What is Lymphedema?

Lymphedema is the chronic, progressive swelling of a body part – most commonly in the arm(s) or leg(s) – due to a blockage or back up in the lymphatic system. The lymphatic system maintains your body’s fluid balance and fights infections. The lymphatic system is made up of about 600-700 lymph nodes that are connected by lymph vessels. These vessels carry protein-rich fluid called lymph. Lymphedema occurs when part of the lymphatic system isn’t working well and extra lymph fluid builds up in the space between the cells.

Primary Lymphedema

  • Hereditary malformation in the lymphatic system that causes chronic swelling to develop at birth or later in life
  • Chronic swelling in which there is no known cause

Secondary Lymphedema (more common)

  • Chronic venous insufficiency
  • Lymph node removal and/or radiation therapy due to cancer
  • Accident/trauma/surgery to the lymphatic system
  • Infection
  • Obesity
  • Filariasis (parasitic disease that is most common in 3rd world countries)

There is no cure for lymphedema, but it can be can be treated and managed. The gold standard of treatment is called Complete Decongestive Therapy (CDT) and is divided into 2 phases.

Phase I: Treatment by a certified lymphedema therapist

  • Meticulous Skin and Nail Care
    • Important to prevent infection
  • Manual Lymph Drainage
    • Special manual technique in which the lymphatic system activity is improved by facilitating lymph drainage through alternative routes made possible by connections in the lymphatic system.
  • Multi-Layer Compression Bandaging
    • Short stretch compression bandages are applied to increase tissue pressure in the swollen extremity. Short stretch compression bandaging is the most effective and aggressive way to decongest a swollen limb.
  • Exercise
    • Simple seated exercises and/or walking increase lymph drainage by activating the muscle pump (the ability of muscles to move fluid with each contraction).
  • Self Care Training
    • The instruction in independent management is a crucial component of lymphedema Phase I treatment to prepare patients for Phase II.

Phase II: Independent Self Care/Management

  • Compression Garments
    • Ready to wear/Off the shelf compression garments, Custom compression garments, or Velcro compression garments are to be worn during the day to help manage/control the lymphedema.
  • Compression Pump
    • An advanced pneumatic compression device mimics manual lymph drainage and is used to help decongest fluid on a daily basis.
  • HEP/At Home Compression Routine
    • Daily exercise, walking, drinking water, moisturizing legs, and leg elevation in addition to wearing compression garments and utilizing the compression pump is important in keeping lymphedema managed and under control.

Untreated lymphedema can worsen over time, leading to increased swelling and pain, progressive hardening of the skin, and recurrent infections (such as cellulitis). Lymphedema can decrease mobility, dexterity, range of motion, and the ability to perform daily activities. It also may significantly increase the cost of healthcare. However, effective management of symptoms is possible. Proper diagnosis of the condition is often critical to achieving effective treatment. With effective treatment, patients can manage their symptoms, minimize infections, improve their health and quality of life, and reduce overall healthcare costs.

Greater Pittsburgh Lymphedema Clinic is open and appointments are available M/W/F at our Jefferson Hills location and T/H at our Jeannette location.