PT Classroom - Lymphedema Management ׀ by Debra Sturm, OT, CHT, CLT

Lymphedema is a condition in which there is progressive swelling of a body part. This is usually seen in the arms or legs but can also be seen in the breast, groin, and face. The lymphatic system is made up of a series of collecting ducts, lymphatic vessels and lymph nodes. In essence, a problem arises when the one-way valves of the lymphatic vessels are affected which allows fluid to return to the extremity. Lymphedema is classified into a primary and secondary category. Primary lymphedema occurs due to an absent or dysfunctional lymphatic system with no outside cause. Secondary lymphedema is a result of a surgical disruption or as a progressive complication from illness.

There are many causes of lymphedema. One cause may be from inactivity such as with paralysis. Other causes may also include node removal with mastectomy, abdominal tumors, chronic venous insufficiency, or trauma. In many cases, an individual may have one of these risk factors without developing lymphedema.

In seeking out treatment, it is advisable to find an occupational or physical therapist who specializes in lymphedema therapy. Often these therapists will have the credential “CLT” or Certified Lymphedema Therapist. There are usually 5 components of treatment: manual lymphedema massage, compression bandaging and/or garments, exercises, vasopneumatic pump and education. Treatment is tailored to the individual’s needs.

Contraindications to treatment include acute renal disease, acute blood clots, cellulites, severe arterial disease, and acute heart conditions.  Chronic renal disease that is controlled is appropriate for treatment as well as cellulites after treatment with antibiotics.