When lymphedema occurs, Improper drainage develops a buildup of lymph fluid in your arms and legs, which can harm your health. As a result of this, you may experience swelling in your arms or legs because the fluid cannot drain normally. Contact In Step Physical Therapy now to receive treatment for lymphedema!

The World Health Organization classified lymphoedema as a dermatological disorder; nevertheless, it has little to do with the skin. The lymphatic system comprises a delicate network of capillaries and nodes just under the skin. Vessels gather fluid from collectors and convey it to nodes located throughout the body, such as the armpit, behind the knee, groin, and deep within the abdominal cavity, where the central lymphatic duct is located. The nodes serve as transport hubs, where fluid accumulates before draining to the next vessel channel.

If you are suffering from this condition, contact In Step Physical Therapy to book an appointment with us today. We will be willing to help you return back to a normal lifestyle with zero pain and maximum comfort. 

How can I know if I have lymphedema?

Lymphedema is classified into two types: primary lymphedema, which arises independently, and secondary lymphedema, which occurs due to another disease or condition.

Lymphedema is often caused by surgical treatment of the lymph nodes. It is widespread in surgical cancer therapies that remove or destroy lymph nodes. However, the reason for primary lymphedema isn’t always evident, and your doctor may request further imaging tests to examine your lymphatic system. An MRI, CT scan, Doppler ultrasonography, or lymphoscintigraphy may be used.

What are the classes of lymphoedema?

Lymphoedema is either primary or secondary based on its etiology.

• Primary lymphedema

One in every 6,000 births results in a congenital disease in which the lymphatic vessels do not grow normally. This is more frequent in the lower limbs, and both sides are generally afflicted. Some people experience no symptoms, while others experience swelling due to an incident such as cellulitis or a mosquito bite. Primary lymphoedema has been linked to a hereditary relationship; many patients report a lengthy family history of “chunky legs.”

• Secondary lymphedema

Secondary lymphoedema develops due to lymphatic system injury caused by surgery, infection, cancer infiltration into lymph nodes, or blockage. The most well-known cause is axillary lymph node clearance for breast cancer therapy, but gynecological malignancies and the associated (pelvic and inguinal) lymph node clearances can also induce pelvically and lower limb lymphoedema.

Conditions that could lead to secondary lymphedema include;

• Cancer
• Surgery
• Infection
• Radiation treatment for cancer

Common signs of lymphedema

Several symptoms may accompany lymphedema and serve as markers that you have this ailment. Remember that lymphedema can sometimes take months or even years to develop due to cancer therapy.

Symptoms often manifest in the arms and legs and vary from modest (noticing slight changes or sensations in your limbs) to severe (noticing extreme changes or feelings in your limbs, to the point where they may be challenging to use).

Noticeable symptoms to look out for include, but are not limited to:

• Infections
• Aching/discomfort
• Heaviness/tightness
• Restricted range of motion
• Swelling
• Fibrosis

Stages of lymphoedema

There are numerous approaches for staging lymphoedema. The International Society of Lymphology’s recommendation is the most frequently recognized.

• Stage 0 – Subclinical edema, no apparent swelling but detectable with bio-impedance.
• Stage I – Lymphoedema with an early start, swelling that reduces with elevation
• Stage II – Elevation no longer helps decrease swelling, and pitting is visible; however, the edema no longer pits when the fluid proceeds to fat and fibrosis.

• Stage III – Also known as elephantiasis, the limb can grow rather big with substantial skin changes.

How to prevent lymphoedema?

The most straightforward strategy to cure lymphoedema is to avoid it in the first place. Those who have been recognized as being at risk of developing lymphoedema should make it a habit to take limb precautions for the rest of their lives, as swelling can occur at any time.

WHAT ARE THINGS TO DO  

The basic rule of lymphoedema prevention is to reduce the risk of infection in the limb from which lymph nodes have been removed. This includes;

• Maintain limb cleanliness and moisture – dry skin is prone to breaking, which provides an access point for germs and bacteria that can cause illnesses.
• Maintain your mobility.
• Keep hydrated.
• Wear gloves in the yard and when cleaning the dishes.
• Wear long sleeves and sunscreen to avoid severe heat and sunburn.
• Wear repellant and long sleeves to avoid mosquito and bug bites.
• Take precautions before traveling – while no proof flying causes lymphoedema, being stationary for long periods, dehydrated, and lifting/pulling large baggage can increase the pressure on the lymphatic system. It is recommended that compression garments be purchased before long-distance flights.

