Lymphedema Management

What is Lymphedema

Lymphedema is an abnormal accumulation of protein rich fluid that causes swelling, most often in the arms or legs and occasionally in the trunk. The condition develops when lymph vessels or lymph nodes are impaired, damaged, or removed. There are two types of lymphedema: primary and secondary. Primary lymphedema is rare and is caused by the absence or abnormalities of the lymphatic system at birth. Depending on the condition swelling may be present at birth or occur later in life.

The majority of lymphedema is known as a secondary lymphedema. These occur as a result of damage or removal of the lymphatic vessels or nodes. Common causes of secondary lymphedema are from an infection, malignancy, surgery, scar tissue formation, trauma, deep vein thrombosis (blood clot in a vein), radiation, or other cancer treatment. Left untreated, lymphedema leads to chronic inflammation, infection and hardening of the skin that, in turn, results in further lymph vessel damage and distortion of the shape of affected body parts.

Effective treatment for lymphedema management is available. Early diagnosis is important since treatment is most effective when lymphedema is diagnosed at the earliest stage. Lymphedema has no cure but can be successfully managed when properly diagnosed and treated.

Signs and symptoms of Lymphedema
  • Heaviness or tightness in limb or trunk
  • Aching in limb or shoulder
  • Restricted range of motion
  • Swelling
  • Fingers may feel puffy and rings may feel tight

Treatment for Lymphedema

Lymphedema is a disease and unfortunately there is no cure due to the permanent damage to or absence of lymphatic components. However, Complete Decongestive Therapy (CDT) is a modality that is used to manage Lymphedema effectively. Known as today’s gold standard of treatment for Lymphedema patients, Complete Decongestive Therapy is used to reduce lymphedema and to prevent future lymphatic overload.

A CDT therapist’s goal is to combine a series of treatments to help reduce the swelling, decrease the risk of infection, prevent hardening of the tissue and improve quality of life for the patient.

Complete Decongestive Therapy consists of 5 components
  • Manual Lymphatic Drainage is a light massage therapy technique in which the skin is moved in specific directions based on the structure of the lymphatic system. MLD techniques are designed to improve the activity of the lymph vessels, and increase the movement of lymph and interstitial fluid from a compromised to uncompromised part of the body. We use manual lymphatic mapping to re-route the lymph flow around the blocked or absent nodes and vessels into more centrally located lymph vessels that drain into the venous system.
  • Compression Bandaging improves the efficiency of joint and muscle pumps, breaks down fibrotic tissue which can form as a result of long standing fluid buildup, and prevent fluid building up again in an area which has been treated with MLD.
  • Exercise is often performed with compression bandaging or a compression garment.  This movement, combined with the compression, increases the movement of lymphatic fluid through the edemacious region
  • Skin and Nail Care is very important in reducing the risk of infection to the affected body part. A compromised lymphatic system means infections can be easily contracted. Infections, such as cellulitis attacks or fungal infections, can be a serious complication in lymphedema. Skin should be kept supple and clean, and insect bites, burns and cuts should be avoided.
  • Instruction in Self Care is vital to the maintenance of Lymphedema. It enables the patient to take part in their own care by understanding the importance of skin care, self bandaging, exercise and self MLD and knowing when to attend follow up visits.

Lymphedema Treatment is Very Specialized

Certified Lymphedema Therapists (CLT) have a minimum of 140 hours of training in this specialized modality.  If you suffer from lymphedema, you must be sure that your therapist is a Certified Lymphedema Therapist. Without this specialized training, manual lymphatic drainage may shift your edema to another part of your body or could be completely ineffective.

Dave Henderson is a nationally certified Therapist for Massage & Bodywork (NCTMB) licensed in the State of North Carolina, and a certified Lymphedema Therapist (CLT), trained in Complete Decongestive Therapy (CDT).