Lymphedema

physiotherapist massaging upper thigh for lymphedema

How to care for Lymphedema

physiotherapist bandages leg and foot of patient with lymphedema

Dealing with the ongoing swelling and pain in your limbs from lymphedema is more than frustrating. Your body may not move or look the same. Activities you once took for granted are now much more difficult. How do you find a new normal?

The first thing you need to know is that you’re not alone. In fact, up to one million Canadians are impacted by lymphedema. The second is that you have many effective treatment options that can help reduce and manage your lymphedema symptoms, so you can get back to a sense of normal. Here’s what you need to know.

What is lymphedema?

Lymphedema is the chronic swelling of a body part caused by excess lymph fluid collecting in the body, usually in the arm or leg, but it can also be in the chest, mid-section, head or groin. The build-up happens because the lymphatic system is unable to function properly.


graphic of the lymphatic system

What is the lymphatic system?

The lymphatic system is a network of tissues and organs that work to filter out toxins, waste and other unwanted materials from the body. It does this by moving lymph fluid, which contains white blood cells, through the body. The fluid is transported via lymphatic vessels, which are connected to lymph nodes that filter the fluid. You have hundreds of lymph nodes in your body. Some are deep (i.e. near the lungs and heart), while others are closer to the surface (i.e. under the arm or groin).


Lymphedema causes

Primary lymphedema occurs because a person is born with a faulty lymphatic system. They either have symptoms as a baby or develop them later in life when body weight or a change in hormones places more of a burden on the already compromised system.

Secondary lymphedema develops because the lymphatic system has been damaged by surgery, radiation therapy or severe injury. This can occur right away or several years later.

Those who have received treatment for certain cancers (i.e. breast, prostate, lymphoma, melanoma and more) are at a high-risk for lymphedema, since treatment for these cancers often involves surgery to remove lymph nodes or vessels, as well as radiation that can damage lymph nodes. Without healthy lymph nodes, lymphatic fluid has difficulty passing through the system, leading to build-up and subsequent swelling.

Secondary lymphedema can also be caused by non-cancer related surgeries, recurring infections, obesity and disabilities that impact lymphatic circulation.


swollen feet and legs edema

Lymphedema symptoms

The key symptom of lymphedema is swelling. If you’re at risk for this condition, you should watch out for:

  • Puffiness in the hand or foot
  • Heaviness or fullness in the arm or leg
  • Deep impressions in your arm left by clothing, watches or rings (like they are suddenly too tight)
  • Loss of flexibility in the joints of your affected limb
  • Frequent infections
  • Difficulty fighting infections

physiotherapist massage upper arm of patient

Lymphedema treatment:

Symptoms of lymphedema can be controlled and managed through various treatment approaches performed by certified CDT (Complex Decongestive Therapy) or CPT (Complex Physical Therapy) therapists. These therapists are typically Registered Massage Therapists or Physiotherapists.

A full treatment program, can include:

  • Manual lymphatic drainage: This type of gentle, rhythmic massage, sometimes called lymph node drainage, helps the body get rid of stagnant fluid. Using small, circular movements, lymphedema massage stimulates the lymph vessels below the skin, moving the fluid in the direction of the lymphatic draining system where it can be cleared away.
  • Bandages and compression garments: Compression garments can be used daily to control mild swelling. Bandaging (sometimes only at night) can be used to reduce more moderate to severe swelling. Limbs are often bandaged following lymphedema massage to maintain the reduced swelling and help you move more freely for other parts of your treatment, like exercise.
  • Exercise: A customized exercise plan helps you maintain mobility and reduce swelling under the supervision of your healthcare team. Using your own body or simple equipment, a lymphedema therapist will instruct you in exercises to help you strengthen your muscles and increase your range of motion. The movements also help drive fluid out of the affected body area.
  • Education for at-home care: Your therapist will teach you techniques for self-massage, wearing compression garments, wrapping bandages and proper exercising, so you can continue your treatment at home. They may also teach you how to measure the affected areas, helping you assess if the swelling has increased, reduced or remained stable.

Other types of treatment include:

  • Pneumatic compression (using an inflatable sleeve with a pump)
  • Laser therapy
  • Kinesio taping

Surgery and medication

While surgery is possible for severe cases of swelling that do not respond to therapy treatments, it’s not standard treatment and isn’t readily available in Canada. If you do have surgery, Complex Physical Therapy (CPT) or Complex Decongestive Therapy (CDT) would continue after surgery.

There is no medication currently available to treat or cure lymphedema.


A cure for lymphedema

There is no known cure for lymphedema. Temporary lymphedema is rare—in most cases, it is a lifelong condition. But, with treatment, the symptoms can be relieved and managed, helping you control the condition.


Prevention

While there are no proven methods to prevent lymphedema, there are approaches you can take to get ahead of symptoms and reduce risks associated with the condition. After cancer surgery or treatment, you can have a clinician take arm measurements (or with other limbs) once every three months. Monitoring the differences during this time will help you catch lymphedema sooner and minimize the effects with earlier treatment.


Protecting yourself at home

It’s important to protect the affected area of your body from injury and infection:

  • Use sunscreen to protect your skin from sunburn.
  • Use insect replant to protect your skin from insect bites.
  • Never have blood drawn from the affected area—make sure medical staff know about your condition.
  • Avoid walking barefoot, especially outside.
  • Wear protective gloves when gardening or doing other outdoor activities that could lead to scrapes and cuts.
  • Take good care of your skin and nails, checking hands and feet regularly for cuts, blisters or signs of infection.