Everything You Need To Know About Lymphedema

/lim·fuh·dee·muh/

What is Lymphedema?

Lymphedema is an abnormal collection of high‐protein fluid just beneath the skin.

This swelling, or edema, occurs most commonly in the arm or leg, but it also may occur in other parts of the body including the breast or trunk, head and neck, or genitals. It is usually chronic, presented as "swelling that does not go away" even after months.

While edema is a symptom, Lymphedema is a condition or disease.

Other conditions that may cause edema, but are not considered as Lymphedema are:

• Venous insufficiency (leaky or obstructed veins)

• Cardiac conditions like heart failure

• Kidney failure

• Other inflammatory conditions

• Water retention

Primary versus Secondary Lymphedema

Lymphedema usually develops when lymph vessels are damaged or lymph nodes are removed (secondary lymphedema) but can also be present when lymphatic vessels are missing or impaired due to a hereditary condition (primary lymphedema).

Stages of Lymphedema (1 to 4)

Stages 1 and 2 are typically reversible with aims to reduce swelling with early intervention and management

Stages 3 and 4 are typically irreversible with aims to maintain and prevent other complications like infections.

When lymphedema remains untreated, it will progress.

How to Treat Lymphedema?

Treatment of lymphedema focuses on slowing down the progression of lymphedema while also improving the symptoms.

Specifically, treatment focuses on:

• Reduction of fluid volume

• Softening tissue fibrosis

• Reducing risk of infection

• Maintaining or enhancing the function of the limb

1) Complete (Combined) Decongestive Therapy (CDT)

• Skin care and education

• Manual lymphatic drainage (MLD)

• Compression therapy (bandaging/ garment prescription)

• Exercise

Depending on the stage of lymphedema, a CDT trained therapist will help you manage your condition with the above.

2) Surgical procedures

• Lymphovenous Bypass (LVB)

• Lymph node transplant

• Liposuction

• Removal of fibrous tissues

Precautions and Contraindications to Treatment

• Signs of infection (pain, redness, rash, increased swelling, increased temperature of skin, sudden fever or chills)

• Presence of blood clots or unresolved Deep Vein Thrombosis (those with history of venous or arterial diseases or on anti-coagulants)

• Close monitoring for patients with congestive heart failure; to seek medical attention if there is shortness of breath after 1-2 days after CDT

If you are unsure about your "swelling that does not go away", do seek medical advice on your next step. In The Rehab Studio, we have a physiotherapist who is trained in Lymphedema Management for the Lower Limb. Contact us to find out more!

Our very own physiotherapist, Jolyn, has also prepared an educational video on this topic, watch here: