What is Lymphedema?

The lymphatic system is one of the body’s most vital systems as it maintains fluid levels within the body and supports the immune response. When the lymphatic system is damaged, blocked, or abnormally developed, lymph fluid may build up in the affected body part, resulting in a chronic condition known as lymphedema.

There are two types of lymphedema:

• Primary lymphedema is an inherited condition, caused by the abnormal development of the lymphatic system. Symptoms typically appear during infancy, puberty, or during/after pregnancy.
• Secondary lymphedema is the most common type of lymphedema, caused by damage to the lymphatic system. The lymphatic system may be damaged or blocked because of trauma, obesity, cancer treatment, surgery, radiation therapy and infection.

Signs, Symptoms, & Stages

Watch for any signs or symptoms of lymphedema and consult a doctor for a proper diagnosis, especially if you have undergone cancer treatment.

• Feeling of heaviness, fullness, tightness in the at-risk body part
• Visible swelling
• Decreased movement and/or flexibility
• Decreased visibility of your veins, tendons, and wrinkles
• Clothing and jewelry feel too tight
• Fibrosis: hardening and/or thickening of the skin
• Pitting edema: Indentation of the skin with applied pressure
• Increased swelling on hot/humid days or after physical exertion

Lymphedema Stages: 0-3

• Stage 0 – The lymphatic vessels are damaged, but you cannot yet see swelling
• Stage 1 – Swelling tends to be present in the evening and goes away when your limb is elevated. Swelling, heaviness, and fatigue are typical. This is the most crucial and best time to control advancement of lymphedema. Bandaging may not be needed; however, there is excellent benefit in being fitted for a daily garment to assist with compression to prevent progression of edema in the affected limb.
• Stage 2 – Swelling can begin to harden with associated skin changes. Rest and elevation have no effect on the swelling.
• Stage 3 – Swelling is severe and the limb becomes misshapen. Lymph fluid can leak from blisters and wart-like growths. Skin infection risk increases and wound healing potential decreases.

Diagnosing Lymphedema

If you are having lymphedema symptoms, it is important to consult with a doctor as early as possible, especially if you have been or you will undergo cancer treatment or have the following risk factors:

• Cancer
• Infection
• Obesity
• Slow healing after surgery
• Having lymph nodes removed
• Venous insufficiency
• Previous surgeries
• Having undergone radiation therapy

Lymphedema is diagnosed with a physical examination and thorough history of your symptoms; there is no standard diagnostic test for lymphedema. Therefore, if you are at risk of developing lymphedema, it is important to promptly consult with your physician and get a referral to a Certified Lymphedema Therapist, especially if you develop any signs and symptoms.

Treatment for Lymphedema

Lymphedema therapy, known as Complete Decongestive Therapy (CDT), is the gold standard treatment for lymphedema. Provided by a Certified Lymphedema Therapist, this individualized treatment consists of these essential elements:

1. Skin Care: the risk of infection and cellulitis are often a concern in patients with lymphedema. A good skin care routine will be essential for preventing lymphedema flare-ups and other complications.
2. Manual Lymphatic Drainage: a specialized light massage technique that enhances lymphatic flow and the movement of lymphatic fluid out of the affected body part.
3. Compression Therapy: multi-layered compression bandages or wraps are first used to reduce swelling and improve skin changes. Once reduced, the correct type and fit of compression garments are used to maintain the size and swelling of the affected area so that your lymphedema can be managed long-term.
4. Exercise/Movement: the pumping action created by your muscles during exercise is essential to improve lymph flow. Your CLT will provide you with a personalized exercise plan to improve your mobility, flexibility and lymphatic flow.