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What is Lymphedema?


Lymphedema is an accumulation of lymph fluid between the tissue layers that can cause swelling (edema). It is most commonly 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. Lymphedema can also cause an inflammatory reaction in the scar tissue called fibrosis. The increases in fluid and inflammation prevent the delivery of oxygen and essential nutrients to the area. The protein in trapped lymphatic fluid is an ideal food source for bacteria, increasing the risk of skin infections such as cellulitis, which can progress into sepsis if untreated.

What Causes Lymphedema?  

There are two primary types of lymphedema:

Primary Lymphedema

This is a congenital form caused by a malformation of the lymph vessels or nodes. It may be present at birth, or develop later in life, and may be associated with genetic disorders. 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 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 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 cure for lymphedema, but symptoms can be managed with a combination of diet, exercise, skincare, and bandaging or compression. Treatment often includes physical therapy or occupational therapy from 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.
  • Compression 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 compression garment when exercising.

Early detection and treatment can minimize the symptoms and improve outcomes for lymphedema patients. ACCESS PT offers lymphedema therapy in our Armonk, Port Jervis, and Woodstock locations as well as our hospital locations:

  • Bon Secours Community Hospital – Port Jervis, NY
  • Good Samaritan Hospital – Suffern, NY
  • St. Anthony Community Hospital – Warwick, NY