What is lymphedema, and how is it treated?
Lymphedema is an accumulation of fluids and protein in the tissue that develops as a result of a malfunction of the lymphatic system. This can occur post surgery, most often related to cancer. Approximately 2.5 million people in the United States develop lymphedema with swelling in the legs, arms, face or trunk.
Lymphedema primarily causes swelling, a feeling of heaviness in the extremity, slight discomfort, cosmetic deformity and an increased risk for infections. If not treated, lymphedema can lead to hardening of the soft tissue called fibrosis. Fibrosis reduces the level of oxygen flow and can interfere with tissue healing.
The most widespread accepted method of treatment for lymphedema is Complete Decongestive Therapy (CDT). This is a combination treatment that includes manual lymph drainage, compression bandaging, meticulous skin and nail care, and decongestive exercises. Patients initially receive daily treatments.Manual lymph draining is a gentle massage of the healthy lymph nodes, to the lymph channels and to the affected area. It promotes drainage of the lymph fluid out of the swollen areas of the body.
After the manual lymph drainage treatment is completed, the affected limb is bandaged in order to promote continued benefit of the massage and to work towards the reduction of swelling. This is worn overnight and reapplied daily. Short stretch bandages are used until the swelling is reduced, then the patient is fitted with a compression garment such as a sleeve, glove or stocking.
Hygiene and topical skin care are done to reduce bacterial and fungal infections. A pH5 lotion is applied and educational material on skin and nail care is provided. Prescribed exercises are given to the patient to be done while wearing compression bandages or garments. The benefits of the specific exercises are to activate the muscle-joint pump and activate lymph flow. This helps to further reduce swelling.
Patients ask if diuretics would help get rid of their lymphedema. Although diuretics help eliminate water retention, with lymphedema there is also protein accumulation which cannot be reduced with diuretics. It is important to seek your lymphedema therapy from a Certified Lymphedema Therapist. Incorrect massage or bandaging can result in more harm than good. Standard Ace wraps cannot be substituted for short stretch bandages since the wraps can tighten and restrict lymph flow. Instead short stretch bandages with good padding are used to achieve a gradient compression wrap.
In order to decrease the risk of developing or worsening existing lymphedema symptoms, precautions must be taken:
-Avoid extreme hot and cold climates
-Avoid hot baths, showers, sauna and hot tubs
-Avoid insect bites
-Avoid manicures and pedicures at salons
-Avoid skin punctures, needle punctures, cuts and acupuncture to the swollen limb
-Avoid pet scratches
-Avoid high impact sports
-Avoid blood pressure cuffs on the affected limb
-Avoid tight clothes, rings or watches on the affected limb
-Avoid a high fat or high salt diet
-Avoid deep massage or Swedish massage
*Photograph shown is after one treatment.