Lymphedema Therapy

Doctor applying wrap to patient lymphedema legs.jpg

What is Lymphedema?

Lymphedema is a condition that causes extreme, chronic swelling from an accumulation of lymph fluid in the body, often in the arms or legs. It is caused by extra fluid that doesn't circulate normally in the body. 

The lymphatic system helps the immune system by filtering waste products (bacteria and debris), proteins, and fluid from body tissues. When the system is not working properly, proteins become trapped and adversely affect body functions. In essence, lymphedema is a backup of the body’s sewage system. 

What Does Lymphedema Pain Feel Like?

Lymphedema causes severe discomfort, feelings of "heaviness" and decreased function of the extremities caused by the retention of lymphatic fluid. Left untreated, it can lead to pain, poor wound healing, permanent skin changes, functional disability, and cellulitis, a skin condition that may require hospitalization.

What Causes Lymphedema?

There are two types of lymphedema: primary and secondary. 

Primary lymphedema is caused by a malformation of the lymphatic system which is typically hereditary. If your sibling, parent, grandparent, or other family member also has difficulty with swelling, you may fit into this category.

Secondary lymphedema has multiple causes with the most common in the United States being cancer treatment or venous insufficiency. Cancer treatment such as lymph node removal or radiation, which disrupts the lymphatic system, decreases the efficiency of the system and can lead to a backup of fluid. In venous insufficiency, backup of blood, usually in the legs, puts strain on the lymphatic system so it must work harder. When the system works at a high level for a long time, it can start to cause damage to the fragile lymphatic vessels which causes a pooling of fluid and proteins in the extremities. More causes of secondary lymphedema can include:

  • Removal of lymph nodes
  • Abnormal or damaged lymph vessels
  • Venous insufficiency
  • Infection
  • Surgery
  • Trauma/injury
  • Cancer treatment
  • Other health conditions such as stroke, heart bypass, morbid obesity

How is Lymphedema Treated?

Evidence-based treatment for lymphedema is Complete Decongestive Therapy (CDT). This treatment consists of Manual Lymphatic Drainage (MLD), compression garments or bandaging, and exercise. 

Lymphedema Treatment

Our therapists are specially trained lymphedema specialists who provide non-invasive lymphedema therapy to patients. Complete Decongestive Therapy (CDT) treatment is an individualized plan of care customized for each patient. The treatment aims to help you control swelling through evidence-based therapy practices that consist of:

  • Manual Lymphatic Drainage (MLD) - Manual lymphatic drainage is a superficial massage which stretches and pulls the skin to stimulate lymphatic vessels. Manual lymphatic drainage via the Vodder technique aims to improve circulation of fluid in the lymph vessels
  • Compression garments or bandaging - Compression bandages and garments support the lymphatic system and maintain fluid movement out of the extremities by helping to reduce swelling and improve circulation. Almost all treatments use low stretch specialized compressive bandages. This method of bandaging requires specific training in techniques to assure a healthy pressure is used and proper patient training is provided. Bandaging treatment results in:
    • Softening the underlying tissues
    • Lessening heaviness
    • Increasing range of motion
    • Promoting wound healing
    • Decreasing size
  • Exercise - Exercises can promote circulation, flexibility and strength.
  • Education - Lymphedema treatment can also include education about the lymphatic system, ways to prevent and decrease the risk of infections, how to control swelling, the role of diet and nutrition and hygienic skin and nail care. Therapists also teach patients and caregivers how to apply treatment at home.

The goal of therapy is to assist the patient with edema reduction and then provide training and resources to independently maintain the edema reduction. Your therapist may teach you or a support person how to complete manual lymphatic drainage (MLD), how to bandage your extremity, assist with purchasing appropriate compression garments and provide exercise recommendations.

Lymphatic System Self-Care

Maintaining a healthy lymphatic system is important to prevent illness and keep other important body systems functioning. Encourage proper function of your lymphatic system by incorporating these healthy lifestyle tips:

  • Drink plenty of water
  • Eat a healthy diet
  • Exercise daily, including both aerobic and anaerobic physical activity
  • Learn to manage stress through techniques such as yoga, meditation and exercise to promote wellness
  • Find or create a support system to help manage limitations including family, friends or other social group

Your lymphatic system is constantly working to keep your body balanced. Maintaining its health is important not only for its own role but the role it plays in many other body systems.

While lymphedema is not typically painful on its own, there may be other limitations that arise at the same time as swelling including joint pain, neuropathy, and decreased activity that are painful and can limit activity. It is important to manage swelling to help minimize the effect of pain from other causes.

Find a Location

Many, but not all, of our physical therapy and rehabilitation locations offer lymphedema treatment. A referral may be required for lymphedema treatment. Talk to your provider to learn if lymphedema treatment may be beneficial and learn about offerings near you.