Occupational Therapy - Frequently Asked Questions About Lymphedema
Q. What is lymphedema?
A. Lymphedema is chronic swelling in any portion of the body (usually an arm or leg) due to accumulation of lymph fluid in the tissue spaces as a result of an obstruction of venous and/or lymphatic vessels, pathways, or lymph nodes.
Q. What are some of the signs/symptoms associated with lymphedema?
A. Signs and symptoms of lymphedema include:
- Aching, weakness, redness, heaviness, or tightness within the limb.
- Swelling within the limb that does not easily resolve.
- Decreased flexibility within the affected body part.
- Rings left on the arm or leg from garments (eg, socks, shoes, sleeves).
Q. Why should lymphedema be treated?
A. If left untreated, lymphedema creates an environment of stagnant fluid, causing lymph channels to decrease in size and number. This reduces oxygen tension throughout the transport system, interfering with wound healing and providing an environment for bacteria, increasing the potential for infection. If the swelling and inflammation persists, the tissue eventually thickens and becomes fibrotic. This leads to decreased active motion, which can intensify the problem.
Q. What are the types and causes of lymphedema?
A. There are 2 types of lymphedema—primary and secondary. Primary lymphedema is caused by an abnormality of the lymphatic system that is present at birth. Secondary lymphedema is caused by infection, injury, surgery, radiation, or trauma. This type of lymphedema may be a side effect following certain types of cancer. It may also occur after removal of lymph nodes or disruption of lymphatic pathways.
Q. Can lymphedema be cured?
A. With early intervention and proper treatment, lymphedema can be controlled, allowing the individual to lead a full and normal life. However, this is frequently a persistent condition. Therefore, techniques for self-management and maintenance are essential factors in its control.
Q. What does treatment* include?
A. Following a comprehensive evaluation, treatment may include:
- Manual lymphatic drainage of the lymph fluid from the affected body part, using the superficial lymph vessels, with non-invasive, gentle manual therapy.
- Multi-layered bandaging of the extremity, to reduce fluid in the swollen tissues, as well as soften the tissue.
- A comprehensive exercise program, including flexibility and strengthening, to enhance lymph drainage.
- A skin care program, to prevent infection.
- Education/instruction—(home program) to control swelling independently. This includes basic range of motion exercises, strengthening, self manual lymphatic drainage, and self bandaging.
- Being fitted with a compression garment—worn during daytime hours, to maintain results achieved in therapy.
- Patients can expect sessions to last 60–90 minutes, based on individual needs.
Q. Who is a candidate for evaluation and treatment?
A. Candidates include:
- Individuals whose surgery or cancer treatment include lymph node removal, lymphatic pathway disruption, and/or radiation therapy.
- Individuals with post-surgical swelling that does not resolve with time.
- Diabetics
- Amputees
- Individuals who have any swelling in the arm, hand, leg, or foot that does not resolve with elevation, water pills, etc. or that is chronic in nature.
Note: If there is a question regarding active cancer or infection, a physician’s review will be required.