Because there is no "one-size-fits-all" treatment for lymphedema, we create a specific treatment plan for each individual. Treatment includes: Complete Decongestive Therapy; Compression bandaging or garments as needed; Exercises to improve lymph flow, range of motion and strength of the affected arm or leg and Cording, Fibrosis or Scar Release.
At CHPT, treatments begin with a full evaluation, including girth measurements of the limb(s) and the creation of goals for you to meet. Subsequent visits include Complete Decongestive Therapy. For lymphedema of a limb, girth measurements are taken on a regular basis to chart your progress. Compression bandages are sometimes applied (except for trunk or breast lymphedema) which should be worn 23 of 24 hours per day. These bandages are replaced by compression garments at a certain point in the reduction process of your limb, although you may need to wear bandages or a special nighttime garment for sleeping. For trunk or breast lymphedema, your therapist will discuss with you a special bra that provides needed compression. Equally important to the treatment is the home management and exercise program you will be given.
Initially, your therapist may want to see you two or more times per week, until the reduction stabilizes. Since lymphedema is a lifelong condition, your therapist will teach you self-massage, exercise and bandaging so you may manage your lymphedema at home. You may need to come in for occasional MLD as needed, if you experience a flare-up of swelling.
Complete Decongestive Therapy: Manual Lymphatic Drainage; Compression; Exercise; Skin Care. Soft Tissue Mobilizations, Myofascial Release, Scar Release, Range of Motion, Joint Mobilizations
Low Level Laser Therapy, Ultrasound
For our current patients, self-pay appointments are available if you need assistance bandaging or learning to bandage; the first two "bandage-only" visits are complimentary.
Commonly Used Terms:
Complete Decongestive Therapy (CDT), also called Complex Decongestive Therapy, is considered the “gold standard” for lymphedema treatment. CDT consists of four foundations: Manual Lymphatic Drainage (MLD); Compression; Exercise and Skin Care.
Manual Lymphatic Drainage (MLD): Through this lymphatic massage, lymph fluid is moved through a gentle massage technique from the congested area into an unaffected area. It is then filtered through the bloodstream and removed through the kidneys.
Compression: Compression bandaging is an application of several layers of short-stretch bandages (not the ones used for a sprain) over the involved limb to reduce fluid. Compression garments are worn daily to maintain the reduction of fluid.
Exercise: The latest research shows that exercise is a huge part of lymphedema management and prevention. The muscles serve as a pump to move static fluid from the limbs into the blood stream. Cardiovascular exercises increase circulation and assist in this pumping action. The old though of "babying the limb" is outdated and can actually worsen edema.
Skin Care: Good skin care and hygiene is essential to the treatment of lymphedema and the prevention of cellulitis. Because the skin is often dry and cracking, a good lotion should be used to improve the skin texture. Skin integrity is also a concern, so proper cleaning and care of wounds is important.
Cording: Also known as Axillary Web Syndrome. Sometimes develops as a side effect of lymph node dissection, cording tends to be painful and restrict range of motion. Researchers are not sure what cording is made of, but it seems to form after trauma, such as surgery. Inflammation leads to scarring and hardening of the tissue encasing blood and lymph vessels. This creates the cords which can spread down the arm.
Fibrosis: The formation of fibrous (hard) tissue caused by the repair process, as in scar tissue. Fibrosis can occur after surgery and radiation treatment, or tissue can become fibrotic when lymph fluid is stagnant in one area for too long.