Jennifer Kanyuch: What is lymphedema?
Most people have heard of the lymphatic system, but most don’t know what it is and what it does in the body. The lymphatic system parallels the circulatory system and is an important component of the body’s immune system. Lymph vessels absorb protein and water from the skin and subcutaneous tissues and transport it to the cardiovascular circulation, preventing fluid accumulation, also called edema, in the tissues. When the lymph system is compromised, swelling can build up in the tissue and cause lymphedema. There are two types of lymphedema: primary and secondary. Primary lymphedema is caused by the imperfect or abnormal development of the lymph vascular system. It is believed that these abnormalities exist from birth, even though symptoms may not occur until later in life. Secondary lymphedema is caused by known factors that damage the lymphatic system. The most common causes include cancer (predominantly breast cancer), lymph node removal, radiation, and scarring from surgery. Any type of problem that blocks the drainage of lymph fluid can cause lymphedema. Secondary lymphedema affects approximately 1 in 1,000 Americans, whereas primary lymphedema is rarer and affects 1 in 100,000.
There are 3 stages of lymphedema with symptoms that range from a feeling of heaviness or aching in the limb to severe skin and tissue changes. If left untreated, lymphedema can cause a significant increase in limb size, as well as pain and infection in the tissues.
The National Lymphedema Network has issued guidelines for the prevention of lymphedema, specifically after lymph node removal or radiation due to breast cancer. These guidelines include avoiding trauma or injury to the affected limb, avoiding tight or restrictive clothing on the limb, avoiding extreme temperatures, as well as prolonged inactivity. Maintaining a healthy weight and regular exercise have been proven to significantly lower the risk of developing lymphedema. It is also important to be aware of the signs and symptoms of a possible infection in the tissues, which can include redness, rash, pain, increased skin temperature, and generally not feeling well. If any of these symptoms are present, it’s essential to see a doctor right away.
Unfortunately, there is no cure for lymphedema, but it can be managed with a specific treatment regime called Complete Decongestive Therapy (CDT).
Physical, occupational, and massage therapists trained in CDT can help to manage lymphedema using several specialized techniques, including manual lymphatic drainage (MLD), compression bandaging, exercises, skincare, as well as instruction for self-care. Additional nutritional and psychological counseling might be beneficial as well.. Once treatment is completed, patients are able to manage the edema independently with specialized compression garments that are worn during the day and, sometimes, at night. These garments vary in material, fit, price and function, so it’s necessary to be fitted for the garment by someone with proper training.
If you suspect you or someone you know may have lymphedema, consult with a doctor to get a referral to a local lymphedema specialist, who might be able to provide you with treatment and additional management tools. Lymphedema is not a curable disease, but it can be treated and controlled, which can lead to an improvement in quality of life, as well as better overall health.
Move Better, Live Better!
Jennifer Kanyuch, PTA, CLT, is a physical therapist assistant at Fit for Life Physical Therapy (https:// http://www.fitforlifencpt.com) in Grass Valley. She had advanced training in lymphedema and has been recently certified by Klose Training as a certified lymphedema therapist
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