Lymphedema is an accumulation of fluids and protein in the tissue that develops as a result of a malfunction of the lymphatic system. Lymphedema is a chronic condition that causes swelling in the leg(s), arm(s), face or trunk.

Lymphedema treatment is targeted to reduce the current swelling, as well as, educate the patient to learn how to help manage symptoms in everyday life. We use a combination of treatment methods, including:

Complete Decongestive Therapy:

Phase one includes

• Manual lymph drainage – a gentle technique that stimulates the lymphatic vessels in order to improve the vessel activity and assist with moving fluid out of the congested limb.
• Compression wrapping – utilizing specific bandages to provide graded compression to decongest the limb. The wrapping will stay on consistently until the patient’s next visit when they will be re-wrapped. This phase of treatment must be consistent in order to reduce the size of the limb, not make it smaller.
• Exercises – designed to help the muscular system pump lymph fluid away from the affected area;
• Training in a home management program.

Phase two includes

• Transition to independent maintenance program
  • Includes recommendation on type of compression garment(s) in order to maintain size of decongested limb
    • May include daytime and/ or nighttime compression garments
  • Transition to independence with self-manual lymph drainage
  • Transition to independence with home exercise program

It is important that you be screened for lymphedema if you suspect swelling into a limb has started. You may also notice a sensation of heaviness in your arm. The faster intervention occurs, the easier the treatment. If you have lymphedema you will present with one limb generally larger than the unaffected side. Your therapist will determine this by taking circumferential measurements up both arms to determine a total limb volume and will compare it to the unaffected side. If both limbs are involved, the measurements will be taken on both sides and used as a baseline before treatment. Evidence of pitting edema versus fibrotic edema will be assessed and skin integrity will also be assessed.

A comprehensive evaluation will be performed to collect objective information on the current status of the patient. This includes but is not limited to:

• Range of motion measurements
• Circumferential measurements of the involved and uninvolved limbs in order to objectively gain an understanding of the amount of fluid accumulation
• Strength measurements
• Functional movement analysis
• Skin integrity check
• Postural assessment

After the evaluation is completed the plan of care will be discussed with the patient based on the findings from the evaluation.

If it is decided that the patient will benefit from treatment of lymphedema with complete decongestive therapy, then there will be a list of supplies provided to the patient that they will need to purchase in order to participate in the compression bandaging portion of the treatment.

If compression bandaging is not necessary the patient may be recommended to participate in a less aggressive program that utilizes only manual lymph drainage, potential use of kinematic taping, use of compression garment and exercise.