WHAT ARE THINGS  NOT TO DO

• Any needles, injections, or blood pressure readings taken from the afflicted limb are prohibited.
• Tattoos
• Engage in any recurrent strenuous activity using the afflicted limb.
• Gain a substantial quantity of weight
• Wear too tight clothing, bra straps, or purse straps that obstruct lymphatic drainage.

How is lymphedema treated at In Step Physical Therapy?

• EDUCATION

This is undoubtedly an essential aspect of therapy, and it should begin with preventive education for individuals at high risk of developing lymphoedema. It is important to emphasize that the ailment is progressive and worsens if left untreated.

Treatment will be determined by the severity of edema and might take the form of an intensive or maintenance phase. Patients with established edema may undergo flare-ups, but they should have a toolbox full of treatment options to reduce swelling independently or with the assistance of an In Step Physical Therapy physiotherapist.

• GARMENTS

Garments can help provide graded compression. The most significant pressure is always applied on the limb’s tip, as fluid must not be forced away from the midsection

Garments can be created in flat knit or circular/round knit and can be purchased off the shelf or custom-tailored for more uneven limbs. Our physiotherapists should always fit them to ensure that the right goals are met.

Garments are often worn all day and removed at night, although they must be worn during exercise since the compression aids the muscle pump. Patients may obtain assistive equipment to help don and doff with clothes.

• Exercise

Exercise is one of the most important yet frequently overlooked aspects of lymphoedema therapy. In Step Physical Therapy physiotherapists should normally lead exercises to minimize repetitive stress on the afflicted limb since too high a load might further strain the system. During the activity, muscles automatically pump to increase lymphatic return. Additional pressure can be supplied to the pump by wearing a compression garment while exercising.

Resistance exercises are included in the lymphoedema treatment plan to improve lean muscle mass. Being overweight is a risk factor for developing lymphoedema, and patients who already have swelling should aim to maintain a healthy weight to prevent further strain on an already stressed lymphatic system. When patients lose much weight, their skin loses its suppleness, making them more susceptible to edema.

Can a physiotherapist help with lymphoedema?

Developing an efficient workout regimen for lymphoedema patients might be tough. They may struggle to move, develop body image issues, and gain weight, injuring the lymphatic system. This is just another reason why In Step Physical Therapy physiotherapy is so important.

• Lymphovenous Anastomosis [LVA]

In individuals with mild to severe lymphoedema, lymphatic tubes are linked to veins to bypass the affected region and restore lymphatic flow from the oedematous limb. This technique produces good outcomes in early-stage lymphoedema where no skin or tissue alterations and lymphatic channels are still functional.

• DEBULKING

Debulking is a relatively antiquated operation in which fibrotic and fatty tissues are removed to reduce the size of the limb, and skin is transplanted over the incision. Patients are left with a reduced limb with lots of scar tissue, but because the deficient lymphatic system has not been corrected, fluid might re-accumulate (in a more limited space). This operation may be considered for advanced cases of lymphoedema; however, due to the potential risks of this technique, the patient’s quality of life must be evaluated.

Several hazards are associated with persistent swelling, including circulation difficulties, infection risk, and the possibility of future harm. It is critical to obtain lymphedema therapy and to maintain regular contact with your physiotherapist at an in step physical therapist.

• MANUAL LYMPHATIC DRAINAGE

This massage method seeks to move edema back into the central nervous system for processing. The old Manual Lymphatic Drainage method was extremely mild, with a significant amount of time spent “preparing” the body region right above the edema.

However, fluoroscopy has updated the procedure to a harder pressure, and there is no longer a need for proximal “preparation.” Fluoroscopy Guided MLD is the name given to the new technology. Our physiotherapist at In Step Physical Therapy teaches patients Self Lymphatic Drainage (SLD), which they may subsequently include in their daily management regimen.

Are you suffering from lymphedema? In Step Physical Therapy can help you out!!!

Begin your journey to a pain-free condition with a physiotherapy regimen today. If you are suffering from lymphedema and need help, don’t hesitate to get in touch with our In Step Physical Therapy right away to book an appointment. 

Our physiotherapist will assist you in reducing your lymphedema symptoms and improving your quality of life.