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Lymphedema Facts and Treatment

By Meredy Parker PT

Lymphedema is a condition of the lymphatic system and is caused by accumulation of lymph fluid (water and proteins) in an area of the body. It is most commonly found in the arms and legs, but depending on the cause, may also be present in the trunk, abdomen, face or genital area. Lymph fluid is formed in the tissues of the body and travels back to the heart, filtering through lymph nodes along the way to cleanse the body of toxins and waste. In the case of lymphedema, this flow is interrupted or slowed, causing a backup in a certain part of the body. Lymphedema is classified as either primary or secondary. Primary lymphedema is caused by the way the lymphatic system was formed from birth and often causes swelling later in life. Secondary lymphedema is more common and often occurs after surgery, removal of lymph nodes, radiation, infection, obesity or trauma. Lymphedema will not heal itself and can never be completely reversed. Lymphedema is very easily treated, but is a disease that requires life-long management. If left untreated, it is likely that it may worsen with time and may also impact the immune system, putting the body at increased risk for infection. Proper treatment will help to move the lymph fluid through the body and out of the affected area with the ultimate goal of reducing the size of the swollen body part to a normal or near-normal size. Proper treatment of lymphedema is important, and the sooner it is initiated the easier it is to manage. There are many components of treatment for lymphedema. The treatment options may include the following: manual lymphatic drainage (MLD), compression bandaging, exercise (including a home exercise program), compression pump therapy and patient education. Each patient will be evaluated, and a treatment program will be tailored to their specific needs. The ultimate goal of therapy is to enable you to care for your lymphedema independently to control the swelling, prevent infection and improve function. Manual lymphatic drainage (MLD): A gentle manual massage to the trunk and affected area to increase the rate of lymph flow out of the area. It increases the natural pumping rate of the lymph vessels and also manually moves fluid out of the area. Over time, MLD treatment will help to decrease the size of the affected area to a normal or near normal size when combined with compression therapy. You will receive this treatment in the clinic and will also be instructed in how to perform self-MLD at home. Compression therapy: The affected area of the body will initially be wrapped with compression bandages to be worn day and night. You will be instructed in self-bandaging to allow you to remove the bandages temporarily and re-wrap at home. When the extremity has decreased to its smallest size you will be measured for a compression garment (i.e. stocking, sleeve, glove) for long-term management. Compression therapy helps to keep excess fluid out of the extremity, improves muscle pump action (the activation of your muscles squeezes the fluid out of the area), helps to reduce hardened tissue and improves the function of your lymph vessels and veins.