Lymphedema


What is Lymphedema?
Lymphedema is an abnormal swelling in a body part due to accumulation of lymph fluid. Swelling is usually in an arm or leg but can also occur in the face, neck, trunk, pelvis or groin.

Although lymphedema is incurable, it is manageable. The lymphatic system is an intricate network of vessels that carry lymph fluid from the tissues to the blood circulation. Lymph fluid carries excess fluid, bacteria, viruses, and cell waste products through the vessels to the lymph nodes that filter out what is not necessary. The remaining fluid is then returned to the blood system.

What are the signs and symptoms of Lymphedema?

  • Persistent swelling, often beginning in the hands or feet.
  • One arm or leg may feel “heavier” than the other.
  • A feeling of tightness to the skin, often more noticeable at the elbow or knee.

Primary Lymphedema
Primary Lymphedemia is congenital and the body part swells due to the absence or malformation of lymph vessels. Swelling may begin at birth or it may not occur until adolescence or even into adulthood.

Secondary Lymphedema
Secondary Lymphedema is when a body part swells due to disease or surgery that changes or removes the lymph nodes or vessels. It may occur with:

  • Surgery or radiation of the lymph nodes of the neck, armpit, abdomen, pelvis or groin.
  • Trauma
  • Chronic infection
  • Chronic swelling of the feet and/or legs

Can Lymphedema be cured?
Lymphedema is not curable but with proper instruction can be managed effectively. The key to good control is prompt identification and treatment.

Why should Lymphedema be managed?
Lymphedema decreases mobility, is sometimes painful and is often embarrassing. Lymphedema management takes less time, energy and money if treated in the early stages. If lymphedema is not treated, the swelling can increase and repeated infections may occur. If the lymphedema advances, the skin begins to harden and thicken. The lymph fluid may begin to leak through the skin often leading to more infection.

How can Lymphedema be managed?
Lymphedema can be managed through Complete Decongestive Therapy (CDT). CDT is a two-phase, four-step program. Phase one is designed to reduce the swelling. Phase two focuses on maintenance through a home program.

CDT phase one, most often a daily treatment program, consists of the following:

  • Meticulous Skin Care, Patients are taught good skin hygiene. Bacterial and fungal growth can lead to cellulitis and/ or lymphangitis and prevent limb reduction. Good skin care reduces the chance of infection.
  • Manual Lymphatic Drainage (MLD), a specialized manual treatment that facilitates the movement of lymph fluid into venous circulation. This technique works to create new pathways that connect together areas of the body where the fluid can be taken care of.
  • Arm WrappingCompression Bandaging, Short-stretch compression bandages are used to increase tissue pressure, which aids in the movement of lymph fluid. Bandages along with various foam products work to break up tissue that has hardened due to scarring and fibrosis. Bandages are applied after MLD and are worn day and night during phase one.
  • Remedial Exercises help to improve lymph circulation – are performed with the bandages or compression garment on. Breathing exercises are also utilized to increase the amount of fluid that is moved.

CDT phase two begins when the limb reduction plateaus. Treatment is modified and contains the following:

  • Meticulous Skin Care
  • MLD, as needed
  • Remedial Exercise
  • Compression Therapy with continued wrapping combined with compression sleeve or stocking.

What if I can’t follow this program?
The most effective way to treat lymphedema is to be seen daily during the reduction phase. However, the treatment regime can be modified during the reduction phase to meet each client’s individual needs. The licensed therapist will work with your physician to best meet all of your needs.

How can I begin treatment for Lymphedema?
If the above signs and symptoms are present, seek medical advice. If Complete Decongestive Therapy is determined to be needed, a prescription for CDT is required.

Who does the treatment?
A licensed therapist certified in Complete Decongestive Therapy will establish the treatment program.

The prescription must have orders for Occupational Therapy to evaluate and treat for Lymphedema Management. It must also include a diagnosis.

Where Can I Get More Information?
The Rehabilitation Center of Decatur Memorial Hospital provides a wide variety of comprehensive health care services like the Lymphedema Management Program. For further information about Lymphedema Management Programs other services offered, please call (217) 876-2600 or Fax (217) 876-2615.

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