Riverside provides lymphedema therapy through physical therapists and occupational therapists who are specially trained and experienced in lymphedema management. Lymphedema is swelling, rich in protein, which accumulates in the interstitial spaces of the body. It occurs as a result of damage or malformation of the lymphatic system. The lymphatic system is tasked with breaking down items that are too big to naturally travel back into the veins and arteries and transporting them back into venous system for the body to get rid of. Once diagnosed, lymphedema is a life-long diagnosis that needs to be managed.
The good news is that while lymphedema, especially in its later stages, can't be completely reversed, it can be effectively managed with proactive strategies and interventions. The goals of lymphedema therapy focus on reducing pain and discomfort, improving movement and avoiding the complications that can be associated with the condition.
Frequently Asked Questions:
Primary Lymphedema – Someone with primary lymphedema is born with lymphedema. It can be hereditary and sometimes does not show symptoms until later in life. It can show up at birth and infancy as well if there is significant malformation of the lymphatics.
Secondary Lymphedema – Occurs as a result of damage or injury to the lymphatics. Common causes include damage to the lymphatics as a result of injury, infection, parasites, removal of lymph nodes due to surgery, radiation, and prolonged/recurrent swelling of an area causing the lymphatics in a particular area to wear out over time.
- Swelling
- Heaviness
- Decreased flexibility/range of motion
- Weakness
- Tightness of the skin
- Clothes/jewelry feel tighter
There is no way to completely prevent lymphedema, but steps can be taken to reduce the risk of developing lymphedema.
Lymphedema does not go away. It is a lifelong diagnosis; however, it can be managed well enough that symptoms are minimal.
A lymphedema therapist is someone who is specially trained to identify and treat lymphedema. It can be treated by both Physical Therapist and Occupational Therapists. Those with special training will have the following additional credentials:
- CLT = Certified Lymphedema Therapist
- ALM = Advanced Lymphedema Management (has undergone extra training in management of lymphedema beyond the initial CLT course). This includes extra training in management of head and neck lymphedema, wound care in lymphedema, and alternative treatment methods for lymphedema.
- CLT-UE = trained in lymphedema management for the upper extremity
- CLT-LE = trained in lymphedema management for the lower extremity
- LANA = this denotes licensure by the Lymphatic Association of North America. For this a therapist must complete a 135-hr course in Complete Decongestive Therapy and complete the CLT-LANA examination
Acute phase
- Treatment in this phase is focused on reduction of lymphatic swelling, reversal of skin changes, and training those with lymphedema how to manage their lymphedema long-term.
Management phase
- The goal at this point is to be able to manage your lymphedema independently. In some cases, there may be occasional follow-up with your lymphedema therapist to assess status.
Both phases have 4 main components:
- Manual Lymph Drainage: gentle treatment where lymphedema therapist uses light touch/strokes to move fluid away from an affected limb/area using specific patterns and pathways. The therapist will also show you how to complete MLD on yourself. In some cases, to improve long-term management of lymphedema, we will also refer you for a pneumatic compression pump.
- Compression Therapy: Initially, compression therapy will include the use of compression wraps to reduce edema to an area. As the edema reduces and skin changes reverse, we will work with you and vendors to fit you for appropriate compression garments for long-term use to manage lymphedema.
- Skin Care: Skin can become dry and cracked with lymphedema. In addition, more swelling means that it takes longer for the skin to receive nutrients from the circulatory system which increases the risk of infection. Therapists will work with you to identify the best way to take care of your skin.
- Diet and exercise: It is important to maintain a healthy weight and eat a low salt diet as a high salt diet can actually result in your body retaining fluid. Exercises begin with movements designed to promote movement of lymphatic fluid through the body. Movement is extremely important as the lymphatic and venous system rely on contraction of muscles and movement of joints to move fluid through their systems. As you progress, exercises will move toward strengthening in order to improve the efficiency of muscle and joint pumps.
- Anybody experiencing edema to include traumatic edema from surgery or injury
- People with a hematoma
- People with CHF (need close monitoring and approval by cardiologist)
- People with vascular issues to include Peripheral Vascular Disease, Chronic Venous Insufficiency and Arterial Insufficiency
- People with Lipedema
- People undergoing treatment for cancer which includes radiation and removal of lymph nodes and extensive surgical changes (initial focus is on reducing the risk of lymphedema as much as possible)