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LYMPHEDEMA 

THERAPY

WHAT IS LYMPHEDEMA?

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Lymphedema refers to tissue swelling caused by an accumulation of protein-rich fluid that's usually drained through the body's lymphatic system. It most commonly affects the arms or legs, but can also occur in the chest wall, abdomen, neck and genitals.

Lymph nodes are an important part of your lymphatic system. Lymphedema can be caused by cancer treatments that remove or damage your lymph nodes. Any type of problem that blocks the drainage of lymph fluid can cause lymphedema.

Severe cases of lymphedema can affect the ability to move the affected limb, increase the risks of skin infections and sepsis, and can lead to skin changes and breakdown. Treatment may include compression bandages, massage, compression stockings, sequential pneumatic pumping, careful skin care and, rarely, surgery to remove swollen tissue or to create new drainage routes.

Symptoms

Lymphedema signs and symptoms include:

  • Swelling of part or all of the arm or leg, including fingers or toes

  • A feeling of heaviness or tightness

  • Restricted range of motion

  • Recurring infections

  • Hardening and thickening of the skin (fibrosis)

Signs and symptoms can range from mild to severe. Lymphedema caused by cancer treatment may not occur until months or years after treatment.

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Primary Vs. Secondary

Lymphedema

Secondary Lymphedema

        It has a number of possible causes, including:

  • Cancer surgery: Cancer may spread through the body via the lymphatic system. Sometimes surgeons remove lymph nodes to stop the spread. There is a risk the lymphatic system may be affected, leading to lymphedema.

  • Radiation therapy: The use of radiation to destroy cancerous tissue can sometimes damage nearby healthy tissue, such as the lymphatic system; this can result in lymphedema.

It may be caused by gene involvement in the development of the lymphatic system. These faulty genes interfere with the lymphatic system’s development, undermining its ability to drain fluid properly.

Primary Lymphedema

     

  • Infections: Severe cellulitis infection may damage tissue around the lymph nodes or vessels. This may lead to scarring, increasing the risk of lymphedema. Some parasite infections can also increase the risk of lymphedema.

  • Inflammatory conditions: Conditions that cause tissue to swell (become inflamed) may permanently damage the lymphatic system, such as rheumatoid arthritis and eczema.

  • Cardiovascular diseases: These are diseases that affect blood flow. Some patients with cardiovascular diseases have a higher risk of developing lymphedema, such as DVT (deep vein thrombosis), venous leg ulcers, and varicose veins.

  • Injury and trauma: More rarely, severe skin burns or anything that results in excessive scarring may raise the risk of developing lymphedema.

Lymphedema Diagnosis

There are no specific diagnostic tests for lymphedema. The doctor will complete a medical history and physical examination. The medical history may include questions regarding the following:

  • Past surgeries

  • Problems following the surgeries

  • Onset of symptoms (When did the swelling appear?)

  • History of edema (severe swelling)

  • Current medications

  • Other medical conditions, such as high blood pressure, heart disease or diabetes

Stages

Upon diagnosis, your doctor will identify which stage best characterizes your lymphedema and diagnose treatment accordingly. Depending on how the swelling has progressed, your doctor will identify the following stages:

  • Stage 1: Abnormal flow in the lymphatic system. No signs or symptoms

  • Stage 2: Accumulation of fluid with swelling. Swelling resolves with elevation. Pressing on the area may leave a dent

  • Stage 3: Permanent swelling that does not resolve with elevation. Pressing on the area no longer leaves a dent. Changes in the skin with scarring and thickening

  • Stage 4: Elephantiasis (large deformed limb), skin thickening with “wart-like” growth and extensive scarring

Decongestive Therapy for Lymph

Treatment for lymphedema depends on the severity and extent of the condition. Prevention and controlling lymphedema play an important role with this condition since there is no cure.

Decongestive treatment is commonly recommended for the first two stages of lymphedema. Treatment options may include:

  • Exercise. Exercise helps to restore flexibility and strength, and it improves drainage. Specific exercises will be recommended by your doctor and/or physical therapist.

  • Bandage. Wearing a customized compression sleeve or elastic bandage may help to prevent an accumulation of fluid.

  • Arm pump. Applying an arm pump often helps to increase the fluid flow in the lymphatic vessels and keeps fluid from collecting in the arm.

  • Diet. Eating a well-balanced diet and controlling body weight is an important part of treatment.

  • Keep extremity elevated. Keeping the limb raised above the level of the heart, whenever possible, allows gravity to help drain the accumulated fluid.

  • Infection Prevention. It is important to follow preventive measures, such as good skin care, to protect the affected arm from infection and skin breakdown.

Lymph Drainage Massage

Due to its potential health advantages, lymph drainage massage has become a popular type of massage. This particular method concentrates on the lymphatic system, a component of the immune system.

This style of massage attempts to support the body's immune system, fluid balance, and healthy blood circulation.

Lymphatic Drainage Massage Types


There are four types of lymphatic drainage massage that are frequently performed by doctors, physical therapists, and massage therapists. These consist of.

VODDER

Vodder. This fundamental technique involves the therapist using a variety of sweeping strokes in the area they are treating.

Foldi. Using circular hand motions and brief periods of relaxation, the massage therapist must switch between the Foldi technique and the Vodder extension.

FOLDI

CASLEY-SMITH

Casley-Smith. Circular hand motions are used in this method of lymphatic massage as well, primarily using the sides and palms of the hands.

LEDUC

 Leduc. In order to collect lymph fluid and then reroute it for reabsorption into the broader lymphatic system, this approach uses hand motions.