic soaps and fragrances
  • Seeking treatment for any indication of lymphedema