Lymphedema or lymphatic obstruction is an abnormal swelling condition that may affect one or many body regions, resulting from a failure in draining the lymph. When someone is born with this condition causing lymphatic system to not work properly, it is known as primary lymphedema. Sometimes, it may occur as damage with surgery or other trauma, known as secondary lymphedema. Most of this occurs with surgery, especially cancer surgery like mastectomy where removal of lymph nodes is routinely performed to prevent cancer from spreading to nearby regions of the body.
What is the treatment or cure of lymphedema?
There is no cure for lymphedema currently, only certain remedial techniques which alleviate the condition exist. If left untreated, it is likely to worsen and can also lead to infection since the congestion which is rich in protein, can serve as medium for bacteria to thrive. Conservative management works wonder in most of the cases, however very rare cases may require surgical measures. Exercise plays an inevitable part of lymphedema management.
Role of physiotherapy:
– Aerobic exercises in the form of walking, jogging, cycling, swimming not only enhances cardiovascular fitness and manage weight, but also increases venous/lymphatic flow—as well.
– Pneumatic compression device may also be used, which is an external device applied through pneumatic sleeve filled with air, resulting in pressure against limb that compresses tissue and provokes fluid removal. It may be used alone or in conjunction with a specialized conservative approach known as complete decongestive therapy (CDT). It is widely accepted and practiced standard of care, consisting of manual lymphatic drainage (MLD), compression bandaging, exercise, skin and nail care.
– MLD is a massage technique using specific hand strokes in a distinct pattern and direction to draw fluid away from swollen parts. It is slow and light using appropriate pressure.
– Compression garments/ bandages are mainly used to apply pressure to the tissue using short-stretch, non-elastic bandage.
– Gentle active exercises also aid in fluid removal and encourages in further reducing the swelling. Flexibility and stretching exercises enhance lymph flow and support muscle and connective tissues. Strengthening exercises using dumbbells, weight cuffs, and therabands also enhances lymph flow, however, monitoring is very important as it may trigger lymphedema, if done in inappropriate doses.
– Skin care is unequivocally important to prevent infection. When nails and cuticles are cut, there is a risk that skin may be damaged and potentially introduce bacteria into the tissue. Hence regular moisturizing of skin and avoiding open areas, cuticle cut, shave cuts, thorn pricks, insect bites, and pet scratches helps reducing the chances of infection.
Simple measures with appropriate care and guidance can keep even lifelong cases of lymphedema under control.
This article is written by one of the best physiotherapists of Ahmedabad :
MPT-Rehabilitation, PhD Scholar,
C.M Patel College of Physiotherapy, Gandhinagar.