Forms of Lymphedema
Primary Lymphedema - this form of Lymphedema is caused by malformations of the lymphatic system. These malformations are most common in women. They can be present at birth or may develop later on, most commonly after puberty or pregnancy. This form of Lymphedema is most common in the legs, but can also occur in the arms or torso.
Secondary Lymphedema - this form of Lymphedema is a result of damage to the lymphatic system, most commonly after surgical procedures such as mastectomies, lumpectomies and/or removal of lymph nodes. This form of Lymphedema is most common in the arms, but can also occur in the legs.
Stages of Lymphedema
Stage I - This occurs as early accumulation of fluid with visible swelling. This swelling can be temporarily reduced, but in most cases, the swelling returns. Edema can also be present.
Stage II - This occurs as swelling increased and the tissues become firm due to fibrosis. Elevating the affected limb does not reduce the swelling like in Stage I and pressure against the affected limb produces a slight indentation.
Stage III - Also known as Lymphostatic Elephantiasis due to the tissue becoming extremely swollen and thickened due to a blockage in the flow of lymph and a buildup of the fluid within the tissues. At this stage, normal elasticity is lost and the skin will hang in folds. Papillomas (small benign tumors) and Hyperkeratosis (increase in thickness of the outer layer of skin) can develop.
Manual Lymph Drainage - Manual Lymph Drainage (also referred to as simply MLD) is a very gentle type of massage therapy used to drain excess fluid from the body and improve the overall functioning of the lymphatic (immune) system. MLD is most commonly used to treat Lymphedema, which is characterized by the blockage of lymph nodes in the arms and legs.
Compression Bandaging - Compression bandaging, also called wrapping, is the application of several layers of padding and short-stretch bandages to the involved areas. Short-stretch bandages are preferred over long-stretch bandages (such as those normally used to treat sprains), as the long-stretch bandages cannot produce the proper therapeutic tension necessary to safely reduce lymphedema and may in fact end up producing a tourniquet effect. During activity, whether exercise or daily activities, the short-stretch bandages enhance the pumping action of the lymph vessels by providing increased resistance for them to push against. This encourages lymphatic flow and helps to soften fluid-swollen areas.
Compression Garment Wear - Elastic compression garments are worn by persons with lymphedema on the affected limb following complete decongestive therapy to maintain edema reduction. Depending on the therapist's discretion, a compression garment may be custom-fit or purchased in over-the-counter, standard sizes. Compression garments are meant to be worn every day to maintain edema reduction and must be replaced on a regular basis.
Exercise - Increases the uptake of fluid by the initial lymphatics and enhance the pumping of the collecting lymphatics. In addition, exercise mobilizes the joints and strengthens the muscles of the involved limbs quadrant, thus decreasing the risk of strain/sprain.Exercise for lymphedema is best done with compression on the affected limb either from compression bandages or compression garments. The bandages provide a new "tight" skin for the muscles to contract against, assisting in pumping the lymph out of the extremity into the central circulation.
Skin care - The goal of skin care is to prevent infection and to keep skin from drying and cracking. Fluid that is trapped in body tissues by lymphedema makes it easy for bacteria to grow and cause infection. We will give you all the tips and care you need to keep your skin from becoming infected and keep it moisturized.
Kinesiotape - Kinesiotaping is a treatment method now being used for those with mild to moderate lymphedema. This is the same tape used by athletes in the Olympics to reduce inflammation and provide support to muscles.