Types of Lymphedema

There are two main types of lymphedema - primary and secondary. Primary lymphedema is rare and usually genetic, involving defects in the lymphatic system present from birth. Secondary lymphedema is more common and occurs when the lymphatic system is damaged or compromised in some way. The lymphatic system can be damaged by infection, radiation therapy for cancer treatment, surgery, trauma or other disorders.

Secondary lymphedema most commonly affects the arms after breast cancer treatment or the legs and genitals after gynecological or prostate cancers. The swelling and discomfort occurs when lymph fluid builds up in the tissues due to damage or blockages in the lymphatic system which impedes its normal drainage function.

Manual Lymph Drainage

One of the most commonly recommended Lymphedema Treatment is manual lymph drainage (MLD). This gentle, skin-massaging technique is performed by a trained therapist to encourage natural lymphatic drainage. The massaging motions mimic the normal flow of lymph through the lymphatic vessels to drain swelling and stagnant fluid.

MLD helps reduce swelling, improve circulation and stimulate the development of new lymphatic channels. It is usually combined with compression bandaging or garments afterwards to maintain drainage effects. A full MLD regimen involves 30-45 minute sessions 2-3 times per week for maximum benefits. Therapists receive specific training to develop skills in very light, rhythmical techniques.

Compression Therapy

Applying graduated compression with bandages or garments is a key part of managing lymphedema long-term. Compression keeps tissues firm and helps drain excess fluid, preventing it from building back up. It also supports new lymphatic vessels as they develop. Bandages are applied snugly from the hands or feet upwards with increasing firmness.

Custom compression garments include fitted sleeves, leggings or full bodysuits. Garments provide all-day compression therapy and free up hands for daily activities versus needing re-wrapping with bandages. Absorbing moisture-wicking fabrics are preferred. Compression must be measured and fitted properly by a certified fitter for optimal effectiveness and wearer comfort.

Exercise and Movement

Gentle rhythmic exercises can stimulate lymph flow too by contracting muscles to "pump" lymph through the vessels. Examples are walking, stationary cycling, swimming or range of motion exercises. The affected limb should be elevated above the level of the heart periodically as well to assist drainage upwards.

However, overly vigorous or high impact exercise should be avoided, especially in the initial stages of lymphedema treatment. Exercise needs to be gradually built up under therapist guidance as full lymph drainage functionality may not yet be restored. Proper compression is also still required during and after exercise for support.

Skin and Infection Care

Maintaining clean, dry skin is important for lymphedema patients. The skin is more vulnerable to injury, infection or inflammation that can further impair already compromised lymph flow. Therapists provide careful skin assessment and care techniques. This helps prevent skin breakdown that may worsen swelling.

Vigilance against infection is also key due to poorer wound healing ability. Any scratches, bites or breaks in the skin need prompt attention. Antibiotics may be prescribed at first signs of infection until it clears to avoid further lymphatic damage from spread. Insect repellents and protective gloves/clothing are recommended as well.

Multilayer Bandaging

For clients with severe, long-term or refractory lymphedema, multilayer lymphedema bandaging (MLB) may offer improved drainage support over traditional techniques. MLB uses multiple layers of low-stretch bandages, padding and compression to gently squeezes fluid through the tissues in a piston-like action.

It induces therapeutic compression changes inside the limb while allowing some flexibility and moisture dispersal compared to rigid casts. MLB is customized according to individual needs and typically changed every 3-5 days by a therapist. Combined with manual lymph drainage, it can effectively reduce very significant swelling over time.

Alternative Therapies

While the above conventional therapies form the mainstay of lymphedema treatment, some alternative options show promising support as adjuncts. Examples include acupuncture which may stimulate lymphatic circulation, lymphatic massage utilizing specialized brushing tools to aid drainage, and intermittent pneumatic compression devices that sequentially inflate compression sleeves.

Other reported supportive therapies include herbal supplements, hydrotherapy involving specific lymphedema-focused water exercises or floatation, and biofeedback training to enhance lymph muscle control. However, more rigorous research is still needed on many alternative modalities. They are usually recommended together with traditional therapy versus as stand-alone treatments.

With proper treatment combining some of the above options tailored to each individual case, long-term lymphedema management is very achievable. Therapists skilled in lymphedema care can create personalized plans to optimize drainage and minimize swelling risks long-term. Having realistic expectations, patience during the recovery process and strictly following treatment recommendations also contribute greatly to successful outcomes.

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