Rita Grant is the certified lymphedema therapist at Banner Thunderbird Medical Center.
Question: What is lymphedema?
Answer: Lymphedema is chronic swelling in the body (usually an arm or a leg) due to an accumulation of lymph fluid in the tissue spaces as a result of damage to the lymphatic system. The lymphatic system is an important part of the circulatory system because it collects fluids from the tissues and blood centrally. It removes impurities as bacteria and produces lymphocytes (disease fighting cells for the immune system). With damage to the lymphatic system, swelling develops with protein rich fluid causing a stagnant environment of bacteria and increased potential for infection. Lyphedema is initially mild and reversible. If the condition of swelling and inflammation persists, the protein rich fluid thickens and becomes fibrotic (hardened) and then moderate to severe lymphedema has developed.
Question: Who is at risk for lymphedema?
Answer: People are at risk for primary or secondary lymphedema. Primary lymphedema is malformation of the lymphatic vessels or lymph nodes and can be present at birth, puberty, at an early onset (before 35 years) or a late onset (after 35 years).
Most commonly, people have secondary lymphedema. Secondary lymphedema can occur after surgical removal of the lymph nodes or other obstructive factors including scaring from infection or radiation therapy. Examples of secondary lymphedema are breast cancer patients with axillary node dissections who develop arm lymphedema. Other examples of secondary lymphedema include lipolympedema, filiarises, and phlebolympedema, which involve venous insufficiency and damaged valves. Venous insufficiency is not true lymphedema, but is treated similar to lymphedema.
Question: What can physical therapy do to improve symptoms of lymphedema?
Answer: A comprehensive treatment program that would improve symptoms of lymphedema may include:
- evaluation by a certified lymphedema therapist to determine the proper course of treatment
- a comprehensive lymphedema program will include education on skin care and skin care precautions to decrease the possibility of infections
- lymphatic drainage which is a noninvasive therapy technique to remove excess fluid from the lymphatic capillaries and out of the limb
- compression bandaging of the arm or leg to provide a firm non- elastic support to promote lymphatic pumping during muscle contraction
- sequential pumping to maximize the swelling reduction
- referral with compression garments.