Lymphedema is an abnormal collection of lymph fluid between the tissue layers that can cause swelling, or edema, which can most commonly be present in the arm or leg, but can also occur in other parts of the body, like the breast, trunk, head or neck. Since the lymph fluid is rich in protein, it gives the affected area a very thick and heavy feeling, making the body experience an inflammatory reaction in the scar tissue called fibrosis, which is the scarring of connective tissue. In result to this, the increased fluid and fibrosis prevents the delivery of oxygen and essential nutrients to the area, increasing the risk of infections in or below the skin, called cellulitis, or of the bloodstream.

What Causes Lymphedema?  

There are two primary types of lymphedema:

Primary Lymphedema

This is a congenital form of lymphedema caused by a malformation of the lymph vessels or nodes. It may be present at birth, or later in life, often occurring when there are other cognitive impairments or genetic abnormalities at birth. The most common form of primary lymphedema is lymphedema praecox. This can be present during puberty, mostly in girls, and usually affects one or both lower extremities. Another form of primary lymphedema is called lymphedema tarda, which begins later in life and usually affects both lower extremities in men and women.

Secondary Lymphedema

This is caused by damage to the lymphatic system, including surgery, infections, radiation, or trauma.  Oncology care including radiation, chemotherapy, surgery, tumors, compromise of the vascular system, burns, liposuction and general trauma can all be contributing factors of lymphedema.

Signs and Symptoms

Signs and symptoms of lymphedema include:

  • A feeling of tightness and heaviness of the skin or tissue
  • Decreased flexibility in joints
  • Clothing or jewelry fitting tight in certain area
  • A tingling or crawling sensation on the skin (only in some patients)

How is Lymphedema Treated?

There is no specific cure for lymphedema. Treatment for lymphedema is done through physical therapy and should be given only by a certified lymphatic therapist who has graduated from a 135-hour certification program.

The treatment options available, focus mainly on reducing the swelling and controlling the pain. The different types include manual therapy, often called Manual Lymph Drainage, compression bandaging, compression garments, and a specific self-massage.

  • The massage is extremely light in pressure, engaging the skin layer only to stretch the skin and cause a contraction of the lymphangion to move fluid and protein through the one-way valve system of the lymphatics.
  • The compression bandaging care is designed to get a good amount of volume reduction in a relatively short period of time.  A bandage is worn 24 hours a day and changed daily, or every other day depending on patient proximity to the clinic.  The patient’s day to day motions will not be restricted with the garment.
  • Compressing garments, like long sleeves or stockings are used to compress your arm or leg to encourage the flow of the lymph fluid out of your affected limb. For better results, wear a compressing garment when exercising.

 

For more information about lymphedema, patient treatment clinics, Access Physical Therapy & Wellness, or to schedule an appointment, please visit http://accessptw.com/ or call the St. Anthony Community Hospital Center office at 845.987.5150 or the Good Samaritan Hospital office at 845.368.5253, both powered by Access Physical Therapy & Wellness. Early detection and treatment can minimize the symptoms and can improve the outcome.

 

 

Resources: http://www.lymphnet.org/le-faqs/what-is-lymphedema/infection-and-other-complications

http://www.mayoclinic.org/diseases-conditions/lymphedema/basics/treatment/con-20025603

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