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Lymphedema Management

What is Lymphedema?

Lymphedema is a swelling of a body part, most often affecting the extremities. It may also occur in the face, the abdomen, the trunk or the genital area. Lymphedema is the result of an accumulation of protein-rich fluid in the subcutaneous tissues, which can have significant pathological and clinical consequences such as chronic pain, infections, loss limb, or malignant conditions for the patient if left untreated.  Regardless of the severity of a patient’s lymphedema, pain, decreased range of motion, decreased limb strength and decreased functional abilities are often present.

This disorder can be the result of a congenital defect in the lymphatic system (primary lymphedema) or subsequent to damage to or removal of the lymph nodes as a complication of surgical intervention or cancer treatment (secondary lymphedema).

Symptoms of Lymphedema

The swelling in the early stage of lymphedema (stage I) may be temporarily reduced by elevation of the limb.  Without proper treatment, the protein-rich swelling causes a progressive hardening of the affected tissues (stage II).  Other complications such as fungal infections, additional hardening and often an extreme increase in volume of the swollen extremity, are typical for (stage III) lymphedema.

Treatment methods in our office

Manual Lymph Drainage (MLD)/Complete Decongestive Therapy (CDT): this non-invasive, painless and effective therapy for lymphedema and other conditions has been used in Europe successfully since the 1960’s and is now widely recognized in the United States.  The treatment consists of four basic steps:

  1. MLD: is a gentle manual treatment technique that improves the activity of the lymph vessels by mild mechanical stretches on the wall of lymph collectors.  MLD re-routes the lymph flow via tissue channels and lymph vessels around the blocked areas into more centrally located lymph vessels that drain into the venous system.
  2. Compression therapy: is achieved with the application of special short-stretch bandages (phase one of CDT), once the limb is decongested (phase two of CDT), the patient wears compression garments during the day.
  3. Exercises: the therapist designs a customized exercise program for each patient. Theses decongestive exercise assist the effects of the joint and muscle pumps and should be performed by the patient wearing the compression bandage or garment.
  4. Skin Care: the skin in lymphedema is very susceptible to infections and usually dry. We use a low-PH lotion, free of alcohol and fragrances to maintain the moisture of the skin.  Patients need to consult their physicians if there are any infections present in the affected limb.

We also use MLD/CDL techniques for the following conditions:

  • Chronic Venous Insufficiency (CVI)
  • Post-surgical/traumatic swelling
  • Lipedema, lipo-lymphedema
  • Amputee stump edema
  • Migraine headaches

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