Lymphedema is an abnormal accumulation of lymph fluid that results in swelling, most often in the arms and/or legs, although it can affect other parts of the body as well. Lymphedema can develop when lymphatic vessels or nodes are missing, removed or not working properly. Left untreated, lymphedema not only causes an increase in the size of the limb, but also reduces oxygen to the skin, limits wound healing, and increases the chance of infection.
Who is lymphedema rehabilitation for?
Individuals with the following conditions are appropriate for lymphedema rehabilitation:
- Congenital lymphedema
- Oncologic lymphedema (after lymph node dissection, sentinel lymph node biopsy, radiation therapy)
- Vascular edema/lymphedema
- Face, neck, trunk, breast, genital and extremity swelling
- Lipedema
What does lymphedema rehabilitation involve?
Physical and occupational therapists at the Cleveland Clinic are currently utilizing Complete Decongestive Therapy (CDT) as the standard of care to treat lymphedema. The treatment consists of four parts; manual lymph drainage, skin care guidelines, decongestive exercise and compression therapy (compression bandaging, garments and pumps). Typically there is an aggressive phase when the therapist customizes the above treatment approach (often including daily compression bandaging) during intense therapy in order to decrease swelling, improve tissue texture by reducing hardened or fibrotic tissue and improve the patient’s ability to function in order to achieve a successful outcome. During this phase, therapists emphasize patient/family education to ensure that the patient can self manage their lymphedema and continue the necessary techniques in the maintenance phase, which often includes daily wearing of a compression garment in addition to good compliance with all aspects of CDT on an ongoing basis.
How long will lymphedema rehabilitation take?
The length of Lymphedema rehabilitation can vary depending on the extent of swelling present, the tissue texture of the skin, and other co-morbidities as well as the patient’s compliance and ability to follow the recommendations provided. Typically therapy performed five days per week with emphasis on patient education is optimal for reducing swelling and can last on average two to three weeks for arm swelling and three to four weeks for leg swelling; however, family involvement and participation in the process can often minimize the frequency of these appointments and still allow for a successful outcome.
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