For Patients - Patient Education

What is Lymphedema?

Lymphedema is an accumulation of lymph fluid between the tissue layers. This presents as swelling or edema. Lymphedema can be present anywhere in the body.

Lymph fluid is rich in protein, making the edematous area very thick and heavy feeling. Treatment is necessary to move the fluid out of the area, as well as the protein. If it is not treated, over time the lymphatic vessels will stretch out permanently and external compression and treatment will be necessary for a lifetime to maintain proper pressure in the valves to move fluid more normally.

When the vessels are full of this protein-rich fluid, there is less oxygen in the vessels, decreasing the rate at which wounds, surgery sites and skin ulcerations heal. This also puts the patient at risk of cellulitis, or infection of the bloodstream.

Many people report the first signs and symptoms of lymphedema as a feeling of tightness or heaviness decreased flexibility in the joints, and clothing or jewelry fitting tightly. Some patients only report strange sensations such as tingling or a crawling feeling on the skin.

What causes it?

There are two primary types of lymphedema. The first is Primary Lymphedema, or from birth. This is a congenital form of lymphedema caused by a malformation of the lymph vessels or nodes. It may present itself at birth, or later in life. Often it occurs when there are other cognitive impairments at birth as well, i.e. Down’s syndrome.

Secondary lymphedema is caused secondary to lymph vessel destruction, or lymph node removal secondary to a disease process or a surgery. Oncology care (including radiation, chemotherapy, and/or surgery), tumors, infection, compromise of the vascular system, burns, liposuction and general trauma can all be contributing factors of lymphedema.

Lymphedema does not necessarily develop right after surgery. It can develop decades later!

Lipidema is a condition that is often confused with lymphedema. The patient presents with symmetrical excess size and fat from the hips to the ankles. The patient often looks disproportionately thin on the top half of the body and at the ankles. The lymphatics present in a corkscrew pattern in a lipidema patient trapping fat molecules, resulting in larger appearance and tenderness to touch. Often there are also large lobules of fat on the inside of the knee.

What does the lymphatic system do?

The lymph system is responsible for creating a homeostasis of fluid between the tissues and the general circulation of the body. The system also has very important immune functions, acting to filter toxins from the body by removing bacteria, viruses, foreign objects, and mutant cells.

How is lymphedema treated?

Lymphatic Care Specialists, LLC teaches courses that meet the requirements for a variety of professions for CEU credits. As a student, you must ensure that the course is currently approved by your appropriate licensing or certification board.

Lymphedema is treated by one or more of the following: Manual therapy, often called Manual Lymph Drainage, compression bandaging, compression garments, a specific self-massage protocol and impeccable skin care. Treatment for lymphedema should be given only by a certified lymphatic therapist who has graduated from a 135 hour certification program.

The massage is extremely light in pressure, engaging the skin layer only to stretch the skin and cause a contraction of the lymphangion to move fluid and protein through the one-way valve system of the lymphatics.

The bandaging component to care is designed to get a good amount of volume reduction in a relatively short period of time. A bandage is worn 24 hours a day and changed daily, or every other day depending on patient proximity to the clinic. The patient’s day-to-day motions will not be restricted with the garment.

An intermittent pneumatic pump is not recognized as the standard of care for lymphedema, but is occasionally used when a patient does not respond to MLD and bandaging therapy. The pump works to gradually move fluid from the limb in segments. The downside of the pump is that is moves only the fluid component, not the protein component. This sometimes creates a cyclical dependency on the pump for daily maintenance.

After volume reduction has been met in the limb, the results will need to be maintained by use of self-massage, compression garments, exercise or a combination of these.

Phone consultations are available to guide you in finding the appropriate help for your specific situation.

Videos on Lymphedema

Cancer Quest: Lymphedema Overview

Lymphedema Therapy with Kristi