Lymphedema

Lymphedema management program at MedStar NRH

The lymph vessels drain toxins and other waste products from your body’s tissues. When these vessels are damaged, lymph fluid accumulates in the tissues of the arm or leg and cause severe swelling, known as lymphedema.

Our team works with other specialties within MedStar Health to develop a treatment plan specific to each patient. Historically, treatment options focused on helping people deal with the symptoms of the condition, not eliminating the cause. But MedStar Plastic Surgery physicians are some of the only ones on the East Coast who offer advanced surgeries such as lymph node transfer and lymphovenous bypass  to treat the root cause and help people return to their daily activities.

What are the causes and symptoms of lymphedema?

Lymphedema usually is caused by removal of or damage to the lymph nodes. This is known as secondary lymphedema and can be the result of cancer treatment (surgery or radiation), infection or injury. About 20 percent of patients diagnosed with breast cancer will develop lymphedema.

Less common is primary lymphedema, a condition you’re born with that is caused by problems with the development of lymph vessels.

Lymphedema presents as swelling in the affected area, usually in the arms or feet. If it occurs after surgery or radiation for cancer, it will appear on the same side as where the cancer was treated.

You also may experience:

  • Feeling like the arm or leg is tight or heavy

  • Pain or redness

  • Thickened skin

  • Tighter-fitting shirts, pants, watches, or rings

If advanced, the swelling caused by lymphedema may be painful or disfiguring and interfere with daily activities. Patients with lymphedema also may develop skin infections such as cellulitis and lymphangitis.

Tests

To differentiate lymphedema from other causes of swelling, such as deep vein thrombosis, heart failure, or kidney disease, your doctor may recommend one or more diagnostic or imaging procedures.

Lymphedema management

The Lymphedema Management Program offers services provided by physical and occupational therapists that have been extensively trained in skilled treatment techniques for lymphedema management. Our rehabilitation program has been developed based on our therapists’ training and working knowledge of current medical management of primary and secondary lymphedema and related rehabilitative needs.

Services by physical and occupational therapists are brought together to develop an individualized treatment plan to restore the patient to the highest level of functioning. A major focus of our program is to educate and instruct the patient in self-help techniques to begin to manage primary or secondary lymphedema independently.

Individualized treatment programs

Aspects of the treatment program include any or all of the following, based on the patient’s needs as determined by the patient and physician:

  • Education: Origin of lymphedema, precautions and lifestyle modification, and current management techniques

  • Pre- and Post-Surgical Assessments: For patients at risk for secondary lymphedema, a rehabilitation physician can perform a pre- and post-operative baseline assessment of current daily functional level, flexibility, strength, and arm measurements

Treatment options

Your lymphedema treatment plan will depend on the cause and severity of the condition. Your doctor may prescribe medication or refer you to a physical or occupational therapist who specializes in managing lymphedema. Therapies to reduce swelling and control pain may include using compression garments, exercises, special massage techniques, or mechanical pumping devices. If your condition is severe, they may recommend more advanced treatments such as lymph node transfer and lymphovenous bypass.

Based on evaluation findings, the following treatment options are available:

Lymphedema management - When lymphedema presents, the patient is offered a comprehensive approach to restore maximal level of function. Treatment may include:      

  • Manual lymphatic therapy
  • Gradient compression bandaging of the limb
  • A comprehensive exercise prescription for flexibility, strength, and edema management
  • Posture and breathing exercises
  • Aerobic and conditioning exercises
  • Sequential compression pump if indicated

Rehabilitation for:

  • Limited range of motion
  • Weakness of the affected limb
  • Pain
  • Correcting muscle imbalances which may have resulted from surgery
  • Fitness programs to restore pre-diagnosis activity levels

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