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Managing Lymphedema With Complete Decongestive Therapy

Individuals with lymphedema should be aware of all their options to help ease symptoms. A variety of therapies are available that can be an important part of a successful treatment plan.

What is lymphedema?

The circulatory system includes the lymphatic system. Our lymphatic system moves tissue fluids from all our tissues back to our venous system, absorbs and transports fatty acids from our digestive system, and filters our lymph nodes to remove microorganisms. Lymphatic tissues are responsible for storing white blood cells that are built. 

Lymphatic vessels run through the body. They are comparable to how veins and artery’s function, however, these lymph vessels all drain into collections of lymph nodes located throughout the body, including the neck, groin, and underarms.

The condition of lymphedema causes swelling in the arms and legs. If left untreated, it can lead to progressive tissue swelling. Lymphedema is not curable, but it can be treated to relieve pain, swelling, and reduce the risk of infection.

What causes lymphedema?

The lymphatic system aids in fighting infections and illnesses. A person can develop lymphedema when the lymphatic system is damaged or when lymph nodes are removed.

In areas where you have a damaged lymphatic system, lymphatic fluid can accumulate and cause swelling. Lymphedema is also associated with open wounds, discoloration of the skin, and infection, which result in reduced mobility.

Most often, lymphatic system damage results from surgery. Radiation for different types of cancer can also cause lymphatic damage. Frequently, when cancer surgery is performed, doctors remove lymph nodes in order to determine the severity of cancer and how far it has spread. There is a disturbance in this system when lymph nodes are removed, which can result in swelling. Lymphedema can be inherited, congenital, or develop without any apparent cause during different stages of life.

How therapies can help

“Lymphedema is uncurable, but its symptoms can be well managed through treatment,” said Elderwood at Waverly Assistant Director of Rehab Jennifer Kozemko, OTR/L, CLT, who is also a certified lymphedema therapist.  “The goal of therapy is to "decongest" the limb - in other words, get as much excess fluid out of the affected area as possible and return the skin to a normal condition.

The gold standard treatment for lymphedema is called Complete Decongestive Therapy. This form of therapy includes:

Manual Lymph Drainage: A very gentle massage to direct fluid away from the swollen area(s).

Multi-layered compression bandaging: Bandages that are placed on the affected limb(s) and meant to be worn between sessions.

Remedial exercises: Patient training in exercises tailored to pump fluid out of the affected area.

Skin care: Patient education in how to properly care for their skin to prevent skin breakdown and infection. Swollen areas are more prone to an often-painful skin infection called cellulitis, so keeping the area clean and moisturized and avoiding things like scratches and insect bites can greatly reduce the risk for infection.

“The patient will be educated on how to maintain good skin integrity and will be assisted in selection of and fitting for compression garments - without continued compression, the fluid would return to the area,” said Kozemko.  “A compression garment can be a traditional compression stocking but there are now other options available such as Velcro compression garments that are generally easier to get into and out of and provide a higher level of compression compared to traditional compression stockings. The therapist will demonstrate the different products available and assist the patient in making the best decision for their particular circumstances.”

Elderwood at Waverly’s Outpatient Rehab Facility recently reopened. The recently renovated facility features physical therapists and assistants that have training and experience with treating lymphedema patients.

For more information on outpatient therapy services for you or your loved one, click here.

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