LYMPHEDEMA: MANAGEMENT AND PREVENTION | Physical Therapy NYC Blog
LYMPHEDEMA is an accumulation of protein rich fluid called lymph that causes a swelling in the spaces just under the skin. This swelling is caused by the lymphatic system’s inability to carry away accumulated fluid and often occurs in an arm or leg but can occur anywhere in the body. There are 2 main types of lymphedema referred to as primary and secondary lymphedema.
PRIMARY LYMPHEDEMA is caused by hereditary factors and commonly occurs anytime from birth to age 35. Later onsets are possible but rare.
SECONDARY LYMPHEDEMA is acquired lymphedema and is the more common type. The greatest number of cases of secondary lymphedema are caused by a parasitic infection called Filariasis which is most commonly found in impoverished countries where the weather is very hot. Most cases of secondary lymphedema in the U.S. are caused by the effects of cancer diagnosis and treatment such as lymph node removal and radiation therapy. These are interventions that damage the lymphatic system. Many cases of secondary lymphedema of the legs are caused by venous insufficiency, a common problem of older people who have poor circulation.
It is impossible to quote the number of secondary lymphedema cases in this country because the data varies based on where you derive statistics. Some patients develop lymphedema shortly after cancer treatment, although it can arise at any time in your life if you are at risk. Most cases usually present themselves within the first 2 years following cancer treatment. The greater the number of lymph nodes removed or irradiated, the greater chances for developing lymphedema, however there are many patients who have had aggressive treatment for cancer who do not develop lymphedema.
The LYMPH SYSTEM is a one-way circulatory system comprised of lymph glands that produce lymphocytes (lymph cells), graduated lymph vessels, some with one-way pumping valves that send lymph fluid with waste products to the lymph nodes for filtering the protein fluid before it is eliminated from the body via the venous system.
There are 3 STAGES OF LYMPHEDEMA:
CELLULITIS is a skin infection that can occur with any of the 3 stages of lymphedema because of the stagnant protein rich fluid that sits trapped under the skin serving as a culture medium for infection. It often spreads rapidly and if left untreated with antibiotics it may result in a life threatening situation.
The most successful TREATMENT AND MANAGEMENT for those with lymphedema or who are at risk involves a conservative program. Those at risk should abide by the following and other common sense guidelines: avoid sun and excessive heat, wear sunblock, protect your skin against cuts and other traumas, avoid cutting cuticles on the affected extremity, increase exercises gradually, avoid tight clothing and jewelry. Patients who have lymphedema are advised to wear specially fitted gradient compression garments on air flights.
Manual lymph drainage and complete decongestive therapy for those who suffer from lymphedema is a 5 part treatment scheme that includes specialized massage techniques, compression bandaging and garment fitting, skin care, prevention education, and remedial exercises. Such a program should not be given by chiropractic NYC or physical therapist NYC but by a certified lymphedema therapist who has attended a course of 125 hours or more.
Excerpts from a presentation given on November 18, 2003 at UCLA Jonsson Comprehensive Cancer Center by Mary Rosenberg, P.T., CLT-LANA