The lymphatic system is a network of lymph vessels, tissues, and organs that carry lymph (clear fluid) throughout the body. Lymphedema happens when the lymphatic system is damaged or blocked and causes a buildup (swelling) of lymph fluid under your skin — mostly in an arm or leg but it can also affect other parts of the body.
Cancer and cancer treatment are risk factors for lymphedema — developing the condition is not uncommon, according to the National Cancer Institute.
“The lymphatic system is the body’s largest fluid regulation system — not part of the blood system,” explains physical therapist Mona Dunlap, certified lymphedema specialist and outpatient rehab manager at Clark Outpatient Rehabilitation Center. “Lymph fluid can collect and get trapped in areas of the body due to damage to the lymphatic system. Lymphedema can result from surgery, like removal of lymph nodes, or other injuries to the lymphatic system including radiation treatment or scar tissue formation.”
Unfortunately, lymphedema can cause long-term physical, psychological, and social problems for patients because of limitations in function and negative body image due to the enlarged area.
Signs of Lymphedema
Symptoms of lymphedema may occur very slowly over time or more quickly if there is an infection or injury to the arm or leg. Normal postoperative swelling should resolve in about two to four weeks. But if the swelling is lingering past the four-week mark, Mona suggests letting your health provider know.
“Lymphedema typically develops between two and 30 months post injury,” she adds. “It is important to know that lymphedema is not painful.”
Some of the signs to look for include the following:
- Swelling of an arm or leg, which may include fingers and toes
- Inability to see superficial veins that were previously visible or are visible on the other arm
- A full or heavy feeling in an arm or leg
- A tight feeling in the skin
- Trouble moving a joint in the arm or leg
- Thickening of the skin
- A feeling of tightness when wearing clothing, shoes, bracelets, watches, or rings
- Itching/dry skin of the arms, legs or toes
- A burning feeling in the legs (not to be confused with neuropathy)
- Loss of hair in the affected area
Physical Therapy Treatment
Still, the outlook for those with lymphedema is brighter than it has ever been. That’s largely the result of what physical therapy can do for patients.
“With increased awareness and early detection, we’ve seen less progression in the disease process. We can teach patient self-management techniques to reduce the likelihood of lymphedema progression,” says Mona.”
The job of physical therapists is educate patients on the signs and symptoms of lymphedema, lymphedema prevention strategies, and to reduce swelling in the affected area in order to decrease risk of infection that can result in the swollen area.
Complete Decongestive Therapy
Doylestown Health physical therapists who specialize in lymphedema are certified in complete decongestive therapy (CDT), which is known as the gold standard of treatment for lymphedema. This therapy aims to reduce swelling of the area and increase mobility. It includes manual lymphatic drainage, which is a type of massage technique to guide the fluid to healthier areas of the body, bandaging techniques and compression garments (using sleeves for arms/legs), exercises, and patient education on self-management.
“Our treatment will typically reduce the patient’s swollen area to as small as we can get them and then we will transition them into compression garments to help maintain the reduction in swelling,” explains Mona. “These could be a sleeve and a hand piece or a thigh-high stocking that patients have to put on first thing in the morning.”
New Treatments
In addition to the gold standard CDT treatment, therapists at Doylestown Health are now using a device called a LymphaTouch®. This technology uses suction designed to stimulate lymphatic drainage and relieve swelling and discomfort from lymphedema.
“It is similar to the cupping device that Olympic athletes use, but it’s a computerized device that uses suction to help move lymph fluid. It can be done either static or in a sliding manner depending on the therapy goals. This eliminates the skin damage that you can get from cupping,” Mona adds. “It helps us break up the scar tissue and encourage lymphatic drainage as early as possible.”
The therapists are also using an FDA-approved, low-level laser that can reduce lymphedema and assist with the healing of the tissue without heating the tissue, according to Mona.
“The changes that occur from the laser are at a cellular level where infrared light is absorbed into the mitochondria of the cell to facilitate healing. There are no contraindications for the laser, meaning that it can be used very early in treatment after surgery or even during radiation and has been proven to reduce lymphedema in the long term,” says Mona. “We are the only rehab program in the area that has this device and we have already seen rapid improvements in the few short months we have had it.”
Before this laser, therapists were limited in what treatment they could perform on a patient who was receiving radiation because of the potential for injuring the skin.
“Our ability to purchase the LymphaTouch and the low-level laser was made possible thanks to the incredible gifts received through One Vision: The Campaign for Doylestown Health,” Mona says enthusiastically. “We are so grateful for the generosity and support of our caring donor community. They are literally changing patients’ lives.”
- For more information on our lymphedema treatment program, call 215.345.2894.
Further Reading
To learn more about lymphedema, visit the National Cancer Institute.
About Clark Outpatient Rehabilitation Center
Located in the Ambulatory Center on the campus of Doylestown Hospital, Doylestown Health's spacious new Clark Outpatient Rehabilitation Center provides a convenient one-stop option for multidisciplinary outpatient therapy. Seamlessly connecting consultation, diagnosis, intervention and treatment services with physical therapy, occupational, hand and speech therapy, the Clark Outpatient Rehabilitation Center is staffed by licensed therapists only.
About Doylestown Health and Doylestown Hospital
Doylestown Health is a comprehensive healthcare system of inpatient, outpatient and wellness education services connected to meet the health needs of all members of the local and regional community. Doylestown Hospital, the flagship to Doylestown Health, has 245 beds and a Medical Staff of more than 435 physicians in over 50 specialties. An independent nonprofit health system, Doylestown Health is dedicated to providing innovative, patient-centered care for all ages.