What is Lymphedema?
Lymphedema is a chronic, debilitating disease of the lymphatic system. This condition develops when the lymph pathways are unable to circulate the excess fluid within the tissues, causing swelling.
Lymphedema may be present in the arms, legs, trunk, abdomen, head and neck, and external genitalia. Onset of symptoms may be gradual in some patients and sudden to others. The condition will continue to progress if left untreated.
Patients with lymphedema may experience a constant achy sensation because of swelling. This will eventually lead to a decrease of function, which ultimately leads to a decreased quality of life. Patients may also have trouble fitting their clothes over the swollen areas. These symptoms require specialized treatment.
A Quick Review of the Lymphatic System
The lymphatic system is a drainage system of the body. It has two primary functions: it helps to protect the body from infection and disease and it collects lymph fluid from tissues and returns it to the blood stream.
Lymph vessels carry excess water, proteins, bacteria, viruses and waste products to the lymph nodes where these materials are filtered. The major lymph nodes are found on the groin area, the armpits, and the sides of the neck. The filtered lymph fluid then rejoins the circulatory system just below the collar bones.
Blockage or damage to the lymphatic system interrupts the ability to move lymphatic fluid. Lymphatic fluid is protein rich and protein acts as a sponge to water. Because of this, lymphedema does not respond by taking a water pill. A water pill takes away the water, but not the protein that is left behind within the tissues.
Who May Develop Lymphedema?
Lymphedema is often seen in patients who have undergone surgery and/or radiation for cancer treatment. However, it can also be related to patients who have a genetic predisposition to the disease, a traumatic injury, tumor growth, or other infections.
Common complications include:
- Severe pain
- Loss of mobility
- Tissue changes (fibrosis)
- Muscle atrophy
- Impaired wound healing
- Reduced quality of life
Lymphedema Treatment and Physical Therapy Management
A case of lymphedema means lifelong management. Although there is no cure for lymphedema, daily treatment of Complete Decongestive Therapy (CDT) can reduce swelling and decrease complications. Effective long-term lymphedema management generally requires in-clinic treatment with a Physical Therapist or a Physical Therapist Assistant certified in lymphedema treatment, followed by daily home maintenance. Click here for more information about lymphedema from the American Physical Therapy Association.
CDT has four components:
- Manual lymphatic drainage (MLD)
- Bandaging and pressure garments
- Meticulous skin care
Additional treatment methods may include:
- Kinesio taping
- Myofascial Release (MFR)
The goals of treatment include:
- Reducing swelling and infection
- Establishing new pathways for lymph fluid
- Reducing scar tissue and fibrosis
- Improving strength, range of motion, and use of arm and legs
- Decreasing pain
- Improving function
Chronic Edema/Chronic Cellulitis
Chronic Edema is the persistent swelling of an area of the body on a patient with intact lymph nodes and working lymphatic system. The condition may develop after an orthopedic procedure (joint scope, total joint replacement) or may be due to a chronic circulatory problem. Patients with nonhealing wounds and chronic cellulitis respond to this treatment very well.
When the lymphatic system is specifically activated and edema routed around damaged= tissue, edema is successfully reduced. The rerouting is accomplished by following the direction of the lymphatic pathways. The whole process is called Manual Edema Mobilization (MEM).
Physical Therapy Treatment for Chronic Edema may include:
- Low stretch bandaging and compression program
- Kinesio taping
- Specific exercises
Who treats chronic swelling?
Riverside’s Certified Lymphedema Therapists develop an individualized treatment plan for patients dealing with any kind of chronic swelling.
How can I get treatment?
The Riverside Physical Therapy Department offers lymphedema and chronic edema management programs at the following locations:
- Riverside Health Fitness Center
- Riverside Medical Group, Primary Care, Manteno
- Riverside Senior Life, Kankakee
- Riverside Senior Life, Bourbonnais
- Riverside Healthcare Watseka Campus
Call Riverside Physical Therapy at (815) 935-7514 to schedule an appointment.