LYMPHEDEMA

 What is lymphedema? 

Lymphedema is an abnormal collection of lymphatic fluid in the tissues just beneath the skin. This swelling commonly occurs in the arm or leg, but it may also occur in other body areas including the breast, chest, head, neck, and genitals. Lymphedema develops when a body region, where lymphatic vessels and lymph nodes are missing or impaired, becoming overloaded with lymphatic fluid.  Lymphatic fluid is normally transported in our body by an extensive network of vessels and nodes. When these vessels are damaged or malformed, there is a risk that lymphatic fluid will not be adequately transported and may result in fluid backing up in body tissues. When fluid congests in the tissue, swelling occurs. This swelling is called lymphedema.  If the condition is left untreated, it leads to progressive tissue swelling over time. Lymphatic fluid congestion also reduces healthy blood flow to the tissue, interferes with wound healing, and enables bacteria to grow, which increases the risk for tissue infections.  Lymphedema should NOT be confused with other types of edema resulting from venous insufficiency, cardiac conditions, kidney failure, or other inflammatory processes. These swelling conditions are systemic, while lymphedema occurs only in the specific regions of the body.

What does the lymphatic system do?

The lymphatic system’s primary function is to absorb and transport throughout the body. The lymphatic system functions in parallel to the circulatory system, but it is made up of its own circuit of lymph vessels, nodes, and lymphoid tissues. Lymph fluid is made of proteins, water, impurities, and waste products from the body’s tissues. In addition, the system produces and transports immune cells (lymphocytes) that fight bacteria and viruses.  Lymph fluid is normally absorbed from body tissues and moves through a series of vessels and lymph nodes, As the fluid passes through the nodes, it is purified of harmful bacteria and viruses. The lymphatic system has regional networks of vessels that are responsible for handling fluid from specific body tissues.

How is it treated?

Complete Decongestive Therapy (CDT)

 

A technique which consists of the following points:

 1. Manual Lymph Drainage (MLD)- A gentle massage technique that stimulates the lymph vessels to move fluid from the affected area, back into the lymphatic system.

2. Compression Therapy- A multilayer bandaging approach that helps move the lymph fluid out of the affected area, utilizing compression. Once there is improvement, wearing a compression garment will help prevent further swelling.

3. Good Skin and Nail Care- This may prevent infection, from skin break down, and infection transfer. (A podiatrist can provide expert foot care.)

4. Exercise and Movement- Both help improve circulation and move lymph fluid which improves lymphatic drainage.

What is a certified lymphdema therapist (CLT)?

A Certified Lymphedema Therapist is someone who has completed a training course that is specific for lymphedema. According to the Lymphology Association of North America (LANA), courses should have a minimum of 135 hours of coursework in Complete Decongestive Therapy (CDT) with 1/3 consisting of theoretical instruction in anatomy and physiology of the lymphatics, and 2/3 being significant hands on instruction. While occupational and physical therapists are among some of the most common CLTs, there are many other medical fields that can be accepted for a CLT course. These include: PTA (Physical Therapy Assistant), COTA (Certified Occupational Therapy Assistant), MT (Medical Technologist), SLP (Speech Language Pathologist), RN (Registered Nurse), MD (Medical Doctor), DO (Doctor of Osteopathic Medicine), DC (Chiropractor), PA (Physician Assistant), and ATC (Certified Athletic Trainer).

Support Networks:

Learning that you have lymphedema can possibly bring up a wide range of emotional and mental challenges. Feelings of isolation are common, especially if you don’t know anyone else with the disease, nor have heard of lymphedema. You are not alone.

 

There are two National Lymphedema organizations that can provide information and support for you or a loved one.

  1.  Lymphatic Education & Research Network (LE&RN)- LE&RN is an international non-profit organization. It has several state chapters across the United States and internationally. They provide educational programs and a supportive network for patients, their families and caregivers.  www.lymphaticnetwork.org

  2. National Lymphedema Network (NLN) The NLN is a non-profit organization. It provides education and guidance to lymphedema patients and health care professionals. www.lymphnet.org

  3. The first New Mexico Lipedema & Lymphedema Support Group.  You can find us at www.nmlipedema.org or www.lymphedemanm.com

Stacey Esch, OTR/L, CHT, CLT

© 2015 Balanced Physical Therapy and Wellness, LLC