Lymphedema: What It Is & How to Manage It

Lymphedema is the abnormal build-up of lymph fluid in the soft tissue of your body, which often results in disfiguring and swelling. While lymphedema can be hereditary, it can also occur after a surgical procedure, infection, radiation, or other physical trauma.

Normally, the lymphatic system works as a part of your body's immune system. Made up of a network of lymph nodes, ducts or vessels, and organs, the lymphatic system collects and carries clear lymph fluid through the body tissues to the blood. The trouble begins when the system is damaged in a manner that prevents lymph fluid from returning to the blood. Instead, it builds up in the body’s soft tissue. Lymphedema is most commonly in the legs and arms; however, it can also be experienced in the face, neck, abdomen, breasts, and anywhere in the body depending on the cause.

Because lymphedema can develop into a long-term or chronic condition that can cause considerable pain and discomfort, it’s important to recognize it in the earliest stages and seek medical help. Early warning signs of lymphedema include:

• Unusual or unexplained swelling  
• Skin feeling tight or hard, changing in texture, looking red, or feeling hot
• New aching, tingling, numbness, or other discomfort near the swelling
• Less movement or flexibility in nearby joints
• Jewelry, such as rings, watches, and bracelets fitting tight even though you haven’t gained weight
• Clothing fits tighter than usual but only in a specific area, such as the arms or legs

Untreated, lymphedema can progress through a series of stages (0 to 3) with increasingly uncomfortable symptoms and a growing risk of related complications, including infection. Fortunately, lymphedema addressed in the earliest stages (0 to 1) can very often be reversed. The longer it goes untreated, the harder it can be to treat.

Treatment for lymphedema needs to be prescribed by a doctor and should ideally be provided by a certified lymphedema therapist (CLT). While there are several different approaches for treating lymphedema, all of which should be pain-free, the shared goal is to move the lymph fluid away from the swollen area. 

The gold standard for lymphedema treatment is Complete Decongestive Therapy (CDT) which is a combination of the following:

• Manual Lymphatic Drainage (MLD): This involves a gentle massage to move the extra fluid to other parts of the body and decrease the lymphedema.
• Compression Therapy. A multilayer bandaging approach that helps move the lymph fluid out of the affected area. Once there is improvement, wearing a compression garment will help prevent further swelling.
• Good Skin and Nail Care. Intended to help prevent infection. A podiatrist may be required for nail/foot care.
• Exercise and Movement. Regular exercise and movement both work to improve your circulation and move lymph fluid throughout the body, which improves lymphatic drainage.

Treatment sessions typically last 1 to 1-½ hours. How frequently they take place is determined on a patient-by-patient basis. In many cases, patients can note a visible change in appearance in as little as one session. A component of the treatment is to educate patients how to learn techniques to help manage the lymphedema themselves.

Again, early diagnosis is essential to getting the maximum benefit from treatment. However, you can benefit from treatment at any stage.

If you have questions or concerns about any unexplained swelling, contact your doctor immediately to schedule an appointment.

Kendra Petro, OTR/L, OTD, CLT is an occupational therapist at Southwestern Vermont Medical Center’s Outpatient Rehabilitation that treats lymphedema.