Lymphedema Management
What is Lymphatic system?
The lymphatic (lim-FAT-ik) system works to keep body fluid levels in balance and to defend the body against infections. It is made up of a network of lymphatic vessels that carry lymph — a clear, watery fluid that contains proteins, salts, and other substances — throughout the body.
What is lymphedema?
Lymphedema is swelling of a body, most often arm or leg though it may also involve face, neck, trunk, abdomen, or genitals. Lymphedema is acute or chronic swelling due to accumulation of protein rich fluid called lymph.
Lymph is a clear protein rich fluid which is produced in our tissues and drains into our venous system.
Causes: Lymphedema occurs due to a failure in lymphatic system. It could be primary or secondary. Primary lymphedema is caused by malformation of lymphatic system and can be found in children or may even develop later in life.
Secondary lymphedema is more common and is most often a result of a disease, trauma, infection, sever venous insufficiency, surgery or cancer treatments. Surgical procedures or radiation therapy that involves lymph nodes are most common reason for lymphedema in North America.
Symptoms:
The most common symptoms are changes in appearance of the area involved, increase in limb size, a feeling of heaviness or numbness, clothes not fitting well or leaving deep dents on skin and jewelry getting tight.
In worse conditions there could be significant deformity of limb, increased risk of infection, fungal or bacterial, lymph leaking from the area involved and physical disability.
Treatment: Currently CDT is considered as the gold standard treatment of lymphedema for conservative management.
There is ongoing research regarding surgical procedures and pharmaceutical management.
What is CDT: CDT stands for Combined Decongestive Therapy. It’s a specialized form of therapy provided by certified and trained professionals like a Physiotherapist. It involves
Assessment: Your physiotherapist will do a comprehensive assessment of your symptoms and gather a baseline information in order to plan an individualized treatment on goals for you.
Manual Lymph Drainage: Manual Lymph Drainage ( MLD) is a gentle hands on technique which helps stimulate the movement of lymphatic fluid in superficial tissues.
Compression: To prevent re-accumulation of fluid in your tissues, it is necessary to apply sufficient compression to the affect body part. Compression therapy can be done by multilayer compression bandages or specially designed Velcro wraps. In later phases once your physiotherapist finds your swelling is under control or your progress has reached a standstill, you may be fitted for a compression sleeve for daily use while you continue to use multilayer bandages or wraps at night.
Exercises: A customized exercise program could be given to you. The exercises are aimed at using muscle pumping action to improve lymph drainage along with improving your strength and function which will in turn help you to avoid any musculoskeletal injuries.
Skin care: Body part affected by lymphedema can have very dry skin. Skin break could give entry to pathogens( germs) which could lead to further infections. A low pH skin lotion is ideal for applying.
Dos and Don’ts of Lymphedema:
- Avoid injuries to skin
- Avoid bug bites
- Exercise under guidance of a professional
- Inform your health professional that you have lymphedema
- Avoid clothing and jewellery that’s too tight or leaves marks on your skin
- Use compression garments consistently
- Seek your therapist if you find any changes in your lymphedema.
