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Treatment of Lymphedema

Lymphedema most often occurs after cancer treatment, but can also occur as a hereditary condition. It can cause heaviness and aching in the area affected, but if untreated can lead to increased risk of infection and wounds.

How can physical therapy help with Lymphedema?

Physical therapists with special training can help control and manage lymphedema through Complete Decongestive Therapy (CDT). CDT consists of four parts including Manual Lymphatic Drainage (MLD) which is a gentle hands-on technique, meticulous skin care, compression bandaging/garments, and decongestive exercises. Initial management of lymphedema is intensive, and patients work closely with their therapist in developing a treatment plan that will best address the swelling and fit the patient's needs. Maintenance management will consist of wearing appropriate compression garments daily and decongestive exercises to keep the swelling under control.

What is Lymphedema?

Lymphedema is a condition in which the lymphatic system of the body is unable to properly move the fluid from the subcutaneous tissue back to the blood stream for the body to eliminate. This leads to swelling, and can occur in the arms, legs, trunk, genitalia, head or neck. Lymphedema is unlike normal edema or swelling, in that it is made up of protein rich fluid (lymph) that can only be drained by the lymphatic vessels.

If the lymph system is not functioning properly, then the fluid and proteins will remain in the tissue spaces despite elevation, and may turn into a chronic condition. Treating lymphedema early helps ensure faster, more successful outcomes. However, those with lymphedema can also benefit significantly from intervention in later, more chronic stages of the disease. Because lymphedema is often caused by structural damage to the lymph system, lymphedema is a chronic condition. There is no cure, but the condition can be successfully managed.

What causes Lymphedema?

Lymphedema has a variety of causes including, but not limited to: Hereditary condition, trauma, surgical intervention (most well known is lymph node dissection during surgery for cancers), infection, or radiation treatment. The most common cause of lymphedema in this country is surgical removal of lymph nodes in the axillary (armpit) region due to breast cancer. Having radiation after such a surgery increases risk.

What are the symptoms of Lymphedema?

Asymmetrical swelling is the main symptom of lymphedema, and can belocalized to one body region or limb. One has increased risk for lymphedema if she has a history of one or more of the above known causes. To determine whether swelling is truly Lymphedema requires a discussion with one’s health care provider. It is important to rule out swelling that may be caused by other organ systems (especially the heart and kidneys) prior to onset of lymphedema treatment.

Who Should be Referred to Avila Physical Therapy for Women’s Health?

Those with:

  • Swelling anywhere in the breast, chest, arm, wrist, hand or fingers after treatment for breast cancer.
  • Trouble getting jewelry on (rings, watches, bracelets) or having sleeves fit correctly.
  • Lack of knowledge about the condition, and prevention of Lymphedema
  • “Pitting” in the tissues of the arm (where an indentation is made by a finger or by leaning against an object and then takes time to ‘fill in’ after the pressure is removed.
  • Anyone who has had lymph nodes removed due to a cancer surgery.