Introduction to Lymphedema
The lymphatic system is a network of lymph nodes and lymphatic vessels. Its primary function is to transport and filter lymph fluid throughout the body. This fluid contains mostly water and protein and is a vital component in maintaining the body’s fluid levels.
Lymphedema is a medical condition that may occur when regional lymph nodes are compromised due to surgery, radiation or injury, or if there is a congenital deformity within the lymphatic system. This results in an abnormal accumulation of fluid in the surrounding tissue and eventually in the entire limb. Lymphedema can be manifested in two ways:
- Primary lymphedema is a rare inherited condition in which lymph nodes and lymph vessels are absent or abnormal. It typically affects just the legs and is more common in women than men. This condition can be present at birth, or develop during puberty or after age 35.
- Secondary lymphedema can be caused by a blockage or cut in the lymphatic system, usually the lymph nodes in the groin area and the armpit. Blockages may be caused by infection, cancer, or scar tissue from radiation therapy or the surgical removal of lymph nodes. Surgeries for the treatment of breast, uterine/cervical, melanoma, prostate, and throat/mouth cancers may lead to the incidence of lymphedema.
Lahey Hospital & Medical Center’s Lymphedema Center offers a multidisciplinary team approach for the evaluation and treatment of lymphedema. The Vascular Medicine Department provides many specialists with expertise in vascular diseases, including lymphedema. In addition, physical therapy provides Vodder- and Lerner-trained therapists who are certified in the treatment of lymphedema.
Lymphedema Treatment at Lahey
Complete Decongestive Physiotherapy (CDP)
There are various treatments for lymphedema. At Lahey Hospital & Medical Center, one method utilized is complete decongestive physiotherapy (CDP). A patient may be directly referred to physical therapy, or may be seen first in Vascular Medicine for an evaluation and to rule out any vascular complications. A referral is then made to physical therapy, where the extent of the therapy needed is determined. CDP is usually administered daily for approximately two to four weeks.
CDP treatment consists of many integral components. The first is manual lymph drainage (MLD), which utilizes specific techniques to assist in mobilizing fluid. Compression bandaging of the affected limb(s) with specialized minimally elastic cotton bandages is applied following MLD to prevent re-accumulation of lymph fluid. The patient wears the bandaging continuously in the time between treatments. MLD and compression bandaging continues until sufficient decongestion is obtained. CDP will not be effective without the combination of MLD and compression bandaging. Patients perform specific exercises twice daily and apply a low pH, lanolin-based skin lotion daily to keep skin healthy and prevent infections.
When sufficient decongestion is obtained, the maintenance phase of therapy begins. The patient is fitted for a custom compression garment, which is worn daily, and compression bandages are worn nightly. This process is necessary to ensure continued decongestion and reduce the risk of developing serious cellulitis infections. Again, depending on the patient’s condition, the extent of compression will vary. Some patients will need to wear a form of compression at all times, while others will require it less often.
Please note that CDP is not a cure for lymphedema. It is, however, a treatment method that may allow a significant decrease in swelling, pain discomfort and the risk of serious infection, while also increasing the patient’s mobility. Therapy is extremely effective in obtaining these goals, but lymphedema is a lifelong condition that requires a continued commitment to maintenance.
Affiliations of Lahey’s Lymphedema Center
Lahey Hospital & Medical Center’s Lymphedema Center is a sponsor of the National Lymphedema Network. This non-profit organization’s mission is to create awareness of lymphedema through education and to promote and support the availability of quality medical treatment for all individuals at risk for, or affected by, lymphedema.
The Lymphedema Center also has an affiliation with the Greater Boston Lymphedema Network. This patient-oriented group meets monthly here at Lahey Hospital & Medical Center, with the goal of educating and supporting patients and their families with regard to lymphedema. Guest speakers are invited to share their information on various topics including lymphedema, lipedema, venous insufficiencies, cancer, acupuncture, herbal medicines and nutrition.
For further information or referrals, we can be reached through:
Vascular Medicine Department