Lymphedema Therapy
The Lymph System
The lymph system is a one-way drainage system made up of tiny vessels and lymph nodes. It drains away excess protein and water which continually escape from the blood, some substances made in the tissues and any foreign substances which enter them. This lymph fluid is filtered in lymph nodes to remove foreign matter (e.g. bacteria), and to start any necessary immune reactions.

Lymphedema
If the lymph system is damaged or blocked, protein continues to enter the tissues from the blood in the normal way and a buildup occurs in the tissues. The accumulation of protein in the tissues causes excess fluid to enter them and the tissues to swell. The swelling decreases the oxygenation of the tissues, interferes with their normal functioning and makes them heal more slowly than normal.

Lymphedema is a chronic and progressive disease that continues to worsen over time when not treated. It can usually be brought under control by good care and attention to lifestyle changes.

Treatment of Lymphedema
Treatment should begin as soon as possible. At present, the most effective and the least invasive approach is referred to as Complete Decongestive Physiotherapy. The length of treatment is variable and depends upon the severity and duration of the lymphedema.

Causes of Lymphedema
There are many reasons why the lymph system may fail, with two main groups: primary and secondary.
Primary: Lack of lymph vessels
Usually there are simply too few vessels. It can appear before birth, at puberty, or later in life.
Secondary: Blocked or cut lymph vessels
Occurs as a result of:
• Surgery, especially for cancer with removal of lymph nodes
• Radiation therapy
• Accidental trauma
• Parasites–most common in tropical countries
• Chronic venous insufficiency
• Repeated infections
• Paralysis with dependent limb position

It is estimated that there are 2.5 million cases of secondary lymphedema in the United States. Most of these cases are caused by breast cancer therapy.

Symptoms of Lymphedema
• Swelling of limb or body part
• Heaviness, aching, tightness
• Limitation of movement
• Joint pains
• Repeated infections (cellulitis)
• Skin dryness and thickening
• Lymph leakage
• Altered lifestyle
• Difficulty fitting into clothing

Prevention
If lymph nodes are surgically removed and/or radiation therapy is received, the risk of developing lymphedema is significant.

Lymphedema may occur within a few short weeks after surgery or radiation, or 15 to 20 years after treatment.

On the affected limb:
Avoid temperature extremes
• Hot baths, hot tubs, hot showers
• Saunas, Turkish baths
• Burns (sunburn, cooking, smoking)–wear sunscreen, oven mitts, etc.
• Travel in climates that are extreme changes from your normal climate

Avoid infections
• Insect bites–wear protective clothing, gloves, long sleeves, repellant
• Manicure, pedicure (do not cut cuticles)
• Shots, blood draws, acupuncture
• Pet scratches
• Skin punctures and cuts; use electric razor

Avoid blunt trauma
• Lifting heavy objects–restrict weight lifting to fifteen pounds or less.
• Repetitive motions against resistance (scrubbing, pushing, pulling)
• Constrictive clothing, blood pressure cuffs, tight clothing (especially bra straps), rings, watches, bracelets, heavy breast prosthesis.

Lymphedema Program
Our lymphedema philosophy is multifaceted and is centered upon Complete Decongestive Physiotherapy (CDP), recognized worldwide as the most effective treatment for lymphedema. The program is individualized for the patient to include:

• Diagnostic Evaluation
• Manual Lymph Drainage (MLD)
• Bandaging Techniques
• Compression Garment Fitting
• Therapeutic Exercise
• Skin Care
• Self-Care Instruction
• Follow-up visits recommended every six months

Please call 641-684-2440 for referral information