What is Lymphedema?
Lymphedema is a disorder of the lymphatic circulation marked by the buildup of lymph fluid, often causing swelling in the arms or legs. This can happen when lymph vessels or lymph nodes are blocked, damaged, or surgically removed.
When the lymphatic system is impaired, lymph fluid can exceed the body’s transport capacity. This may lead to a buildup of protein-rich fluid in surrounding tissue, reduced oxygen delivery, delayed wound healing, increased infection risk, and long-term tissue hardening known as fibrosis.
What kinds of lymphedema are there?
Lymphedema can be grouped into three main types.
1. Primary Lymphedema: This is a congenital abnormality sometimes known as Milroy's Disease. It may develop during childhood or early adulthood. There is no cure, but it can be managed through therapy.
2. Secondary Lymphedema: This is the most common form of lymphedema. It results from damage to lymph nodes or the lymphatic system, often after surgery or radiation treatments for breast cancer, cervical cancer, rectal cancer, or anal cancer.
3. Venous Disorders: Chronic Venous Insufficiency is a common venous condition associated with swelling problems. It can develop because of partial vein blockage or blood leakage around the vein valves and may contribute to ulcers, clotting issues, and cellulitis.
What are the treatments for lymphedema?
1. Elevation: Keeping the limb elevated, often above heart level, may help encourage fluid drainage. This method requires no special equipment, but it may take time to show results.
2. Lymphatic Massage: Manual lymph drainage is performed by trained therapists using specialized techniques to help move lymph fluid. Some patients can also be taught self-management methods, though insurance coverage varies.
3. Compression Garments: Compression garments help maintain limb size and may be off-the-shelf or custom-made. Compression strength varies, and garments generally need regular replacement as they lose effectiveness over time.
4. Pneumatic Compression Pumps and Sleeves: These air-filled devices fit over the swollen limb and use controlled pressure to help move fluid toward the body. Many systems use gradient compression and are commonly prescribed as part of a broader therapy plan.
Many physicians and therapists recommend combining several therapies for better long-term management of lymphedema.