Therapeutic Services

Lymphedema

 

Lymphedema is a chronic, abnormal condition of swelling in the body, usually in the extremities, although any part of the body that has lymphatic vessels can be affected.  The involved extremities can include not only the arms or legs, but also the neck or genitals.
 

Regardless of the type or cause of lymphedema, the lymphatic system is part of the body's immune system.  One of its functions is to return proteins to the venous system for 'recycling'.  Under normal circumstances, about 1.5 to 2.0 liters (2-3 quarts) of lymphatic fluid are returned to the blood stream by this system each day.

 
Lymphedema usually occurs following damage to the lymphatic system as a result of traumatic injury, infection, cancer, surgery, radiation, parasite or some other cause.  Some people experience no obvious cause, and may have been born with a condition which invites the lymphedema.  The lymphatic system loses its ability to carry lymph as it did prior to the injury or illness, and fluid begins to collect in the affected body part, causing swelling and, ultimately, lymphedema.
 

Lymphedma is not the same condition as that which people experience following a sprain or other injury -- for instance, where the body is reacting to an acute injury.  Usualy such swelling resolves rapidly.  Lymphemema is a chronic condition, meaning that it is not yet curable, and will always needs some degree of management.
 

Lymphedema is best managed by Complete Decongestive Therapy (CDT which involves:
 

1.  Meticulous skin and nail care to avoid the risk of infection


2.  Manual lymphatic drainage (MLD), or specialized massage techniques to stimulate the lymphatic system, soften the tissues and drain the abnormal fluid accumulation

 
3.  Pressure garments (to prevent the re-infiltration of fluid after MLD)

 
4.  An exercise program to further reduce the accumulation of fluid

 Each case is different, but generally people should expect and plan to be seen 3-5 days for the first 1-2 weeks of treatment, or longer if the condition is severe enough.  Initial sessions are up to 2 hours in length, especially if more than one limb is involved, but tend to shorten during treatment to about an hour per visit.  Patients should plan on being seen occasionally for maintenance visits, perhaps 2-3 times per year following initial treatment to have garments refitted or for additional MLD.