What Is Lymphedema?

Lymphedema is swelling of a body part, most often an extremity, caused by the accumulation of lymph fluid. It can also occur in the face, neck, abdomen, or genitals.

When the lymphatic system is damaged, this fluid collects in the tissue. Lymphatic fluid consists of protein-rich, rather than water-based, fluid.

There are two types of lymphedema:

• Primary lymphedema is the accumulation of lymphatic fluid which is present at birth, but may develop later in life.
• Secondary lymphedema is much more common. During cancer treatment it may be the result of surgery or a side effect of radiation therapy. However, it also may be the result of injury, scarring, trauma, chronic venous disease, obesity, or infection of the lymphatic system.

Goals of therapy include reduction of swelling in order to reduce potential risks for infections. Areas of the body which are chronically swollen are more at risk for infection.

Treatment

Phase one -- Treatment phase

This phase can last between four weeks and three months (or more with complex conditions). You will work with your therapist from three to five days a week to reduce swelling. It is important that you are consistent with your appointments. Treatment phase consists of:

• Manual lymphatic drainage by massaging the skin to move fluid to other areas of the body, away from the swollen area.
• Compression bandaging to maintain the effects of massage.
• Meticulous skin and nail care to prevent infection and promote good hygiene.
• Remedial exercises in self care to teach patients how to care for their lymphedema.

Once the swelling has reduced, you will graduate from the treatment phase and move on to the maintenance phase. You may receive a compression garment to maintain the new size of the area.

Phase two -- Maintenance phase

This phase consists of self care:

• Compression garment to maintain the new size; it is worn only during the day
• Self bandaging to be worn at night
• Meticulous skin and nail care
• Remedial exercises
• Self manual lymphatic drainage as needed
• Possible follow up visits with your therapist

Remember, everyone responds differently to treatment. Some patients require compression at all times and some, only a few times per week. During the treatment phase, you will learn how you respond to treatment and what type of compression you require.