What is Lymphedema?
Lymphedema is a specific type of swelling in one or more extremities due to insufficient functioning of the lymphatic system. The lymphatic system is part of the circulatory system and plays a role in filtering out bacteria, viruses, and foreign substances that are found throughout the body. If the lymphatic system is not functioning properly, the lymphatic system becomes blocked and filtering is unable to take place leading to swelling of the involved extremity.
It can be classified as either primary or secondary depending on the cause of the dysfunction of the system.
Primary Lymphedema in an inherited disorder that leads to insufficiency of lymph vessels causing swelling in the extremities. It is rare but can occur at any point in life. Common diagnoses associated with primary lymphedema are Milroy’s Disease and Meige’s Disease.
Secondary lymphedema is caused by other conditions or surgical procedures leading to the development of lymphedema. The treatment of cancer such as surgeries and radiation therapy are the most common causes of secondary lymphedema.
Lymphedema is staged based off of the severity of the swelling.
Stage 0: During stage 0 there is no visible swelling but there may be tightness or heaviness of the arm. Anyone who has undergone surgical removal of lymph nodes now has a compromised lymphatic system and is considered to be stage 0.
Stage I: Stage I is referred to as reversible lymphedema and elevation of the extremity can relieve the swelling.
Stage II: Stage II is considered irreversible lymphedema and elevation does not relieve swelling. The arm may begin to feel boggy or even hard.
Stage III: Also known as Elephantitis, this stage is characterized by changes in the skin such as dryness, fluid leaking, fibrotic changes, and it is common for skin infections.
It is important to know that without treatment, lymphedema can continue to progress to different stages and with each stage comes new and longer lasting challenges, so it is key to begin treatment as early as possible.
How is Lymphedema Treated?
There is currently no cure for lymphedema, but Complete Decongestive Therapy (CDT) is the currently the gold standard for the treatment of lymphedema. CDT is a four part therapeutic technique combining the use of compression (bandaging and compression stockings), manual lymphatic drainage, exercise, and self-care to normalize the tissue texture and volume associated with the diagnosis of lymphedema.
Skin Care: Skin care consists of education to prevent infection which can occur in the swollen limb as well as the use of lotions to reduce dryness of the skin that is common with lymphedema.
Compression: Depending on the phase of treatment, compression can consist of temporary bandaging to decrease swelling as well as long term use of garments to prevent re-accumulation of swelling following decongestion.
Manual Lymph Drainage: MLD is a hands-on technique to improve the activity of the lymph vessels to encourage mobilization of lymph fluid out of the affected limb.
Exercise: Specific exercises are used to improve muscle pump to encourage lymph transportation as well as maintain functional use of the affected extremity. Education will also be provided in order to safely perform exercises that will prevent worsening of the swelling.
Our therapist is certified through the Academy of Lymphatic Studies and is trained in all four areas of complete decongestive therapy. Contact us if you have or suspect you have lymphedema to determine if CDT is a good treatment option for you.