What is lymphedema?
Lymphedema is accumulation of protein rich fluid in the interstitum due to a low volume insufficiency of the lymphatic system. It is a progressive chronic disease. It affects any part of the body, but more frequently the limbs. If left untreated it can become disabling and at the very worst can become sarcomatous (cancerous). It affects anyone, both genders and onsets at any age.
It has several reasons, a few of which are:
- 1- Primary lymphedema: due to a birth defect, were a family history of the same case will usually be present. It most commonly occurs before the age of 35 but may also occur after that, most typically around the age of 17. This type is much more common in females.
- 2- Secondary lymphedema: were there is a known cause for the presence of lymphedema. There are many causes for secondary lymphedema. Its most common cause in the tropical region of the world is an infection known as filariasis. This form is caused by a mosquito born parasite. While the most common cause in the non- tropical region of the world is cancer therapy. Other causes of secondary lymphedema may include the following trauma, obesity and infection.
Treatment of lymphedema:
Once the diagnosis of lymphedema is confirmed, treatment could start as soon as possible, as the earlier the therapy starts the better the results are. Since there is no cure for this chronic condition, the goal of the treatment is to reduce the swelling and to maintain the reduction. For most of the patients, this can be achieved by the skillful application of complete decongestive therapy (CDT).
This technique is composed of two phases. The first phase aims to reduce the swelling. It is achieved by manual lymph drainage (MLD) and bandaging. MLD is a gentle hand on technique that stimulates the activity of the lymph vessels and manually moves lymph fluid. This technique has to be done by a skillful well trained practitioner.
Bandaging is a key element for the success of CDT. Using inelastic with low extensibility bandages called Short stretch bandages (lymphedema bandages). These bandages produce high working pressure and low resting pressure. This produces a massaging stimulatory effect on lymph vessels.
In phase two we aim to maintain the reduction obtained in phase one. The patient plays the big role in this phase. Wearing gradual pressure garments, being meticulous about skin care and performing therapeutic exercises will assure continued success.