What is Lymphedema

Lymphedema is an accumulation of lymphatic fluid causing abnormal swelling of the arms, legs, breast, abdomen, neck or head.

Lymphedema develops when lymphatic vessels are damaged or lymph nodes are removed (secondary), or when lymphatic vessels are impaired or missing (primary).

Lymphedema occurs when the impairment becomes so great that the lymphatic fluid exceeds the lymphatic transport capacity.

Lymphedema becomes apparent when the protein rich fluid builds up and swelling begins.

STAGES OF LYMPHEDEMA

Stage 1 (mild) - Upon waking in the morning the limb or affected area is almost a normal size.The tissue is still in a "pitting stage" ( when pressed by a finger the area indents and holds the indentation).

Stage 2 (moderate) - The tissue is "non-pitting" (when pressed by a finger the tissue bounces back without leaving an indentation). The tissue has a spongy consistency.

Stage 3 (severe) - The tissue at this stage is hard (fibrotic) and will be unresponsive to the touch. The swelling is irreversible and the limb is very large and swollen. Infections are possible at any stage of lymphedema but occurrence becomes greater as stages progress. A swollen limb, left untreated, becomes hard (fibrotic) and full of lymph fluid which is high in protein and a perfect medium for bacteria and infections.

CAUSES OF LYMPHEDEMA

Secondary and Primary

Surgical procedures and/or radiation therapy in the treatment of Breast, Gynecological, Head , Neck, Prostate or Testicular, Bladder, Colon Cancers or Melanomas.( Due to treatment, there is removal of, or damage to the lymph nodes or vessels so that lymph fluid is no longer able to be transported properly in the body).

Trauma - injuries and accidents in which the lymphatic system is interrupted or damaged

Infections - which interrupts normal lymphatic pathway function

Primary

Present at birth for unknown causes or associated with arterial-venous abnormalities.

Lymphedema Praecox - appears during puberty, mostly in girls, and usually affects one lower extremity.

Lymphedema Tarda - occurs in both male and female adults. The onset is sudden with no apparent cause and can affect one or both extremities.

TREATMENT FOR LYMPHEDEMA

Complex Decongestive Physiotherapy, (CDP) or Complete Decongestive Therapy (CDT)

Manual Lymphatic Drainage

This treatment is a gentle light touch massage. This prevents damage to the tissues. It promotes lymph flow through the collateral (superficial) lymph vessels to channel the lymph into the abdominal area ( the "watershed") and into normal functioning lymphatic vessels and nodes. These collateral lymph vessels are usually working normally and the problem lies in the deeper vessels which were damaged and scarred.

Bandaging

The therapist places compression bandaging around the limb. Often foam chip pads are placed under the bandaging to increase pressure on fibrotic area to break down scar tissue. These bandages stay on 24 hours a day throughout the treatment period. They come off only to shower, do skin care, assess the swelling reduction and to do the MLD.

Skin Care

Use a soap with a low pH., unscented and not antibacterial soaps. A good liquid soap is Cetaphil. The skin must be moisturized after bathing. Use a lotion like Eucerin or Nivea. If there are any irritations use an antibacterial cream. Always dry the area very well,and gently, after washing.

Exercises

An individualized exercise program will be given by the therapist to each patient. They will improve muscular contractions and joint mobility.There will also be strengthening exercises for the limb that will reduce muscle atrophy. Muscular contractions along with the low-stretch bandages provide constant counter pressure to keep the lymph fluid moving.

Low-Level Laser Light Therapy

Read more about this new and innovative laser therapy

Normal Lymphatic Flow

THERE IS HOPE FOR PATIENTS WITH LYMPHEDEMA!