Lymphedema Treatment

Lymphedema Treatment

Lymphedema Treatment

There is currently no cure for lymphedema (LE). Untreated lymphedema can worsen, leading to debilitating pain and swelling, progressive hardening of affected tissues (fibrosis), and recurrent infections (cellulitis). LE can decrease mobility, dexterity, range of motion and the ability to perform daily activities. With effective monitoring in a Lymphedema Prevention Program (LPP) (link to LPP), early stages of lymphedema can be detected and reversed with simple at home care! However, if you do not have access to a LPP, with efficient surveillance, patients can manage their symptoms, minimize infections, and improve their health and quality of life.

Compression Therapy

Compression therapy is well-established as a component of therapy. Compression of the limb may be applied in various ways including multi-layer bandaging, compression stockings, custom compression garments, and intermittent pneumatic compression devices. A patient should be thoroughly evaluated to create an effective program to manage symptoms and prevent the progression of swelling.

 

Complete Decongestive Therapy (CDT)

CDT is a multimodal treatment approach consisting of intensive in-clinic treatment provided by a lymphedema therapist, followed by an at-home treatment program. The focus of in-clinic CDT is to reduce limb volume and fibrosis and provide the patient with tools and knowledge to enable them to succeed with a lifelong successful home management program.

Components of in-clinic CDT may include:

  • Education on the lymphatic system, how lymphedema occurs, skin and nail care and other health precautions specific to the condition
  • Gradient compression bandaging
  • Manual lymphatic drainage therapy (MLD)
    • This key component of CDT employs a sequence of hand motions, consistent with established anatomic and physiological principles, which redirect fluid from congested and swollen areas to functioning lymphatic regions.
  • Intermittent pneumatic compression (IPC) devices.
  • Development of a comprehensive at-home Program for effective self-management.

 

At-Home Self-Management

Ultimately, if not detected and reversed in the early stages through a LPP (link to LPP) the patient and/or their caregiver(s) will be responsible for managing chronic non-reversible LE symptoms at home. Home treatment components should be customized to meet each patient’s needs and may include:

  • Compression garments
    • Wear light compression garments during flights greater than three hours or during vigorous exercise.
    • All patients who have had an isolated episode of swelling should wear a sleeve and/or glove regardless of the length of the flight.
    • All patients with chronic lymphedema should wear a sleeve and/or glove during ALL air travel.
    • Replace the garments every six months.
  • Gradient compression bandaging
  • Intermittent pneumatic compression device
  • Meticulous skin and nail care
  • Daily decongestive exercise