Lymphedema is swelling caused by excess lymphatic fluid (lymph) collecting in the body’s soft tissues, usually in the arms or legs.
Lymph circulates within the lymphatic system, which is part of the immune system. Lymphedema is typically caused by a blockage of this system.
There are two types of lymphedema. The first is primary lymphedema which comes from rare, inherited conditions when the lymphatic system doesn’t develop properly. This type is present at birth or shortly after puberty. Then there is secondary lymphedema, the most common type. It occurs as a result of something else such as infection, injury or cancer that affects the lymphatic system.
There are several causes for lymphedema including pregnancy, cancer, surgery, parasites and radiation treatments for cancer.
So, what are the symptoms? It presents through swelling of either a part or the whole leg or arm including fingers and toes. Swelling in the head or neck can also be a tell-tale sign of lymphedema. Patients also have restriction of range of motion of the limb, discomfort or aching in the affected limb as well as thickening and hardening of the skin.
There are several physiotherapy treatment options.
Compression garments: Compression sleeves and stockings for the arms and legs relieve swelling. Compression pushes the fluid back into circulation by increasing the rate that the lymphatic fluid is filtered out of the soft tissue. Compression also gives you external containment which prevents and helps control swelling.
Multi-layer compression bandaging: A short stretch bandage helps reduce swelling to soft tissue. They are applied with levels of pressure to help re-route fluid from the swollen areas. Once the lymph fluid is moved out of a swollen limb, it’s a good time to wear compression garments to prevent swelling from returning.
Manual lymphatic drainage (MLD): This is a very light form of massage involves gentle skin stretch on soft tissues by a therapist. Lymph from the swollen area is gently transferred into an area with working lymph vessels. Patients can be taught to perform MLD on themselves.
Exercise: Physical exercise as well as decongestive exercise stimulate lymphatic drainage. The muscle pump contraction filters out lymphatic fluid, and the decongestive exercises help to stimulate the lymphatic system to take up the fluid.
Complete decongestive therapy: It combines compression, manual lymphatic drainage, meticulous skin care and exercise. Depending on the severity, this type of lymphedema treatment can last from two weeks to several months.
Mr Washe is a physiotherapist at Chiropractic & Physiotherapy Health Centre.